Polyp of the endometrium: causes, symptoms, prevention, prognosis

One of the options for a benign neoplasm in the uterine cavity is the endometrial polyp. Such a tumor is found relatively often, and can arise as a single formation, or multiple polyps of different sizes.

If we are talking about multiple polyps of the endometrium, then this pathology is a growth of the basal endometrial layer, which has the appearance of polyps.

The structure of the endometrial polyp is made up of epithelial cells, and the polyp itself is constructed from a body on a foot-like base.

[1], [2]

Epidemiology

Endometrial polyps can be found in patients of different ages. But most often this disease is typical for women, starting from the age of 30 years.

The incidence of endometrial polyps in women varies between 0.5 and 5%.

[3], [4], [5], [6], [7]

Causes of the polyps of the endometrium

Modern specialists still can not pinpoint the cause of the appearance of the endometrial polyp. As a rule, they identify individual risk factors that can affect the development of the disease:

• Disorder or change in ovarian function due to increased estrogen secretion along with progesterone deficiency.
• Mechanical damage to the uterus - for example, during abortion, scraping, with the long use of the uterine spiral.
• A habitual miscarriage, complex births, after which blood clots in the uterus are retained, particles of the placental layer.
• Endocrine disorders, extragenital pathologies (thyroid dysfunction, all degrees of obesity, diabetes, hypertension).
• Psycho-emotional imbalance (long-term depression, deep stressful conditions).
• Critical drop in immunity.
• Chronic problems with the organs of the reproductive system, frequent or prolonged inflammatory diseases.

Polyps of the endometrium after childbirth develops on mucous uterine tissues with inferior placenta removal. Elements of the placental layer are firmly retained on the endometrium of the uterus, clots of blood "cling" to them, which gives rise to the formation of the endometrial polyp. Over time, such a polyp grows and increases in volume.

Endometrial polyps after IVF can develop against a background of strong hormonal transformations - for example, after several courses of stimulation with hormones. If this happens, then further attempts at ECO are postponed, and the polyp is removed.

Psychosomatic plays a significant role in the development of the endometrial polyp. It has long been known that a woman's health is directly related to her psychological and emotional balance. Even without focusing on individual points, experts are sure: the majority of gynecological diseases in women are provoked by internal problems - women are often subjected to stress, fall into depression, and experience dissatisfaction with any circumstances. Many psychologists believe that the development of tumors, myomas, polyps and erosions in women is associated with the accumulation of negative energy, pain, troubles and fears in the body. Therefore, in order to prevent the appearance of polyps of the endometrium, doctors advise, besides the usual preventive measures, to pay attention to other practices: one must begin to perceive oneself with dignity, love yourself as a person and as a woman, achieve harmony in life. Sometimes a woman is able to cope with such tasks independently, and in some cases you have to contact specialists.

[8], [9], [10]

Pathogenesis

The pathogenetic features of the endometrial polyps are only partially studied.

A few years ago, physicians linked the formation of polyps in the disorders of hormonal work capacity of the appendages - an especial role was played by the excess of estrogens against the background of a deficit of progesterone. But to date, this state belongs to a number of hypotheses, since it has no official evidence. Against this hypothesis is the fact that often the formation of the endometrial polyp is diagnosed in patients with an adequate ovulatory cycle of the month, as well as in women with hyperandrogenism (for example, in ovarian polycystic syndrome). Also, the appearance of polyps in patients with endometrial atrophy is not excluded.

To date, an overwhelming number of specialists have given preference to the theory of the inflammatory origin of the disease. If we believe this theory, a prolonged inflammatory reaction in the endometrial tissue causes degenerative and proliferative processes with a disruption of the reparative function and differentiation of cells, with the formation of hyperplastic zones.

Experts believe that this theory can be supplemented with information about a painful change in the vasculature in the basal layer. Vessels thicken and sclerosed, up to hyalinization. Violated tissue metabolism, changes receptor perception of the endometrium.

The endometrial polyp arises as a result of proliferative changes in the glandular apparatus of the basal layer of the endometrium. The vascular pedicle of the endometrial polyp consists of fibrous tissue and smooth muscle tissue. To this structure, the term "stromal tissue" is often used.

An endometrial polyp without a pedicle can occur in the early stages of the disease. Such a polyp, as it grows, acquires a leg, through which the nutrition of the formation is carried out, because it is in it that the vessels pass. Only in some cases, the polyp continues its growth on a broad base - this type of growth is considered the most unfavorable. You should remove this polyp as soon as possible.

The development of polyps of the endometrium is associated with the growth of the same tissues. The most frequent localization of the painful process is the cervix or uterine cavity (upper or middle segment). The polyp in the bottom of the endometrium is found least often, however, this type of development of the disease is possible.

[11]

Symptoms of the polyps of the endometrium

The endometrial polyp is not always manifested by any clinical signs. Especially secretly develop polyps of small sizes. In most patients, they are diagnosed accidentally during a planned ultrasound.

