Are Endometrial Polyps Overtreated?

Hi Patricia,

While I’m reluctant (and not qualified) to tell you what to do about treating/not treating your polyp, I can cite the study from the article and tell you what other women coming to this site have said.

When you say your polyp is “symptomless and staying the same size” you are in the 41.7% from the study. Clearly, you are in the majority.

Further, my guess is that you would not be asking me or your doctor about the polyp if you weren’t concerned somewhat about your polyp.

1) Please talk to your doctor about the pros and cons of removing your polyp. There are side effects and risks to surgery or other therapies.

2) Ask your doctor why she wants to remove your polyp. This questioning might sound silly but my point is that your doctor should be able to convince you of the need to undergo therapy and take on the risks, to remove your polyp.

If your doctor can’t convince you to remove your polyp, in other words, if, based on the past 5-6 years living with the polyp, not causing any problems, you can’t agree to undergo the pain, cost, etc. in exchange for whatever the positive reasons are for removing the polyp, then why would you want to remove it?

I have done lots of therapies in my past, related to my cancer, based on my doctor telling me to do something. No reason, just “this is what I think you should do.” I now ask my doctor for more specific reasoning for undergoing therapies.

And you may decide to have your polyp removed. But your doctor owes you a thorough explaination, thorough reasoning.

Let me know if you have any questions.

David Emerson

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; 
in 24 (8.0%), there was a greater than 50% increase in polyp diameter.”

Hi Regina-

I am a cancer coach. I am not qualified to respond to your situation. I am sorry I can’t be more help.

David Emerson

Hi Tanaya-

I am a cancer survivor and cancer coach. I posted the study about overtreatment to educate about the low risk of polyps being cancerous according to the research. I am not qualified to address any of the issues outlined in your post to me.

I apologize for not being more help to you. Good luck.

David Emerson
Cancer Survivor
Cancer Coach
Director PeopleBeatingCancer

Hi Meg-

While I appreciate your input I’m not sure I understand what you are saying. The study that is discussed focuses on polyps. Both of the links are for polyps. I can’t even find the work “fibroid” on the page. I wrote a different post about uterine fibroids. Those are two different posts. I don’t “give out” comments. Readers write the comments.

David Emerson

Hi Pashta- thank you very much for your observation.

David Emerson

Hi Akig-

I agree with your doctor. I have excerpted the study that you read to support my thinking. If you monitor your polyp you should be able to keep an eye on if the polyps resolves, stays the same, shrinks, or grows.

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

David Emerson

Hi Lina-

I am sorry to read of your unexpected endo polyp diagnosis. I get this kind of question frequently. I am a long-term cancer survivor and cancer coach. I blogged about the study that you read to highlight polyp “over treatment.” In short, according to the study discussed in the blog post, only 2.5% of polyps are malignant (lead to cancer).

Having said that I fully understand that “watching and waiting” is difficult for people. I am not fully experienced but I believe that “D & C” to remove the polyps is painful and can cause side effects. Further, I understand that simply surgically removing a polyp does not prevent the polyp from growing back.

I am not qualified to speak about fertility issues. I can offer the types of evidence-based, non-conventional, non-toxic therapies that increase the chances of endometrial polyps shrinking and disappearing. But this is as far as my experience goes.

One more thing. You mentioned that you are not experiencing any symptoms. Pain and bleeding appear to be the most common symptoms of endo polyps. You are doing well NOT to be experiencing any symptoms plus this fact reduces your risks of malignancy. See the excerpt below.

Re your questions:

1) “What are the chances that they (polyps) will interfere or affect my chances of getting pregnant?”
Pregnancy rates after hysteroscopic polypectomy depending on the size or number of the polyps.

“Hysteroscopic polypectomy of endometrial polyps appeared to improve fertility and increase pregnancy rates in previous infertile women with no other reason to explain their infertility, irrespective of the size or number of the polyps. Type of infertility of patients seems not to affect fertility rates after hysteroscopic polypectomy. Menstrual pattern was normalized in the majority of patients after hysteroscopic polypectomy. In addition, hysteroscopic polypectomy is a safe procedure with low complication rate.”

2) “Are there any other risks associated? (with polyps)”

Not sure what you are asking. The risks are associated with removing or not removing. D & C is bad, hysteroscopy is okay according to the study. Depending on when you are trying to get pregnant, consider non-toxic therapies to try to shrink and remove the polyps and then have a hysteroscopy polypectomy if they don’t resolve with non-toxic therapies.

Hang in there,

David Emerson

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

Hi May-

I am a cancer survivor and cancer coach. I posted the study to discuss the potential of cancer and endo. polyps. I am not qualified to answer your question.

Good luck.

David Emerson

Hi Lucia-

I am a cancer survivor and cancer coach. I am not qualified to answer your question “what does this mean?”

David Emerson

Hi Becky-

I am sorry to read of your endometrial polyp. Regarding your comments, I am not qualified to comment on over treatment. My role is that of a cancer coach curating information to provide someone like you. The studies provided provide therapies beyond conventional treatment.

