Endometrial Polyps

An endometrial polyp is a localized overgrowth of the uterine lining that projects into the endometrial cavity. It contains endometrial glands, supporting stroma, and blood vessels. Because the lesion is focal, its fragile surface can bleed unpredictably when the surrounding endometrium undergoes cyclical change. Polyps are common in both premenopausal and postmenopausal patients. Some cause no symptoms. Others produce intermenstrual spotting, heavy or prolonged menstrual bleeding, bleeding after menopause, or difficulty conceiving because the lesion distorts the cavity or interferes with implantation. Most polyps are benign, but a benign-appearing lesion cannot be assumed to be harmless from symptoms or ultrasound alone. Premalignant or malignant tissue may be present within a focal lesion, which is why tissue diagnosis matters when the clinical pattern or risk profile is concerning. Bleeding after menopause is not a normal menstrual variation. A polyp is one possible cause, but endometrial hyperplasia, endometrial cancer, cervical disease, medication effects, and other causes must also be considered. A leiomyoma may also distort the cavity, but it arises from uterine muscle rather than the endometrial lining. The distinction cannot always...