The first signs appear if the endometrial polyp reaches more pronounced sizes:

• disrupted the monthly cycle, there are "smearing" or profuse intermenstrual secretions;
• in patients in the postmenopausal period there are occasional spotting from the vagina;
• spastic pains in the lower segment of the abdomen are noted (especially severe pains occur during sexual contact);
• there are additional pathological discharges;
• bleeding may occur after sexual contact;
• there are problems with the conception of the child.

The endometrial polyp and temperature, contrary to the opinion of many, do not have a close relationship. However, the temperature is a sure sign of the presence of an inflammatory reaction in the body, which, in turn, can become an indirect cause of the development of the polyp of the endometrium.

Monthly in the endometrial polyps are violated almost always. Even in the asymptomatic course of the disease, various abnormalities occur in the endometrial polyps - from a slight "swelling" to dysfunctional uterine hemorrhages of a cyclic or acyclic type. When polyps are often observed menorrhagia - abundant menstrual discharge, a sacred liquid before menstruation, "smearing" between monthly bleedings. In many women, pigmentation with the endometrial polypeptide is detected after sexual intercourse. Such regular blood loss can cause anemia, which is accompanied by a pale skin, dizziness, a state of general weakness.

Delay of menstruation with polyps of the endometrium is observed against the background of the appearance of extraneous mucous secretions - on any day of the menstrual cycle. Allocations become more intense after sexual intercourse, and may contain impurities or blood veins.

Pain in the endometrial polyp can be different - from a state of slight discomfort in the lower abdomen to strong spastic painful sensations, both at rest and after physical exertion or sexual intercourse.

Diagnostics of the polyps of the endometrium

Polyps of the endometrium must be differentiated from other diseases of the gynecological sphere. Therefore, it is very important to conduct an accurate and complete diagnosis of pathology.

To date, experts have different diagnostic techniques that can identify the polyp of the endometrium. The primary diagnostic procedure is ultrasound, which detects the polyp in the form of a homogeneous tumor structure with even edges. In addition, the doctor can prescribe a histological examination of the endometrial particles, as well as hysteroscopy.

[12], [13], [14], [15], [16]

Treatment of the polyps of the endometrium

Any treatment regimen for endometrial polyps involves the removal of this formation. Removal is carried out in various ways, suitable for each specific case. After removal, the patient is given a rehabilitative treatment. First of all, you need to restore the broken menstrual function, adjust the hormonal balance, eliminate endocrine problems, etc. Treatment is selected individually, taking into account the age of the patient, the presence of reproductive function, the size of polyps, etc.

Read also:

• Treatment with alternative means.
• Medicinal treatment of the endometrial polyp.

Prevention

Of course, any disease is easier to prevent than to find a way to solve the problem. It makes sense to pay attention to the prevention of polyps of the endometrium. For this purpose, one should listen to such advice:

• A visit to a gynecologist for any woman should be mandatory and regular.
• It is important to monitor your weight, not to allow the development of obesity.
• It is necessary to use reliable methods of contraception and not to allow abortions.
• Any gynecological disease must be treated immediately after its detection, strictly adhering to the doctor's recommendations.

If any woman will be attentive to her health and regularly consult her gynecologist, it will help to avoid a lot of troubles and diseases, including preventing the development of the endometrial polyp.

How to avoid recurrence of the endometrial polyp?

If a woman has a predisposition - for example, hereditary, to the formation of endometrial polyps, then preventive measures should be carried out even after the removal of the problematic education. Such prevention will include the following points:

• it is necessary to take a course of preventive hormonal therapy;
• In addition, one should strengthen his own body defense by taking multivitamin preparations;
• if necessary, the doctor to prescribe a specific antimicrobial prophylaxis.

Patients with a tendency to form endometrial polyps should visit the gynecologist not just regularly, but even more often than other women. This will help, if not avoid the disease, then detect it as soon as possible.

[17], [18], [19], [20]

Forecast

It can be considered a favorable prognosis in the case when the endometrial polyp was detected and removed in time. But we must not forget that in about 6% of patients the polyp can develop repeatedly, so it is very important to regularly see a gynecologist. When diagnosing complications, the prognosis will depend on the severity of the problem and on its stage.

What complications can we talk about?

• Disorders of reproductive function, violation of the monthly cycle.
• Pain in sexual contact.
• Anemia due to heavy or chronic blood loss.
• Malignancy (cancerous degeneration of the tumor).
• Necrosis of the polyp when the legs are twisted or when trophic processes are disrupted.

In any of the options, the quality of the forecast depends on the timeliness of seeking medical help.

Hospital after removal of the endometrial polyp

Since during a few days after removal of the endometrial polyp the patient may experience some discomfort - for example, there may be pain or discharge, she gets a sick leave for about 4 days. During this time, a woman should not go to work, but also perform physical exercises. It is forbidden to take a bath, have sex, lift heavy objects, bend sharply. If during the recovery period the patient's fever has risen, severe pain or bleeding has occurred, then you need to see a doctor immediately. In case of complications, the doctor will prescribe appropriate therapy and prolong the action of the sick leave sheet. Polyp of the endometrium is a serious disease, the elimination of which requires all efforts and efforts, and only in this case the disease will recede forever.

[21], [22], [23], [24]