What should you do if you have endometrial polyps?

Endometrial polyps can be treated through regular review, drug treatment, hysteroscopy, endometrial resection, hysterectomy, etc. Endometrial polyps may be related to factors such as excessive estrogen levels, chronic inflammatory stimulation, obesity, hypertension, and long-term use of tamoxifen.

1. Regular review

Small, asymptomatic endometrial polyps can be temporarily observed, and ultrasound should be reviewed every 3-6 months. Polyps may regress naturally, especially in postmenopausal women, who are more likely to shrink as estrogen levels drop. If symptoms such as abnormal uterine bleeding and infertility occur during the reexamination, timely intervention is required.

2. Drug treatment

Progesterone drugs such as progesterone capsules and dydrogesterone tablets can antagonize the effects of estrogen and promote polyp atrophy. The levonorgestrel sustained-release intrauterine system can locally release progesterone and inhibit endometrial hyperplasia. Medical treatment is suitable for patients who are not suitable for surgery or whose polyps are small, and the effect needs to be evaluated for 3-6 months.

3. Hysteroscopic surgery

Hysteroscopic polypectomy is the treatment of choice, in which the base of the polyp is completely removed through an electrosurgical ring or cold knife. The operation has small trauma, fast recovery, and can simultaneously explore the shape of the uterine cavity. It is suitable for those who need fertility. Postoperative pathological examination can clarify the nature of the polyps and rule out the possibility of malignant lesions.

4. Endometrial ablation

Hysteroscopic endometrial ablation may be considered for patients who have no desire to have children and have recurrent polyps. The polyp and its surrounding intimal functional layer are removed through an electrosurgical ring to reduce the risk of recurrence. This procedure preserves the structure of the uterus, but may cause reduced menstrual flow or amenorrhea.

5. Hysterectomy

Postmenopausal women may consider total hysterectomy if they are combined with atypical hyperplasia or malignant tendencies, or if polyps recur multiple times and are accompanied by severe anemia. Surgical approaches include laparoscopic, vaginal, or open surgery, which require a comprehensive assessment based on the patient's age, complications, and reproductive needs.

Patients with endometrial polyps should avoid high-estrogen foods such as royal jelly after surgery and keep their weight within a normal range. Keep the perineum clean, and prohibit bathing and sexual intercourse within 2 weeks after surgery. If you have fever, persistent abdominal pain, or vaginal bleeding that exceeds your menstrual flow, you should seek medical attention promptly. It is recommended to undergo gynecological examination and ultrasound monitoring every year, especially those who use hormone replacement therapy for a long time, and need to be wary of recurrence.