Endometrial Polyp

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Endometrial polyp is a non-cancerous growth in women, attached to the inner wall of the womb [uterus]. It is common in reproductive-aged women, or women who have completed their menopause.  The polyp size varies. These endometrial polyps are also known as “uterine polyps”. They come from the tissue that lines the uterus [also called the […] Read More

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Endometrial Polyp

Endometrial polyp is a non-cancerous growth in women, attached to the inner wall of the womb [uterus]. It is common in reproductive-aged women, or women who have completed their menopause.  The polyp size varies. These endometrial polyps are also known as “uterine polyps”. They come from the tissue that lines the uterus [also called the hyperplastic endometrium]. They range in size [from as small as sesame to as big as a baseball].  The growth of endometrial polyp may be one or many polyps at once. Most uterine polyps are benign [non-cancerous]. Many women do not have symptoms of endometrial polyps, and some do not even require treatment. It is a mild health condition. They are prevalent in older women or women undergoing menopause although there have been reported cases of younger women. They develop mostly in women between the ages of 40 and 50 years. The chances of a uterine polyp being cancerous is low in premenopausal women than in women that have gone through menopause. COMPLICATIONS OF ENDOMETRIAL POLYPS Most uterine polyps aren’t malignant. But some might become cancerous, later on. Women who have gone through menopause are at a higher risk of cancerous polyps.  Infertility can also be caused by the formation of polyps. They may keep you away from getting pregnant or may make you more likely to have a miscarriage. The reason behind this is that they can keep a fertilized egg from attaching itself to the uterus or block the fallopian tubes or cervix.  Some research studies have found that the removal of polyps can help women get pregnant. However, this may not be the case for everybody. Enlarged polyps can block the development of the fetus in the uterus and may probably result in miscarriages. DIAGNOSIS OF ENDOMETRIAL POLYPS If your doctor suspects that you have endometrial polyps, the doctor may perform any of the below:
  • Transvaginal Ultrasound.
Here, a slender device placed in your vagina emits sound waves and creates an image of your uterus, including its interior. He/she may see a polyp that is present or may identify an endometrial polyp as an area of thickened endometrial tissue. A related procedure known as hysterosonography [also known as sonohysterography] involves having saltwater [saline] injected into your uterus through your vagina and cervix.  The saline expands your uterine cavity and gives the doctor a clearer view of the inside of your uterus during the ultrasound.
  • Curettage
This process both diagnose and treat the endometrial polyps. A long metal instrument called the curette which has a small loop on the end is used to scrap some polyp tissues, and samples are sent to the lab.
  • Hysteroscopy
In this diagnosis, your doctor will insert a thin, flexible lighted telescope [called hysteroscope] through your vagina and cervix, into the uterus. This allows the doctor to examine the inside of your uterus.
  • Sonohysterography
Here, salt water is injected into the uterus using a small tube thread that is inserted through the vagina into the cervix. It is done together with an ultra scan to give a clearer picture of the uterus.
  • Endometrial biopsy.
This is carried out with the use of a suction catheter, a specimen of your uterus lining for lab testing. Uterus polyps may be confirmed by an endometrial biopsy, but the biopsy could also miss the polyp, especially when the polyp is single. Most uterine polyps are non-cancerous [as earlier said]. However, some pre-cancerous changes of the uterus [endometrial hyperplasia] or uterine cancers [endometrial carcinomes] appear as uterine polyps.  Because of the aforementioned reason, your physician will likely recommend removal of the polyp and send a tissue sample for laboratory analysis; to be sure you do not have uterine cancer. SPECIALTY The specialists involved in the diagnosis and treatment procedures of endometrial polyps are obstetricians and gynecologists. TREATMENT OF ENDOMETRIAL POLYPS Before getting treated against uterine polyps, your doctors may recommend:
  • Watchful waiting.
Small polyps without symptoms may likely fade away [on their own], over time. There is no need to treat small polyps unless you are at risk of uterine cancer.
  • Medication.
Certain hormonal medications may lessen the symptoms of polyps. These drugs include progestins and gonadotropin-releasing hormone agonists. They have a short-term solution at best. Symptoms typically re-occur once you stop taking them. Surgical removal.
  • During hysteroscopy, instruments inserted through the hysteroscope make it possible to remove polyps. The removed polyps will be sent to the lab, for microscopic examination.
  • Endometrial ablation involves destroying the uterus lining.
  • Local removal of benign endometrial polyps using curettage or hysteroscopy.
In case a uterine polyp contains cancerous cells, your doctor will counsel you and discuss the next steps in evaluation and treatment.  Rarely, endometrial polyps can recur. You might need more treatment if they do come up again. Uterine polyps natural treatment include:
  • Use of vitamin E
  • Use of ginger
  • Garlic
  • Gingko Biloba
  • Feverfew
  • Vegetables
  • Cooked beans
  • Fish
PREVENTION Since it is mostly due to abnormal estrogen levels in the blood, preventive measures are not yet clear but the following things could be done
  • Regular gynecological check-ups
  • Avoid obesity or overweight
  • Reduce stress in other to reduce the increase in blood pressure
  • Avoid taking tamoxifen to treat breast cancer
  • Avoid smoking.
MORBIDITY RATE OF ENDOMETRIAL POLYPS The incidence of malignant or pre-malignant findings in endometrial polyps ranges from 0.5% to 4.8%, in the general population, and from 2% to 10% in menopausal women. SURVIVAL RATE OF ENDOMETRIAL POLYPS If cancer has spread regionally, the 5-year survival rate is about 69%. If uterine cancer is diagnosed after cancer has spread into the other areas of the body, the survival rate is 17%.  

