What is an Endometrial Polyp?

An endometrial polyp is a benign growth arising from the endometrial lining of the uterus.
 

Causes and Risk Factors

Although the exact cause is unknown, several factors are associated with increased risk:

•    Hormonal imbalance
•    Chronic endometritis
•    Use of tamoxifen (used in breast cancer treatment)
•    Long-term cyclic menopausal hormone therapy (MHT)
•    Obesity, metabolic syndrome, arterial hypertension
•    Polycystic ovary syndrome (PCOS)
 

Types and Classification

Histological classification:

•    Glandular — composed mainly of endometrial glands
•    Glandular-fibrous — mixed glandular and stromal tissue
•    Fibrous — predominantly dense stroma
•    Atypical (adenomatous) — with proliferative changes, potentially precancerous
•    Placental polyps — formed from retained placental tissue after childbirth, miscarriage, or abortion

Other features:

•    May be solitary or multiple
•    Size ranges from a few millimeters to several centimeters
 

Clinical Presentation

Many polyps are asymptomatic and discovered incidentally during ultrasound. However, possible symptoms include:

•    Acyclic uterine bleeding
•    Prolonged or heavy menstruation
•    Infertility or subfertility
•    Postmenopausal bleeding
 

Diagnosis

Initial assessment: transvaginal ultrasound
Gold standard: hysteroscopic polypectomy followed by histopathological examination
 

Treatment

The primary treatment is hysteroscopic removal (polypectomy) with histological verification.
Observation may be an option depending on patient age, symptoms, and reproductive goals.

Polyp removal is recommended if:

•    Symptomatic (e.g., heavy or irregular bleeding)
•    Associated with infertility
•    Found in postmenopausal women
•    Size >1 cm
 

Complications and Prevention

Potential complications:

•    Anemia
•    Recurrence of polyps
•    Malignancy risk (0.3–5.4%), especially postmenopause

Prevention strategies:

•    Regular gynecological check-ups
•    Managing modifiable risk factors: obesity, metabolic or hormonal disorders
•    Timely treatment of uterine or adnexal inflammation
 

Endometrial Polyp and Pregnancy

Endometrial polyps may impair fertility or cause miscarriage, especially if they distort the uterine cavity or interfere with embryo implantation.
Hysteroscopic polypectomy significantly increases the chances of natural conception or IVF success.
 

When to See a Doctor

•    Irregular or heavy menstrual periods
•    Intermenstrual or postmenopausal spotting
•    Difficulty conceiving
•    Suspicious findings on ultrasound indicating a possible polyp

Karina Tonoyan, Gynecologist

Karina Tonoyan, Obstetrician-gynecologist

 

Education

 

• Faculty of Medicine of Yerevan State Medical University named after Mkhitar Heratsi
• Clinical residency in obstetrics and gynecology at the Altai State Medical University, 2020
• Ultrasound diagnosis, 2022, Barnaul
• Gynecological endocrinology, 2024, Moscow

 

Professional activity

• Maternity hospital No. 2, Barnaul, 2020-2022
• Hospital of urgent treatment, Barnaul, 2020-2022
• "VitaMed" Medical Center, Yerevan, 2022

 

Conferences

 

• "Unresolved problems of diagnosis, treatment and recovery in obstetrics and gynecology" scientific conference
• "Antibacterial therapy in obstetrics: controversial issues" scientific conference
• "Principles of diagnosis and treatment of non-infectious diseases of the anogenital area" scientific conference

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