David Emerson

Hi Ginger-

I apologize for the slow reply. I am a cancer coach and have limited knowledge about your issue. I posted the study to address the possibility of cancer caused by polyps. The study states that “Malignant polyps represented 2.5% of the total sample” meaning 2.5% of polyps where cancerous. I do think you have other health issue to discuss with your doctor but your polyps shouldn’t be a concern according to the study excerpt below.

“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

David Emerson

HI Nathalie-

I am sorry to read of your endo polyps. I am a cancer coach specializing in blood cancers. I am sorry I can’t be more help
to you.

David Emerson

Hi Maria-

I am a cancer coach. I have no training or education with fertility issues. The post you read is there for those concerned about the risk of malignant polyps. I am sorry I cannot be more help.

David Emerson

Hi Michelle-

First and foremost, I am a cancer survivor and cancer coach. I posted that article and study in order to address the issue of polyps. As you say, your radiologist said that “everything looks fine” and that you are getting a pathology report to confirm that your polyp is benign.

I will say that your instinct, that a complete hysterectomy at this stage, is overkill. While I am no expert I have researched the issue of hysterectomy enough to know that there are side effects related to this procedure.

There is a small chance that your polyp is malignant-2.5%. There is a good chance that the polyp will not return. I agree with you that “Is removing the polyp only a good first step while waiting for biopsy results?” I do not see any harm in waiting while there is potential harm in having a complete hysterectomy.

Take it easy and good luck.

David Emerson
Cancer Coach

Hi Shreya-

I am a cancer coach. I am not qualified to answer your situation. I am sorry I can’t be more help.

David Emerson

Hi Ali-

I am a cancer coach. As such I am not qualified to try to answer your questions. You appear to have learned a lot about your situation. I would continue to consult both with your gyn. and naturopath.

thanks and hang in there,

David Emerson

can I ask what the integrative holistic protocol was?

Hi Pat-

If your question “are biopsies part of over treatment” no, the study you read is not referring to biopsies as over treatment. The article linked below discusses the risk of biopsing an endometrial polyp.

Your health situation, 43, regular periods, some spotting, etc. supports your thinking to monitor your polyp. According to the study the risk of a cancerous polyp is 2.5%.

While there is little evidence that a biopsy might make a polyp “worse,” there are risks. See below.

As the study explains, polyps usually stay the same or shrink. I would add those evidence based lifestyle and nutritional therapies to help shrink your polyp.

Let me know if you have any questions. Thanks.

David Emerson

“Endometrial Biopsy”
“Risks
There is a small chance that the cervix or uterus could be punctured during the biopsy. Bleeding or a pelvic infection is also possible.

Hi Natalya-

I am a cancer coach. I am not qualified to give you any advice about endometrial polyps. I wish I could be more help.

Thanks and good luck.

David Emerson

Hi Ria-

I am not a gyn. or obstatrition. I am a cancer coach so please take the info below with a grain of salt. According to the Mayo Clinic study linked and excerpted below, yes, uterine polyps are associated with infertility.

Complications
By Mayo Clinic Staff
Uterine polyps might be associated with infertility. If you have uterine polyps and you’re unable to have children, removal of the polyps might allow you to become pregnant, but the data are inconclusive.

Uterine Polyps

Let me know if you have any more questions.

David Emerson

Hi Shirley-

While I am sorry to learn of your endo polyp I am glad to read that you have taken the proper steps to 1) diagnose 2) treat (D&C) and then get a pathology report that should put your mind at ease. Meaning your polyp is benign.

I am not an OB/GYN so I can’t say officially that you shouldn’t have any bleeding at all one month after removing your polyp but I have to think that the “C” in D&C was substantial so it might take you awhile to heal completely. Certainly you should follow up with the physician who did your D&C to allay any anxiety you might have.

If you are interested there are antioxidant supplements that studies say reduce the risk of polyps returning. Let me know if you want more info.

In the meantime, take it easy.

thanks

David Emerson

Hi Jennifer-

I understand that most people “freak out” when they think of cancer. However, in your case I will present the odds (from the article that you came in on) and you can draw your own conclusions.

The study found that only 2.5% of polyps are cancerous. Further, I will quote the findings of the study as to what may happen to polyps- resolve, shrink, etc.

Keep in mind that the overall issue discussed in the blog post was if endo polyps were overtreated. Your Dr. and your OBGYN recommended not to treat.

If you are interested, there are antioxidant supplements such as green tea extract that studies have shown to shrink endo polyps. Or if you want to you can have another check-up to see if your polyp is still there, resolved, shrunk, grown, etc.

To sum, I agree with the thinking of both your original Dr. and your obgyn. However, I can provide you with more information if you are interested.

Let me know. Hang in there,

David Emerson

“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”

Hi Lacie-

I am sorry to learn of your health difficulties. For the record, I don’t like hospitals either. In answer to your questions please understand that I am not qualified to recommend an ER visit versus an appointment to your OBGYN or family doctor. Certainly you need to see one of these medical professionals though from here, without knowing your history I can’t make the call.

Please let me know if you have any questions. I am sorry that I can provide more help and support.

David Emerson

Hi Anne-

While I am sorry to read of your situation I have to say that you have thought through your indicators, options, etc. very well. I can’t offer any thinking that your doctor cannot offer. My only contribution is to add the experience of those women who have contributed to the blog post that you read.

