What are Endometrial Polyps
Endometrial polyps are benign tissue growths that form on the inner surface of the uterus, known as the endometrium. These small protrusions range in size from a few millimeters to several centimeters. Although in the vast majority of cases they are benign, they can cause bothersome symptoms that affect women's quality of life.
Epidemiology and Frequency of Endometrial Polyps
Endometrial polyps appear most frequently in women after the age 30. According to medical studies, approximately 8% of the women aged 20-74 may develop endometrial polyps.
Causes and Risk Factors of the Endometrial Polyps
Hormonal Disorders
Hormonal imbalances are the main factor in endometrial polyp development. Specifically:
- Excessive exposure to estrogen without adequate progesterone opposition
- Polycystic ovary syndrome (PCOS)
- Hormone replacement therapy
Genetic Factors
Family history appears to play a significant role in endometrial polyp development. Women with relatives diagnosed with the condition show increased risk.
Lifestyle Factors
- Obesity: Excess fat increases estrogen production
- Diabetes mellitus: Affects hormonal metabolism
- Hypertension: Associated with uterine vascular disorders
- Smoking: Affects circulation and hormonal balance
Symptoms of Endometrial Polyps
Menstrual Disorders
The most common symptom of endometrial polyps is abnormal menstrual cycles:
- Menorrhagia: Heavy and prolonged menstruation
- Metrorrhagia: Bleeding between periods
- Dysmenorrhea: Painful menstrual periods
Other Symptoms
- Pain: Especially during menstruation
- Infertility: Polyps may affect the fertility
- Vaginal discharge: May cause abnormal discharge
- Fatigue: Due to chronic blood loss
Diagnosis of Endometrial Polyps
Gynecological Examination
- Clinical examination is the first step in diagnosis. During examination, the gynecologist may detect cervical polyps.
Diagnostic Imaging Techniques
- Uterine Ultrasound
Vaginal ultrasound is the first line imaging choice for detecting endometrial polyps. It provides detailed endometrial imaging.
- Magnetic Resonance Imaging (MRI)
MRI provides excellent tissue resolution and is particularly useful for differential diagnosis between polyps and other conditions.
Invasive Diagnostic Methods
- Hysteroscopy
Hysteroscopy is considered the gold standard technique for diagnosing endometrial polyps. Through a thin optical fiberscope, the physician can directly visualize the inner surface of the uterus and accurately detect the presence of polyps.
- Endometrial Biopsy
Endometrial biopsy is necessary for histological examination and exclusion of malignancy. A tissue sample is taken for microscopic analysis.
Treatment of Endometrial Polyps
Surgical Management
- Hysteroscopic Removal
Hysteroscopic polypectomy is the most common and effective surgical technique. It is performed through a hysteroscope and allows precise polyp removal without major trauma.
Prognosis and Complications of Endometrial Polyps
Benign Nature
Endometrial polyps are benign in >95% of cases. However, histological examination is required to exclude malignant transformation.
Complications if Left Untreated
- Chronic anemia due to continuous bleeding
- Infertility: Polyps may affect the fertility
- Rare malignant transformation in a small percentage of cases
When to Visit a Doctor
It is important to consult a gynaecologist if you notice:
- Abnormal vaginal bleeding
- Heavy bleeding during period
- Pelvic pain
- Fertility problems
Conclusions
Endometrial polyps are a relatively common gynecological condition affecting a significant number of women. Although usually benign, they can cause bothersome symptoms that may affect the quality of life. Timely diagnosis and appropriate treatment are mandatory for the effective management of the condition.
Timely diagnosis with regular gynaecological check-up helps in early detection and treatment of the endometrial polyps. If you notice symptoms that concern you, do not hesitate to consult an experienced gynaecologist for the best possible care of your health.
Kostis Nikolopoulos is specialized in intrauterine pathologies.
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