Symptoms

ENDOMETRIAL POLYP SYMPTOMS

Uterine polyps symptoms may not be prominent, especially when you have small polyps or just one. Some pointers to uterine polyps include the below:

  • Frequent irregular menstrual bleeding with variable heaviness and durations. This is the most common sign of endometrial polyps.
  • Menorrhagia or prolong and heavy menstrual bleeding.
  • Bleeding or spotting between your menstrual periods.
  • Vaginal bleeding after menopause.
  • Difficulty getting pregnant.
  • Regular miscarriages.
  • Infertility.

In some cases,

  • Bleeding after sex
  • Abdominal pains
  • Prolapses as the polyp comes out through the cervix.

Causes

ENDOMETRIAL POLYP CAUSES

The cause of uterine polyps is not known. It may be linked to the changes in the hormonal levels of the woman affected. 

Each month, your hormonal level rises and falls, causing the lining of your uterus to thicken and shed afterward, during your period. When too much of the uterine lining grows, polyps are formed soon after. 

Certain conditions might promote the formation of polyps. These may include:

  • Age.

The formation of uterine polyps is more common in women from the age of 40 to the 50s. which may be due to the changes in estrogen levels that occur just before and during menopause.

  • Being perimenopausal or postmenopausal
  • High blood pressure.
  • Drugs for breast cancer, such as tamoxifen. 
  • Obesity.

FAQ

Can cervical polyps be a sign of cancer?

Cervical polyps are usually not cancerous [they are benign] and can occur alone or in groups.  Most polyps are small, about 1cm to 2cm long. Because rare types of cancerous conditions can look like polyps, all polyps should be removed and examined for the signs of cancer.

What size of uterine polyps is dangerous?

The size of endometrial polyps may be relevant, and those above 15mm are more likely to lead to malignant transformation. However, this thought is controversial, and others have found no link between the size of polyps, hypertension, abdominal uterine bleeding, and malignant transformation.

Can you tell if a uterine polyp is cancerous by looking at it?

It is rare to find cancerous polyps. If the polyps are not causing any issues, monitoring them over time is a reasonable approval. If you develop symptoms such as abnormal bleeding, the polyps should be removed and evaluated, to confirm that there is no evidence of cancer.

Can a benign uterine polyp turn malignant?

The overgrowth of cells in the lining of the uterus [endometrium] leads to the forming of uterine [endometrial] polyps. These polyps are usually benign [non-cancerous], although some can eventually build up into cancer [these are known as pre-cancerous polyps].

Are giant uterine polyps cancerous?

A giant polyp is an abnormal female genital tract pathology, usually arising more often from the cervix than the endometrium. It is a great masquerader of cervical or endometrial malignancy. It can lead to a diagnostic dilemma and aggressive interventions uncalled for.

How common are uterine polyps?

They are quite very common especially benign uterine polyps with about 1 in every 100 women developing uterine polyps before the age of 30.

What are the foods that cause uterine polyps?

Foods that can increase the risk of uterine polyps include red meat, bacon, sausages, and hotdogs.

Can uterine polyps burst and bleed?

Uterine polyps can burst and bleed and can result in excessive menstrual bleeding or vaginal bleeding and spotting. Sometimes it may even result in bleeding after sex.

Can uterine poly grow back after removal?

It is quite unusual for uterine polyps to grow back after an effective and efficient removal although some factors may stimulate its growth again and have a 2.5 to 4.5% rate of recurrence but at a different location.

Do uterine polyps cause discharge?

Uterine polyps could cause occasionally bloody discharge especially those found on the cervix.