D&C can be painful and can lead to side effects. If you or your doctor don’t know the result of this procedure it is difficult to promote the cost and problems that may occur as a result.(I too have a high-deductible health insurance plan) The risk of malignancy from a polyp is quite low and yes, it is frustrating if you are peri-menopausal and don’t fit the studies statistics.

The only therapy that I can offer is those antioxidant supplements that studies have shown shrink endometrial polyps- curcumin, green tea extract and vitamin D3. Regular consumption of these supplements have the benefit of reducing the risk of a host of cancers. I have taken each for years. If you are interested I can send the studies citing the anti polyp action and links to what I take.

I understand and agree with your comments about breast cancer biopsies. Yes, a case can be made for testing but a stronger case, in my humble opinion, can also be made for over-diagnosis and over-treatment. But that’s another blog post.

I am sorry I couldn’t offer more information.

Let me know if you have any questions. Thanks and hang in there.

David Emerson

1) “Doc recommends hysteroscopy/D&C removal, but can’t be sure whether this polyp is 1) actually what this little thing is, 2) actually causing symptoms, or 3) new or something that’s been there since my previous ultrasound…”

2) …send me down this expensive diagnostic path (I have a high deductible insurance plan, so I will pay every penny of this out of pocket).”

3) “I’m not pre-menopausal. I am not post-menopausal. It seems that nothing during perimenopause can be ruled out or ruled in without expensive diagnostics, and that none of the statistics quite apply to the perimenopausal woman.”

4) “thankful afterward to be pronounced cancer-free, but dismayed by the expense and the stress and the resulting scars and loss of sensation, and the general sense of “you should just be grateful.””

Your question “Not eager to go that road again but don’t want to foolishly ignore something that might be problematic. Anyone, any insight to share?”

I can relate as a 54 year old who had similar perimenopausal bleeding situation but have had no bleeding since October. my probable polyp, diagnosed feb 2021 is large (2cm). I canceled a couple of surgeries opting instead for “watch and wait” for now. I will do a 3rd ultrasound in 3 months. dr. says if all good can do another in 9 months. but I may opt for surgery in 3 months if anything is questionable. surgery is hard on the body and I’d like to avoid but the waiting is stressful.

Hi Sarah-

I’m not quite sure of everything you are saying in your cancer coaching email so I will have to make a few assumptions based on what I think you are saying…

1) your biopsy was negative for cancer
2) but your Dr. thinks that your bleeding may be caused by a uterine polyp?
3) You will undergo D and C procedure to remove the polyp?
4) I’m not sure about this one- you say that you have already had a biopsy that came back negative yet you are wondering if your uterine tissue can be be malignant? A negative biopsy means that you do not have cancer. My understanding of your email is that your biopsy is negative which means you to NOT have cancer.

But I will excerpt the study you were reading to try to put your mind at ease. A chance of any uterine polyp being malignant is 2.5%. Since you experienced some postmenopausal bleeding your risk increases to %3.67 but this is still a very low risk.

“”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

Thanks, Sarah and let me know if you have any questions.

David Emerson
Director PBC

Hi Juliana-

I am sorry to read of your health challenges and I wish I could shed some light onto you situation. However the situation you describe needs to be observed and diagnosed by a medical doctor. Let me know if you would like information about nutritional supplementation to eliminate endometrial polyps.

Thanks

David Emerson

Hi Maryam-

Great to read that you are trying to conceive. I am sorry to read of your Polycystic ovary syndrome. Your question “Please suggest if it would be a good option to go for the polyp removal keeping in mind that the polyp shrinked on its own” depends on your wishes. Meaning that it would appear that your polyp is disappearing on its own. Nutritional supplementation such as green tea extract could enhance the shrinking.

On the other hand, your thinking about trying to conceive may make it difficult for you to wait patiently while your endo polyp shrinks and disappears. When I’ve read comments from women trying to conceive only to discover an endo polyp, they often sound as if they can’t wait to cut out the polyps so they can hopefully conceive.

Does this make sense to you? I am 55 and after years of side effects from my cancer I believe that people should go under the knife only if they have to. Waiting to cure an endo polyp naturally makes sense to me. But then again, my son Alex is sixteen and my wife and I don’t want more kids.

That comment was meant to be a bit humorous but my comments never come across as being funny. Sorry. I’ve tried to present you with both sides of your decision and your answer depends on you priority.

If you are interested in more info about nutritional supplementation with studies to suggest therapies and dose to further reduce your endo polyp, let me know.

Let me know if you have any questions. Thanks and good luck.

David Emerson

Hi Reg-

I understand your concern and thanks for reaching out. Your questions are some of the most often asked on PBC. I will try to link the info below for you to think through your options to hopefully help your decision-making.

First things first. As stated in the study that you came in on, your risk of one of your polyps being malignant is less that 2.5% Less depending on your age, lifestyle, diet, etc.

To think through to have your polyps removed or wait and see, first, the studies’ statistics about your polyps are below. To help you shrink your polyps, I will link studies and info about supplements below.

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

Here is a blog post about uterine fibroids/ endo polyps that links to a study about green tea extract and UF/endo polyps-

Green Tea Extract shrink Fibroids

The brand, dose, etc. of green tea extract that I use and recommend.

