What are endometrial (uterine) polyps?

Endometrial polyps are fingerlike growths in the endometrium (uterine lining). They are also known as uterine polyps. They can range in size from a sesame seed to a golf ball. There may be one or multiple polyps.

Most endometrial polyps are noncancerous, but they can be precancerous or cancerous. The likelihood of developing cancer is higher in individuals who are in the post-menopausal phase, on tamoxifen treatment, or experiencing irregular menstrual cycles.

What are the symptoms of endometrial polyps?

There may be no symptoms associated with endometrial polyps. If you are experiencing symptoms, they may include the following:

• Irregular periods
• Bleeding between periods
• Heavy flow during periods
• Post-menopausal bleeding
• Difficulty getting pregnant

What are the risk factors for endometrial polyps?

The exact cause of endometrial polyps is unknown. However, experts have linked the condition to changes in hormone levels. They tend to grow when there is a higher level of hormone oestrogen in the body.

Endometrial polyps are commonly seen in women between 20 to 40 years of age.

Risk factors include:

• Tamoxifen (treatment for breast cancer)
• Obesity
• Hormone replacement therapy
• Family history of Lynch and Cowden syndrome (a genetic condition)

How are endometrial polyps diagnosed?

Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.

• Transvaginal ultrasound: This is the first line of choice to evaluate patients with suspected endometrial polyp or abnormal bleeding. It is a test to look at the uterus, fallopian tubes, ovaries, cervix, and pelvic region.
• Hysteroscopy: A thin, flexible hysteroscope is placed through your vagina and cervix and into your uterus to look at the tissue lining the inside of your uterus.
• Endometrial biopsy: A piece of tissue is taken from the lining of your uterus to be examined in the laboratory.

How are endometrial polyps treated?

Treatment of endometrial polyps may include:

• Watchful waiting: Small polyps without symptoms may resolve on their own and may not need intervention.
• Medications: Progestins or gonadotropin-delivering hormone agonists may help reduce symptoms. However, these are only temporary measures, as the symptoms may reappear when you stop taking the medications.
• Hysteroscopic polypectomy: This is the treatment of choice for most endometrial polyps. Polyp can be removed during hysteroscopy.

How to prevent endometrial polyps?

• Oral contraceptives
• Levonorgestrel intrauterine device (IUD)

Remember, your health is your most precious asset, and early detection of endometrial polyps can significantly improve your chances of successful treatment and a healthier future.

A dedicated and expert team of obstetricians and gynaecologists at Pantai Hospital is available for consultation to provide the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions about endometrial polyps.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.