How to check for endometrial polyps?

Written by Zhang Xiu Rong
Obstetrics and Gynecology
Updated on September 30, 2024
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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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Endometrial polyp removal time

Endometrial polyps require hysteroscopic polypectomy, which is a type of minimally invasive surgery, performed under intravenous anesthesia or general anesthesia. If the polyp is small and the cervical opening is relaxed, the surgery typically concludes within about an hour. After the surgery, the patient can leave the operating room once they regain consciousness. However, if the polyp is located near the uterine corner and the cervix is relaxed, it can complicate the surgical procedure, extending the duration to about one and a half to two hours. Post-surgery, it is important to monitor the patient's bleeding levels.

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Can uterine polyps disappear on their own?

Endometrial polyps are generally located in the uterine cavity. Some endometrial polyps may be expelled during menstruation, as each menstrual period involves the shedding of the endometrial lining, causing some small polyps to disappear after menstruation. However, if the endometrial polyps persist and are relatively large, causing irregular bleeding, excessive menstrual flow, or affecting pregnancy, it might be necessary to perform a hysteroscopy for examination and treatment, and to send samples for pathological testing.

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Causes of endometrial polyps

There are many causes of endometrial polyps. One is the excessive secretion of estrogen in the body, leading to an uneven distribution of hormone levels. Furthermore, long-term use of health products and hormone medications can stimulate their development, as can gynecological inflammations from events like abortion, childbirth, or surgical procedures, all of which can lead to the formation of endometrial polyps. Additionally, high blood pressure and obesity are also high-risk factors for endometrial polyps. Therefore, it’s crucial to carry out a timely hysteroscopic examination once endometrial polyps are detected. This examination should take place three to seven days after menstruation at a hospital. If the polyps are larger than one centimeter in diameter, or if there is continuous vaginal bleeding, an immediate hysteroscopic polypectomy is necessary.

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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.