Vitamin d and the risk of uterine fibroids.

This study is dry and full of medical jargon but it says that lower blood levels of vitamin D increase the risk of Uterine Fibroids. By supplementing with vitamin D you may either get rid of your fibroids or reduce the risk of a recurrence of getting fibroids.

If you are wondering how to check your blood levels of vitamin d you can get this tested or simply start supplementing with vitamin D. I take 2000 mg daily with the brand linked below. Increased blood levels of vitamin D will reduce your risk of several chronic diseases. Read the post about vitamin d’s health benefits to learn more.
Vitamin D3 health benefits

Inhibitory effect of curcumin on uterine leiomyoma cell proliferation.

Again, research study full of jargon but the bottom line is that curcumin “inhibits” uterine fibroid growth.

This is the brand and dose that I use and is most bioavailable (gets in your blood).

Curcumin health benefits

To summarize Reg, taking one capsule of green tea extract, vitamin d and curcumin with food daily will, according to the studies, should help your endometrial polyps shrink.

Please ask me questions if anything is unclear or if you are wondering about anything.

thanks

David Emerson

Hi Gayle-

Thanks for reaching out. Your questions, concerns are some of the most frequently asked questions I get on PBC. Yes, I have read that surgical removal of endo polyps is painful. And yes, they can return.

Ahhh, the first issue I have to acknowledge is that I understood a uterine polyp, an endometrial polyp and a fibroid to be basically the same thing. All caused by estrogen, all low risk of malignancy, problematic for sure but not life-threatening.

All the studies I will link below talk about natural therapies to either remove polyps/fibroids and or reduce the risk of relapse (polyps returning…). I take green tea extract, vitamin D3 and curcumin myself for a host of medical reasons, mostly to reduce the risk of my cancer relapsing.

To confirm the basic statistics from the previous study:

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

Here is a blog post about uterine fibroids/ endo polyps that links to a study about green tea extract and UF/endo polyps-

Green Tea Extract shrink Fibroids

The brand, dose, etc. of green tea extract that I use and recommend.

Vitamin d and the risk of uterine fibroids.

This study is dry and full of medical jargon but it says that lower blood levels of vitamin D increase the risk of Uterine Fibroids. By supplementing with vitamin D you may either get rid of your fibroids or reduce the risk of a recurrence of getting fibroids.

If you are wondering how to check your blood levels of vitamin d you can get this tested or simply start supplementing with vitamin D. I take 2000 mg daily with the brand linked below. Increased blood levels of vitamin D will reduce your risk of several chronic diseases. Read the post about vitamin d’s health benefits to learn more.
Vitamin D3 health benefits

Inhibitory effect of curcumin on uterine leiomyoma cell proliferation.

Again, research study full of jargon but the bottom line is that curcumin “inhibits” uterine fibroid growth.

This is the brand and dose that I use and is most bioavailable (gets in your blood).

Curcumin health benefits

To summarize, taking one capsule of green tea extract, vitamin d and curcumin with food daily will, according to the studies, should help your endometrial polyps shrink.

Please ask me questions if anything is unclear or if you are wondering about anything.

thanks

David Emerson

Hi Victoria-

I understand why you feel desperate however please understand recurring polyps are common. I don’t want to sound like I am minimizing your situation. I will give you choices based on studies below. I am not a doctor and cannot give advice. I am simply offering studies that can guide your thinking. Sorry for the long reply but I try to include studies to explain why I do what I do or to support recommendations.

Also, your current lifestyle, 5’6”, 124, (trim), active, exercise, are all good. Keep these up. Please do not have a hysterectomy.

As the endometrial polyps over-treatment article stated, if you are diagnosed with a polyp and do nothing,

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

I will assume that you understand conventional therapies to remove polyps aka polypectomy, etc.

Here is a blog post about uterine fibroids/ endo polyps that links to a study about green tea extract and UF-

Green Tea Extract shrink Fibroids
Vitamin d and the risk of uterine fibroids.

This study is dry and full of medical jargon but it says that lower blood levels of vitamin D increase the risk of Uterine Fibroids. By supplementing with vitamin D you may either get rid of your fibroids or reduce the risk of a recurrence of getting fibroids.

If you are wondering how to check your blood levels of vitamin d you can get this tested or simply start supplementing with vitamin D. I take 2000 mg daily with the brand linked below. Increased blood levels of vitamin D will reduce your risk of several chronic diseases. Read the post about vitamin d’s health benefits to learn more.

Vitamin D3 health benefits
nhibitory effect of curcumin on uterine leiomyoma cell proliferation.

Again, research study full of jargon but the bottom line is that curcumin “inhibits” uterine fibroid growth.

This is the brand and dose that I use and is most bioavailable (gets in your blood).
Curcumin health benefits

To summarize Victoria, taking one capsule of green tea extract, vitamin d and curcumin with food daily will, according to the studies, reduce the risk of a recurrence of uterine fibroids aka endometrial polyps. Again, according to those studies there are not side effects with this form of integrative or complementary therapy.

I hope I have answered your question “what are my choices.” Please ask me questions if anything is unclear or if you are wondering about anything.

thanks

David Emerson

Hi Jeanette-

I hope you are feeling okay.

