Endometrial Polyp

One of the causes of Infertility is an Endometrial or uterine polyp. It can also increase the risk of miscarriage. Endometrial polyp is a mass in the inner lining of the Uterus. They range in size from few mm to several cm.

Causes:

• No definitive cause is known.
• Some are affected by Hormonal Treatment or changing of the normal hormones during the cycle (Estrogen and progesterone).

Symptoms:

• It can be asymptomatic.
• Irregular menstrual bleeding.
• Post coital bleeding.
• Heavy period (menorrhagia)
• Bleeding after menopause.
• Some times dysmenorrhea (pain with menstrual periods)

Diagnosis

Diagnosis can be done by ultrasound (vaginal) scan and Hysteroscopy. It can also be seen as a filling defect in a HSG (Hysterosalpingogram).

Treatment

The best way to remove the polyp is by Hysteroscopy and Polypectomy. Some doctors do D & C but it can be missed. After removing the polyp it should be sent for Histopathology study as it can be Benign or malignant, although majority tend to be benign.

Risk Factors

• Age → Commonly seen in females (between the age of 40 – 50)
• Obesity.
• High blood pressure.
• Cervical polyps (when the female has a history of cervical polyp).
• Taking hormonal replacement therapy.

Sometimes, a fibroid can grow inside the uterine cavity (fibroid is a masses of tissue rooted and growing from the uterine muscle and then grow into the cavity). Such fibroids are referred to as sub-muscular-intra-cavitory fibroids.

These fibroids cause pelvic pain, heavy bleeding, and prolonged periods. The best way to treat this type of fibroid is by giving injections of Gonadotrophine antagonist for 1-2 months to reduce the size of fibroid followed by Hysteroscopy and Polypectomy. Some large size fibroids cannot be removed by Hysteroscopy and many require laparoscopic Myomectomy.