How to investigate endometrial polyps?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 08, 2024
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Endometrial polyps require an ultrasound examination to be detected, as they are located within the uterine cavity and cannot be seen by a gynecological examination alone. Under ultrasound, one can see a polyp-like object in the uterine cavity, which usually measures only a few millimeters, although some may be about ten or more millimeters in size. Certainly, if possible, a hysteroscopy can also identify them. However, generally, an ultrasound is conducted first to observe the endometrial polyps, followed by a hysteroscopy to remove them.

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Written by Liu Wei Jie
Obstetrics
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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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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What should I do about endometrial polyps?

Endometrial polyps, if diagnosed, are generally treated within 3 to 7 days after the end of menstruation. You can go to the hospital to have the polyps removed under hysteroscopy. Postoperative anti-inflammatory and symptomatic treatment is then sufficient. The removed polyps should be sent for pathology analysis, and based on the pathology results, an appropriate treatment method can be selected. Generally, most endometrial polyps are benign, with a very small percentage having a tendency to become malignant. Endometrial polyps are prone to recurrence, so it is essential to undergo proper anti-inflammatory and symptomatic treatment after the removal of endometrial polyps. The diagnosis of endometrial polyps generally requires a hospital visit for a color Doppler ultrasound. After menstruation, if the ultrasound shows thickened endometrial echoes or uneven echoes, most can be diagnosed through this ultrasound. Treatment can only be performed surgically.

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Written by Yue Hua
Obstetrics and Gynecology
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Symptoms of endometrial polyps

The most common clinical symptom of endometrial polyps is vaginal bleeding, which manifests in the following ways: Some women may experience heavy menstrual flow with a large amount of blood clots. This is because most patients with endometrial polyps have excessive proliferation of the endometrial lining. When this excessively proliferated endometrium sheds during menstruation, it can result in a heavier flow. Additionally, some women may experience vaginal bleeding after their menstruation has ended. Typically, this bleeding is not heavy and is dark red in color. This could indicate the presence of endometrial polyps.

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Written by Shen Li Wen
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Can endometrial polyps be cured?

Women with endometrial polyps can be completely cured. First, endometrial polyps are benign lesions, which may be due to abnormally high levels of estrogen in women, leading to proliferative lesions. It is possible to completely remove the polyps through hysteroscopic endometrial polyp electrocision surgery. However, after surgery, some women may experience recurrence. To prevent this, periodic oral progestogen medication can also be administered to prevent recurrence. Some women may have endometrial inflammation, leading to the recurrence of endometrial polyps. In this case, broad-spectrum antibiotics can be used for anti-inflammatory treatment to prevent recurrence. (The use of drugs should be carried out under the guidance of a professional doctor.)

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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.