My guess is that you are asking this question because you are anxious about your pathology report. The answer is up to your pathologist though it should not take too long. However I will say that according to the study you came in on, depending on your age, pre/post men. status, bleeding or not, there is approx. a 3.8% risk of your polyps being malignant.

Further if you are looking for information about evidence-based research into therapies to reduce the risk of relapse, please let me know.

I am sorry I couldn’t be more specific.

good luck

David Emerson

Hi Swethaven,

Your english is difficult for me to understand so I will try to confirm what you are asking. Okay?

You have been trying to get pregnant (excellent) for the past 4 years and you are wondering if everything is okay down there-

1) hystoscopy 3 months ago.
2) dhupaston
3) follicle scan showing one polyp-
4) endometrium is .38
And your question is
” was there any serice thing to worry ?is there a chane that poly will grow again and the chance of poly becoming cancerous?”

The study that you read about endo polyps being overtreated states that 1) the risk that a polyp is malignant (cancerous) is 2.5%. And 24.3% of the time polyps will grow.

Therefore, as the study indicates, the majority of the time, a polyp with stay the same, shrink or disappear. Lastly, while I cannot link the study for you, I’m pretty sure that I read a study saying that removing endometrial polyps INCREASES the chances of getting pregnant.

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

I hope I have answered your questions. Let me know if you need clarification about anything.

thanks and good luck!

David Emerson

Hi Elaine-
Your questions are on-point. However, as I understand it, they can’t be answered definitively. By this I mean that being post menopausal causes changes in your hormones but as you have identified your polyp is tiny and your lumpectomy was benign. Both endo polyps and fibrocystic changes are common.

The stats below are excerpted from the original study and indicate that your tiny polyp will either stay the same size or resolve. Thickening of the endo walls increase these risks but since you have no thickening you are doing well.

To answer your question “am I creating too much estrogen or something causing these things?” Though estrogen is the theory I have never found a study that proves that estrogen produces polyps.

The decision to remove the polyp is up to you however I think your dr. is offering good advice to watch and wait. If you are like me watching and waiting my be difficult. Therefore I can offer evidence-based, modest lifestyle therapies that increase the chances that your tiny polyp will resolve. Moderate regular exercise also may help.

Nutritional supplementation for endo polyps-

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

I hope this helps. Let me know if you have any questions.

David Emerson

Hi Naomi-

I understand that any surgery, anything like a uterine polyp can cause a person to be “scared to death.” As for “any insight to ease your mind” I can offer what is quoted in the article- the risk that your polyp is malignant is %2.5 which is reduced if you are postmenopausal. I will assume that you are pre menopausal. Lastly, though I can’t find the study now, I have read that removing polyps may help you conceive.

“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…”

Good luck.

David Emerson

Hi Rea-

I am excerpting the original article below. You have probably read the percentages but I thought I should cite them again. You know that you are the only one who can make this decision as it is your body. But since you asked my opinion I will offer it.

Based on the risks below, endo polyps will will stay the same or shrink about 75% of the time. Based on this, I would go with your radiologist and watch and wait. The studies I have read say that weight is associated with estrogen and polyps so, at the risk of annoying you I would also recommend exercising.

On a personal note, my own health issues spurred me to live a much healthier lifestyle. So this diagnosis my spur you as well.

Please let me know if you have any questions or comments. Thanks.

David Emerson

“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…

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

Hi JO-

I am sorry to learn of your polyp though I have to say everything you mention sounds pretty normal. This might not make you feel any better but both your situation and what your gyno recommended sounds good. What I mean by this is that in many cases a full hysterectomy may be too much. This procedure may create problems aka side effects years from now.
Surgical removal of the polyp may have the effect of returning your heavy menses to normal. As for the 3 month wait do you mean a 3 month wait for the surgical removal of the 18mm polyp? I am not a professional but the studies I have read indicate that the odds are that 1) the polyp will remain the same, or 2) shrink a bit. Your quality of life (heavy menses) will not change but the time shouldn’t be a problem otherwise.

So to answer your question “What are the chances of it growing anymore?” to quote the study

“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”

Number 4- the chances of the polyps growing are 24.3%-

Let me know if you have any questions.

Thanks

David Emerson

Hi Radhika-

If I read your post correctly you have been diagnosed with “multiple polyps.” You also have been experiencing menstrual bleeding that increased with regular sex? (“after my marriage…”). Further, you are young- 30 years old.

According to the study outlined in the original article about overtreatment of endo polyps:

1) “Malignant polyps represented 2.5% of the total sample” further 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,”

The risk of malignant polyps is low at 2.5%

2) I will try to link the study but it is my understanding that removal of endometrial polyps may help to become pregnant. Below is a list of therapies to get rid of endometrial polyps. Please discuss these therapies with your doctor.

Radiofrequency ablation – This technique delivers intense heat to destroy thickened or abnormal tissue inside the uterus. An electrode inserted into fibroid tumors or thickened areas melts tissue away.

High-frequency ultrasound – This method uses high-frequency ultrasound to destroy small fibroid tumors.

Myomectomy – A surgical procedure used to treat uterine fibroids. The uterus remains intact and only the fibroids are removed.

