“Uninvited guests” in the womb
Endometrial polyps are a common benign lesion of the endometrium in clinical practice. Those with only one polyp or a small polyp may not have any obvious symptoms. Symptomatic patients may manifest as menorrhagia, intermenstrual bleeding, and bleeding before and after menstruation , Irregular menstruation or postmenopausal bleeding, etc., may be accompanied by symptoms such as lower abdominal pain, increased leucorrhea, and bleeding after sex.
So far, the causes and mechanisms of endometrial polyps are not very clear. Clinical studies have shown that age, endometriosis, endometrial inflammation, use of tamoxifen, hormone replacement therapy, or obesity, diabetes, high blood pressure, etc., may cause endometrial polyps. Foreign studies have shown that after postmenopausal women use hormone replacement therapy, the incidence of endometrial polyps increases compared with those who do not use drugs, which may be related to the imbalance of estrogen and progesterone caused by drugs. Endometrial polyps can be seen in women of any age after puberty, and the incidence rate will increase with age, but endometrial polyps are rare in elderly women after the age of 70.
The existence of endometrial polyps may affect the activity of sperm in the uterine cavity and the implantation of fertilized eggs, resulting in infertility; for postmenopausal women, endometrial polyps may be related to endometrial malignancy. Therefore, after the above symptoms appear, it is recommended to seek medical attention in time to find out the cause.
Drugs and surgery are the main treatments
For the treatment of endometrial polyps, commonly used clinical treatment methods include drug therapy and surgical treatment. In general, if the polyp diameter is <1cm and the patient has no obvious symptoms, the polyp may disappear naturally and the malignant transformation rate is low. The doctor will advise the patient to watch and wait and pay close attention to the progress of the disease. Drug treatment mainly includes short-acting oral contraceptives (such as drospirenone and ethinyl estradiol) and levonorgestrel intrauterine sustained-release system (LNG-IUS), which are suitable for patients with single and large diameter who are ineffective in expectant treatment and unwilling to undergo surgery. Endometrial polyps <1 cm. Due to large individual differences, there is no absolute best, fastest, or most effective medication. You should choose the most appropriate drug based on your personal situation under the guidance of a doctor. For patients with polyps that are larger, symptomatic, or potentially cancerous, doctors will recommend surgical treatment, and surgery under hysteroscopy is recommended. Hysteroscopic surgery is a minimally invasive surgery that is performed directly through the vagina or cervix into the uterine cavity without causing damage to the patient's external skin and muscles. The operation is less traumatic, less painful for the patient, less bleeding, and quicker to recover. It can also help doctors to conduct a more detailed examination of the intrauterine environment of the patient, and can detect endometrial cancer at an early stage. Drospirenone Ethinylestradiol Is Not Just Contraception The high recurrence rate of endometrial polyps may be due to incomplete polypectomy, or it may be related to hormone replacement therapy and late menopause. Therefore, after polypectomy, those who have completed childbirth or have no family planning in the near future can use short-acting oral contraceptives or levonorgestrel intrauterine sustained-release system (LNG-IUS) according to the doctor's advice to reduce the risk of polyp recurrence. Among them, drospirenone and ethinylestradiol is a compound preparation of ethinylestradiol (an estrogen) and drospirenone (a progestogen), and is a relatively new short-acting oral contraceptive on the market, and contains more estrogen. Less, less side effects. The occurrence of endometrial polyps may be related to long-term high-level estrogen stimulation. Short-acting contraceptives can reduce the production of endogenous estrogen by inhibiting ovulation, and can be used as a drug for conservative treatment of endometrial polyps and prevention of recurrence after surgery. Not only that, drospirenone and ethinylestradiol can also make the menstrual cycle more regular, reduce dysmenorrhea, reduce bleeding, etc.; it also has anti-mineralocorticoid activity, which can prevent weight gain and other symptoms caused by fluid retention, Fights estrogen-related water and sodium retention, provides good tolerance, and also has a positive effect on PMS.