Posted April 1, 2005
The uterus is mostly made of muscle but is lined by endometrial
tissue that thickens and thins at different phases of the menstrual
cycle. Each cycle the endometrium grows and changes to prepare the
uterus for pregnancy. The most important hormone causing this growth
is estrogen. If a woman does not become pregnant, most of the tissue
is shed causing a menstrual period.
Sometimes, areas of the endometrial tissue will grow too much, creating
a polyp. Polyps are attached to the wall of the uterus by a stalk
and grow outward into the endometrial cavity. Growths can be single
or multiple and are generally small, about the size of a pencil eraser
or fingertip, but if left untreated can become very large.
Endometrial polyps are common, affecting 10-24% of women. They are
commonly seen in women 40-50 years old and are rare after menopause.
The exact cause is unclear, but polyps seem to be related to excess
estrogen levels. They may also be associated with tamoxifen, a drug
used in breast cancer therapy.
Since most polyps are small, they often do not cause symptoms. Women
who have polyps may experience heavy menstrual bleeding (menorrhagia)
and spotting between periods (metrorrhagia) or after sex. Since these
symptoms are also associated with more severe illnesses, such as
uterine cancer, it is important for women who experience them to
see their doctor. Endometrial polyps are almost always benign. Less
than 1% are associated with cancer and risk increases with age.
Diagnosis of polyps can be made on sonohysterogram
(an ultrasound done with sterile water in the uterus) or hysteroscopy
(a tube with a camera that can be used to look in the uterus), but
biopsy or removal of the polyp is the only way to make a definitive
diagnosis. Endometrial polyps can be treated with the help of a hysteroscope
and targeted removal or with dilation and curettage (D&C), which
scrapes off the lining of the uterus.
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NewsPath® Editor: Megan
J. DiFurio, MD, FCAP
This newsletter is produced in cooperation with the College of American
Pathologists Public Affairs Committee and may be reproduced in whole or
in part as a service to the medical community. Copyright © 2006 by
the College of American Pathologists.
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