Intrauterine device (IUD) – Inserting an IUD within the uterus (similar to the birth-control device) laced with the hormone progesterone can reduce endometrial wall thickening and control excessive menstrual bleeding.

Loop electrosurgical excision procedure (LEEP) – A conservative procedure that preserves the uterus while removing abnormal cells in women with cervical cancer.

Hormonal therapy – Hormone pills, similar to birth control pills, or hormone injections can reduce pain, and excessive or irregular bleeding.

Anti-estrogen therapy – Hormone blockers given until natural menopause occurs can keep ovaries from producing estrogen, which can shrink fibroids.

Uterine artery embolization (UAE) – Usually performed by an interventional radiologist, this procedure cuts off the blood supply feeding fibroids. A catheter is threaded through a blood vessel in the groin to the area of the uterus. Eventually tissue fed by the zapped blood vessel dies and is reabsorbed.

Dilatation and vaginal curettage (D&C) – A procedure that resurfaces the uterine lining and may help to control excessive bleeding temporarily.

Pain Medications – Some non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, not only reduce painful cramps but can calm heavy bleeding.

Herbal and dietary supplements – Certain dietary supplements and teas may help relieve menstrual cramps and regulate blood flow. Cramp bark, derived from the viburnum plant can quell cramping; valerian root has a sedating effect that can relax the uterus; pycnogenol can reduce swelling and pain; and red raspberry leaf tea (rubus) can help keep the uterus muscle toned.

Radhka, please let me know if you have any question. I hope this info helps.

Thank you,

David Emerson

Hi Susan-

I’d like to research your specifics. I need to research polyp removal- by “risky” are you thinking of the spread caused by power morcellators? Again, I need to research this issue further. As for a biopsy, yes, I think this is a good idea. Biopsy-ing of all polyps makes sense but I will reply again to morrow. There is always a risk of polyps returning. And the risk of malignancy increases a bit with post menopausal women. I will reply again.
thanks and hang in there.

David Emerson

Hi Susan-

I’ve been researching the issues you ask about in your post and I will try to address each question:

1) “would it be risky for him to ‘cut it up’ to get it out if there happened to be cancer cells in it? Would they spread? Also: Should I request a biopsy? I’m thinking it might be difficult to get a biopsy of both polyps.”

As you can read from the first link below, fibroid tumors can grow as large as “20 cm.” While there may be long-term health issues with hysterectomy, I found no articles or studies talking about any problems associated with removing large polyps or masses. While the risk of malignancy is low, I think it is prudent to make sure your doctor examines the polyp for malignancy.

2) “Should I request a biopsy? I’m thinking it might be difficult to get a biopsy of both polyps.” I have been assuming that you want to remove your polyps one way or another so I’m not sure why you would be thinking about asking for a biopsy. If the masses are removed they will be examined.

Further, I have excerpted and linked discussion of what I read as your type of tumor- “submucosal, bleeding, etc.”

3) “He also said my endometrial lining was ‘sticky’ and I have several small fibroids in my uterus as well.”

Types of Fibroid Tumors

“Fibroid tumors may grow as a single nodule or in clusters and may range in size from 1 mm to more than 20 cm in diameter. Fibroid tumors are the most frequently diagnosed tumor of the female pelvis and the most common reason for a woman to have a hysterectomy. Although they are often referred to as tumors, they are not cancerous.”

“Submucous or Submucosal fibroids are found within uterine lining and can protrude into the uterine cavity. Generally, these are ones that can cause the most problems. Since they are located in the uterine endometrium, they can cause heavy prolonged bleeding during menstruation.”

Long-term Effects of Hysterectomy

4) “I’m concerned that if I don’t get the hysterectomy and the polyps return in a few years, I will most likely be post menopausal by then and I’ve read about the increased risk of those polyps being malignant after menopause.”

As you will read in the above link about possible long term negative side effects of hysterectomy, yes, there are possible problems with a hysterectomy. Also, yes, there is a possibility of polyps returning if you don’t have a hysterectomy. While, according to the research in the original linked study, the risk of malignancy increases slightly with post-menopausal women, the increase is slight.

Is your main concern with long-term problems from a hysterectomy or possible cancer from polyps? I have no experience with this form of polyp removal but I thought would pass along the site to you-

http://www.uterine-fibroids.org/

http://www.uterine-fibroids.org/Debbie.html

thanks and let me know if you have any questions.

David Emerson

Hi Joanna-
Your situation seems to be pretty complicated but I will try to link and excerpt studies that address your questions as well as possible. My understanding is as follows:
1) Good to read that the 1 cm polyp was removed, non cancerous and your periods returned to normal.
2) At 46, you are young from an endometrial polyp standpoint.
3) my understanding is that yes, endo polyps can complicate getting pregnant. I will link supporting studies below.

As many of these sites document, endo polyps can complicate getting pregnant-

However, as is discussed in this link, pregnancy outcomes improve with endo polyp removal- click and read this study–

“Women in the study group had a better possibility of becoming pregnant after polypectomy, with a relative risk of 2.1 (95% confidence interval 1.5–2.9). Pregnancies in the study group were obtained before the first IUI in 65% of cases. CONCLUSIONS: These data suggest that hysteroscopic polypectomy before IUI is an effective measure.”

