Endometrial polyps

Question 1

Definition

Answer 1

An endometrial polyp is a growth or small, typically benign, tumour that develops in the lining of endometrium

Question 2

Epidemiology

Answer 2

Women in 40’s or 50’s and those who have undergone menopause

Question 3

Aetiology

Answer 3

Not fully understood but risk factors:
- Excess oestrogen
- Women in their 40s and 50s
- Obesity
- Genetics
- Use of medications such as tamoxifen
- Chronic inflammation
- Previous uterine surgery

Question 4

Pathophysiology

Answer 4

Overgrowth of the endometrial tissue which results in the formation of polyps due to hormonal imbalance.
Composed of glandular and fibrous tissue. This glandular tissue produces excess oestrogen which can contribute to the growth of the polyp.

Question 5

Symptoms

Answer 5

Menorrhagia
Intermenstrual bleeding
Post menopausal bleeding
Pelvic pain
Dyspareunia
Infertility

Question 6

Diagnosis

Answer 6

FIRST LINE = Transvaginal USS
GOLD STANDARD = Hysterectomy with biopsy
MRI

Question 7

Treatment

Answer 7

ASx: Watch and wait
Sx: FIRST LINE: Hysteroscopic polypectomy
Hormonal treatment: e.g. progestogens if FL not suitable for Px.
Hysterectomy: in rare cases recommended for women with large or multiple endometrial polyps, causing severe symptoms, or if cancer suspected.

Question 8

Complications

Answer 8

Recurrence,
Cancer,
Anaemia,
Infertility