Can endometrial polyps be misdiagnosed?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 06, 2024
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Endometrial polyps can be misdiagnosed as they are caused by excessive proliferation of the endometrial lining. Clinically, the thickness of the endometrium varies throughout the menstrual cycle. Typically, just before menstruation, the endometrium is quite thick. As a result, some women might notice that their endometrium appears thick, resembling a polyp. If such a condition is observed, it is advisable to wait until after a menstrual period when the endometrium has shed before undergoing an ultrasound examination. If it is indeed an endometrial polyp, it will not shed with the menstrual flow. If it’s just thickened endometrium, it will resolve after menstruation. Therefore, it is essential to perform an ultrasound after menstruation to confirm if it is an endometrial polyp. If the polyp persists after a clean menstrual cycle, it can be diagnosed definitively.

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Do uterine polyps affect pregnancy?

Endometrial polyps refer to the hyperplasia of the endometrial lining due to inflammatory stimuli, resulting in many polypoid tissues. Whether endometrial polyps affect pregnancy mainly depends on the number and size of the polyps, and whether they cause clinical symptoms. First, if the polyps are small and few in number without causing an increase in menstrual flow, they generally do not affect pregnancy and do not require removal of the endometrial polyps, as removing them could instead easily damage the function of the endometrial lining. Second, if the polyps are large, over one centimeter, or there are multiple endometrial polyps, and they cause an increase in menstrual volume, this indicates that the endometrial polyps have impacted the woman's body. In such cases, it is necessary to use a hysteroscope to remove the endometrial polyps before trying to conceive.

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Do uterine polyps cause lower abdominal pain?

Endometrial polyps generally manifest clinically with a shorter menstrual cycle, usually occurring every 20 days or so, and a longer period, typically lasting 8 to 10 days or more before it ends. This is a typical clinical presentation of endometrial polyps, and there is usually no pain in the lower abdomen. However, if there is frequent bleeding and the bleeding lasts for a long time, causing endometrial inflammation, pain in the lower abdomen may occur. If the endometrial polyps are not inflamed, there will be no pain in the lower abdomen. If endometrial polyps are detected, the treatment generally involves performing a polypectomy under hysteroscopy within three to seven days after the end of the menstrual period, followed by anti-inflammatory treatment as appropriate. With simple endometrial polyps, there is no pain in the lower abdomen.

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ultrasonographic appearance of endometrial polyps

Under normal circumstances, the diagnosis of endometrial polyps is usually determined clearly by performing an ultrasound at the hospital. Normally, the endometrial line is continuous. There is a specific thickness to the endometrium. Typically, a thickness of 3-4mm in the endometrium at the end of menstruation is considered normal. During ovulation, the thickness of the endometrium is 8mm. Before menstruation starts, the endometrial thickness is generally more than 10mm. If it is within this range, it is generally considered normal. If there is an increase in endometrial thickness and the echo of the endometrium is not continuous, and the endometrial echo is uneven, in most cases, endometrial polyps are suspected. The diagnosis of endometrial polyps can generally be clearly determined through color Doppler ultrasound. This diagnosis is not difficult. Once endometrial polyps are clearly diagnosed by ultrasound, they can be removed by hysteroscopic polypectomy at the hospital.

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How to prevent endometrial polyps

Endometrial polyps can be prevented through some daily life adjustments. Firstly, it is important to maintain a good mentality and avoid being in a consistently gloomy mood for a long period, as these negative emotions can lead to a decrease in the body's immune function, which may trigger certain diseases. Additionally, it is important not to marry and conceive too early, and also to avoid conceiving too late. The optimal age for childbirth is between 25-28 years old. These measures can effectively prevent endocrine disorders and the occurrence of endometrial polyps. Furthermore, after marriage, if there is no plan for childbirth, women can take some contraceptive measures, such as using condoms or an intrauterine device, to prevent accidental pregnancies. This is important because accidental pregnancies, followed by surgical or medical abortions, can affect the body's hormonal balance and may lead to the development of endometrial polyps.

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Difference between endometrial polyps and cervical polyps

Endometrial polyps and cervical polyps are two types of reproductive system polyps that are relatively common in women. Their differences lie in the following aspects: First, the location of the polyps is different. Endometrial polyps are located inside the uterine cavity, whereas cervical polyps grow in the cervical canal or on the external cervix. Second, the symptoms caused by each are different. Cervical polyps may cause symptoms or tend to cause abnormal vaginal bleeding outside of menstruation. In contrast, endometrial polyps typically lead to increased menstrual flow and generally do not cause bleeding outside of menstruation. Third, the examination methods are not completely the same. Endometrial polyps are primarily diagnosed through ultrasound, while cervical polyps are mainly checked through gynecological examination.