Lastly Joanna, your childbearing history is event filled (congrats on the three kids-BTW and I am sorry to read of your miscarriages)- I don’t think any study can exactly cover all the intricacies of your situation. However, the single most important issue cited by studies is that endo polyp removal improves pregnancy rates.

I hope I have addressed all of your questions or concerns. Let me know if you have any questions.

Thanks and hang in there.

David Emerson

Hi Clate-
Thank you for reaching out to PBC. I will try to address each of your question/concerns-

1) “Here is a problem, i am also on contraceptive pill for cysts, i had ovarian cyst removed early this year.” Yes, oral contraception pills are one form of therapy for ovarian cysts.

2) “Here is a problem, i am on holiday at the moment, and on the active pills(the homone ones)at the moment, but i start having light bleeding 6 days ago…….could it caused by polyp?”

To confirm, you were diagnosed with an endometrial polyp for which you will have surgery on June 5th. You are taking contraceptive pills for your ovarian cysts. While on holiday, you are experiencing light bleeding. You are wondering if the light bleeding could be caused by the endometrial polyp?

Yes, endometrial polyps can cause bleeding.

“Cause and symptoms
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″

3)”Should i be concerned ? how long this bleed can last or when should i be concern ? I am oversea at the moment…”

Depending on your age, weight and how long you will be on holiday, the articles and studies linked do NOT raise concern for light bleeding. As the original article/study states, the majority of endo polyps resolve on their own. Since you have been through something similar, when you return from holiday I would go see the same physician who worked with you on your uterine polyps.

Let me know if you have any questions.

thanks

David Emerson

Hi Roxana-
Normally I begin these responses by saying that I am sorry that the person has been diagnosed with such and such but your post reads as if you did everything possible for someone with a diagnosis of a uterine polyp. You have made all the right decisions. I know of no studies of precancerous polyps sprouting more polyps that are cancerous. While a person can get another polyp after D&C removal, I have never read a study that cites an increased risk of malignancy AFTER polyp removal.
I believe the point of the D and C that you underwent is to remove any chance of cancer. Yes, there is always a chance of another polyp in the future, non, pre or cancerous but I believe that you are correct in wanting to take a wait and see approach.

I understand that it is difficult to not do what a doctor “insists” on but you are the patient and it is your body. I am not qualified to tell you what to do. I am simply saying that your reasoning sounds correct to me. Based on the original “overtreatment” article in addition to the article linked below, there are small chances of premalignant polyps (1.6%) and malignant polyps (2.5%) but as you say, you had the pre malignant polyp removed.

You are young (52) and this reduces your risks of malignant polyps further. The decision to have a hysterectomy is yours. I wish I could find a study that talks about cancerous polyps after D and C but I can’t find any.

Risk of Malignancy in Endometrial Polyps in Premenopausal and Postmenopausal Women According to Clinicopathologic Characteristics

“Women were diagnosed with benign lesions in 95.8% of cases. Premalignant polyps accounted for 1.6% of the total number of cases. 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.”

I hope this reply has helped. Please ask any more questions that you may have.

thanks

David Emerson

Hi Caroline-
Your post is well-written and your thinking is logical- right off the bat you sound like you are handling your situation well. I don’t mean to sound silly but you really do sound on top of your situation. I will try to address your questions one at a time. Let me know if I miss something.

1) “Am I right in thinking it is very unlikely to be cancerous?” Yes, very unlikely. 2.5% chance. You have a small risk of malignancy. You are young, pre-menopausal with a diagnosis of a “small endo polyp.” All good. To quote the study-
“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…”

2) “And is my best option to have it removed?” Of course this is up to you. I wrote the blog post based on the study saying that endo polyps where over-treated. My advice is to take it one test at a time. In other words, talk to your doc and see how often you can get tested, see how your “small endo polyp” goes. The odds are that your polyp will remain the same, shrink or disappear.

“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”

As for your weight, yes, according to the study, endo polyps may be triggered by estrogen. Losing weight reduces estrogen. At least while you are concerned about your polyp working a bit to help your body shrink it or resolve it will make you feel better I think.

I hope this helps. Let me know what your doc tells you.

Hang in there.

David Emerson

Hi Priya-
I will try to address your question ” is it foolish of me to even consider taking a non-surgical stance?” by outlining the findings of the article about endo polyps.
First and foremost, at 41 you are not menopausal. This is good as menopausal has a 4 fold higher likelihood of a malignant polyps.

“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…”

Secondly, yes, you mention “excessive bleeding” but again, the article mentions “postmenopausal bleeding” as a potential risk factor.
““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…”

Finally, with regard to “taking a non surgical stance” as you say, by watching and waiting, the majority of the time, the polyps shrink or remain stable.

“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”

Having said all that, the decision comes down to what you feel most comfortable with. Yes, I would encourage you to exercise modestly and lose some weight but I would say that regardless. In other words, I am a cancer survivor myself and I read studies all the time about how lifestyle and nutrition can lower risk of cancer or cancer relapse.

