Are Endometrial Polyps Overtreated?

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The article and comments below give some basic info to those women trying understand endometrial polyps

If you are diagnosed with endometrial polyps, what should you do? Treat or watch and wait? If you choose to treat, how should you treat your polyps?

While the ultimate decision is up to the individual, the article and comments below give some basic info to those women trying to think through their choices. Three questions to ask yourself are:

  • What are the chances of endometrial polyps becoming cancer?
  • Are you pre or post memopausal?
  • Have you experienced bleeding?

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Hysteroscopy May Disseminate Endometrial Cancer Cells


Are Endometrial Polyps Overtreated?

“Women who were menopausal with polyps had an almost 4-fold higher likelihood of that polyp being malignant than when polyps were diagnosed in reproductive-aged women,” said Dr. Kaunitz. Correspondingly, a polyp was 2-fold more likely to be malignant in women with bleeding than in those who were asymptomatic…

What Happens When You Watch and Wait?

From January to July of 2010, Dr. Hartman examined 300 women who had been diagnosed with endometrial polyps in the previous 2 to 43 months.

Results of these examinations showed that in 41 (13.7%) of these women, the polyp had naturally resolved; in 125 (41.7%), there was no change in polyp size; in 61 (20.3%), there was a decrease of at least 1 mm; in 49 (16.3%), there was an increase of greater than 50% of the originally measured polyp diameter; and in 24 (8.0%), there was a greater than 50% increase in polyp diameter.”

“Malignant polyps represented 2.5% of the total sample. Postmenopausal bleeding and age greater than 60 years were the only factors that remained associated with a higher risk of malignancy with a prevalence ratio of 3.67 (95% CI, 1.69–7.97) and 1.5 (95% CI, 1.01–1.09), respectively…”

To summarize: If you are diagnosed with endometrial polyps:

1) 13.7% of the time the polyps resolve on their own-

2) 41.7% of the time the polyp size stays the same-

3) 20.3% of the time the polyps shrinks at least 1mm-

4) 16.3% + 8.0% of the time the polyps grow at least 50% larger

What is an endometrial polyp?

“An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus. They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated)…”
“No definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen.[2] They often cause no symptoms.[3]…
Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding (menorrhagia), and vaginal bleeding after menopause.[2][5] Bleeding from the blood vessels of the polyp contributes to an increase of blood loss during menstruation and blood “spotting” between menstrual periods, or after menopause.[6] …”

 

  • Treatment
  • Prognosis and complications
  • Risk factors and epidemiology

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