Clinical meaning
Endometrial polyps are localized overgrowths of the endometrial lining (the inner lining of the uterus) that project into the uterine cavity. They are composed of endometrial glands, stroma, and blood vessels. Polyps develop when areas of the endometrium respond excessively to estrogen stimulation, causing focal overgrowth. They can range in size from a few millimeters to several centimeters and may be single or multiple. Most endometrial polyps are benign, but they commonly cause abnormal uterine bleeding - including intermenstrual bleeding, heavy menstrual bleeding, and postmenopausal bleeding. The risk of malignant transformation is low (approximately 1-3%) but increases in postmenopausal women, those on tamoxifen therapy, and those with larger polyps.
Exam relevance
Risk factors: - Obesity (increased estrogen from adipose tissue) - Perimenopausal and postmenopausal age - Tamoxifen use (estrogen agonist effect on endometrium) - Hypertension - Hormone replacement therapy (estrogen-only) - History of endometrial polyps
Diagnostics: - Expect transvaginal ultrasound to visualize endometrial thickening - Expect saline infusion sonography (SIS) for better polyp visualization - Expect hysteroscopy for direct visualization and possible removal - Expect endometrial biopsy to rule out malignancy - Monitor menstrual pad count and bleeding patterns