What are endometrial polyps?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 12, 2024
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Endometrial polyps refer to excessive proliferation of the endometrial lining, forming polyp-like tissues. Patients typically experience irregular vaginal bleeding, primarily manifesting as minor vaginal bleeding after menstrual periods have ended. Upon visiting the hospital and undergoing a vaginal ultrasound examination, a polyp-like tissue can be detected within the uterine cavity. Once identified, a hysteroscopy or diagnostic curettage is required to remove these tissues. Subsequently, a pathological examination must be conducted to clearly determine the cause and nature of the polyps.

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How to check for endometrial polyps?

Endometrial polyp examinations are generally conducted through ultrasound at hospitals, which can provide a clear diagnosis. The best time for this ultrasound is within three to seven days after the end of menstruation. During this period, the thickness of the endometrium is between three to four millimeters, and the endometrial echo is uniform. If, during this period, the endometrial thickness is greater than four millimeters and the echo suggests unevenness, this generally indicates a high possibility of endometrial polyps. Patients with endometrial polyps typically experience shorter menstrual cycles, usually occurring every 20 days, with longer menstruation periods. Normally, the menstruation period lasts from three to seven days, but in patients with endometrial polyps, it can extend to over eight to ten days. Therefore, through symptoms and ultrasound, it is possible to determine whether there are endometrial polyps.

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Endometrial polyp pain sensation

Do endometrial polyps feel painful? Generally, endometrial polyps do not cause any pain unless there is malignant transformation. In such cases, one might experience discomfort or a dragging pain in the lower abdomen. How are endometrial polyps typically diagnosed? They are diagnosed due to clear changes such as excessively heavy menstrual flow. An ultrasound can reveal polyps, or if the menstrual flow is too heavy, a dilation and curettage (D&C) procedure is performed, and the material removed is sent for pathological examination to confirm the presence of endometrial polyps. If the polyp is small, it can be left alone as 27% of them resolve on their own. However, if the polyp is large and causes changes in menstruation or affects fertility, a hysteroscopy is necessary.

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Will uterine polyps cause bleeding during intercourse?

Endometrial polyps generally do not cause bleeding after sexual intercourse. However, bleeding after sexual intercourse can occur if there are polyps in the cervical canal. Clinically, endometrial polyps generally present with shorter menstrual cycles, occurring every 20-something days. The period duration is also typically longer; normally, a period lasts from three to seven days. In patients with endometrial polyps, the period can extend up to eight or nine days. Under such circumstances, endometrial polyps are generally suspected, and patients are often advised to visit a hospital for an ultrasound to examine the thickness of the endometrial lining and its echo characteristics, allowing for a definitive diagnosis of endometrial polyps. Endometrial polyps do not cause bleeding after sexual intercourse. Bleeding after intercourse is generally considered clinically if there are conditions such as cervical cancer, precancerous cervical conditions, cervical polyps, or other cervical alterations. Thus, if bleeding after intercourse occurs, it is crucial to undergo cervical cancer screening at a hospital.

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Can you get pregnant with endometrial polyps?

Endometrial polyps can affect pregnancy, but it does not mean that conception is impossible. Rather, it means that the chances of becoming pregnant may decrease. Endometrial polyps can affect the lining of the uterus and thereby hinder the implantation of a fertilized egg after the sperm and egg have combined. Even if fertilization and implantation occur in the uterus, miscarriage is more likely to happen. Therefore, when endometrial polyps occur, treatment can be administered based on the size and extent of the polyps. If the condition is mild with few and small polyps that do not affect pregnancy, conception is still possible.

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Can you have intercourse with endometrial polyps?

Endometrial polyps do not prevent sexual intercourse. This is because endometrial polyps are located within the uterine cavity, and sexual intercourse generally affects the vulva, vagina, and cervix. As long as these organs do not have any pathological changes, sexual intercourse is generally possible because the polyps inside the uterine cavity are not contacted during intercourse. Therefore, intercourse does not significantly affect the presence of polyps and can occur. However, if endometrial polyps are discovered, it is crucial to undergo early surgical treatment, which can be done through hysteroscopy or diagnostic curettage, as the polyps can grow larger over time.