Endometrial Polyps

An endometrial polyp is a localized overgrowth of endometrial glands and stroma supported by a vascular core. It projects into the uterine cavity from either a broad base or a stalk. Because the lesion is focal, it can disrupt the normally smooth endometrial surface and bleed unpredictably. Polyps are a structural cause of abnormal uterine bleeding in the PALM classification. They are not primarily an ovulatory or hormonal disorder, although hormonal stimulation can influence their growth. A patient may have intermenstrual spotting, heavy menstrual bleeding, postmenopausal bleeding, infertility, or no symptoms at all. Some are discovered incidentally during imaging. Most polyps are benign, but benign appearance does not replace histologic assessment when removal is indicated. The estimated risk of premalignant or malignant change is low, approximately 0.5% to 5%, and rises with increasing age, postmenopausal status, postmenopausal bleeding, and tamoxifen exposure. Obesity and hypertension are also recognized risk factors.