If you would like to pursue taking steps to reduce your risks of cancer (your father’s side of the family) I will email studies and articles about specifics that may help you. But again, it is up to you. I don’t want to overwhelm you any more than you are.
Lastly, you can take a watch and wait approach slowly- meaning a few months at a time. Re assess your thinking after you see your doctor again in a few months.

Let me know what you think or if you have any questions.

David Emerson

Hi Jacqui-

I have one adolescent son and I can only imagine how rewarding it must be to have raised 3 children. Congrats.

Based on your post and your question, it seems as though you understand your body and endo polyps pretty well. While I am not qualified to give you a medical diagnosis to your questions:

1) yes, according to the study, estrogen may be a cause of polyps
2) your second question sounds as if you would prefer to wait for a few months rather than surgery. As the study’s results excerpted below indicate, the odds are that polyps either resolve on their own, remain the same or shrink. Exercise and diet may help this.
Further, you are pre-menopause and as you say, bleeding is slight. I have not read that a third recurrence of polyps increases the risk of cancer.

“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”

If you have any other questions don’t hesitate to reply. Thanks and good luck.

David Emerson

Hi Vasu-

Before we discuss possible therapies for endo polyps, we should confirm the basic issues discussed in the article you read about possible overtreatment of endo polyps.

If you have been diagnosed with endo polyps the first things to think about 1) if you are pre or post menopause as this affects your polyps risk of malignancy and 2) have you experienced bleeding? This also affects the risk of malignancy.

I have excerpted that part of the blog post which discusses specific percentage.

“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”

To answer your question about anti endo polyp nutrition, the only site that I found that discusses endo nutrition simply talks about estrogen and a healthy balanced diet.

http://www.livestrong.com/article/471313-uterine-polyps-and-a-healthy-diet/

Rather than approaching endo polyps from a nutritional standpoint, the link below will take you to sites about anti endo herbs. I cannot vouch for the efficacy of this info as I have no experience with anti endo polyps herbs.

https://search.yahoo.com/yhs/search;_ylt=A0LEV7.XZAxVvDEAnbAnnIlQ?p=herbs+for+endometrial+polyps+removal&ei=UTF-8&hsimp=yhs-002&hspart=mozilla&b=1

What I am saying is that I could not find much about nutritional solutions to endo polyps. Let me know if you have any other questions.

thanks

David Emerson

Hi Kathleen-

My guess is that you are thinking though your endo issues- you ask questions in your other two posts but not this post. Let me know if you have other questions. I will address the other post now.
thanks
David

Hi Kathleen-
If I understand this post, you are asking for non-invasive or “natural” therapies for removing endo polyps? You seem to have a good understanding of Dr. Hartman’s study of polyps- yes, while the study documents the percentage of endo polyps that either shrink, resolve or remain the same, Dr. Hartman’s study does not cite what, if any, polyps become malignant.
There are drug therapies listed in the article though my guess is that you don’t want to pursue drugs to shrink your polyps.

Reading through some of these sites about herbal remedies for endo polyps makes me nervous in that there is little if any evidence-based research or documentation. I wish I could offer better info… let me know if you have any questions.

https://search.yahoo.com/yhs/search;_ylt=A0LEV7.XZAxVvDEAnbAnnIlQ?p=herbs+for+endometrial+polyps+removal&ei=UTF-8&hsimp=yhs-002&hspart=mozilla&b=1

David Emerson

Jessica-

Thanks for posting. I will email you directly.

Thanks

David Emerson

Hi Yahaira-

I will spell out your questions as I understand them. Let me know if I misunderstand something.

1) What is “d&C?” What are possible side effects?

http://en.wikipedia.org/wiki/Dilation_and_curettage

2) Age at diagnosis?
Yes, the article linked below does say that younger women have less chance of polyp malignancy.

“Because of the low prevalence rate of malignancy in asymptomatic young women with no risk factors, routine removal of the lesions might be avoided because of its lack of cost-effectiveness. ”

http://www.medscape.com/viewarticle/754861_6

3) Size of polyps and how they relate to your health?

I can’t find any studies that say anything about the size of endo polyps beyond saying that polyps do vary in size, some shrink and some grow.

“Endometrial polyps are usually benign although some may be precancerous or cancerous.[2] About 0.5% of endometrial polyps contain adenocarcinoma cells.[10] ”

Let me know if you have any other questions.

David Emerson

Comments from Margaret-

I have had three d&c’s/ with hysteroscopes-1 every year at the same time for a or I believe recurring polyp.

I am a nurse myself and work in the operating room-have for 48 years.

As to my experience as to note attached of woman in her 30’s, I feel are different. My research on the polyp occurrence took in my age, size-pudgy so careful to watch such as it heightens estrogen and thus that the higher incidence of polyps.

Though two different Drs did my 3 procedures, which included a hysteroscopy, I feel certain neither fully excised the polyp completely the first two times. I hope that is so, as if this thing comes back a fourth time I will be having a hysterectomy.

Goodluck!

Hi Yahaira,

How are doing now ? What was your treatment ? I also have been diagnosed with EP. Going in for surgery soon.

Thanks
Vasu

Hi Bee-
Wonderful to read that you and your husband are trying to conceive. While the article focuses on endometrial polyps not uternine, being peri menopausal lowers your already very low risk of the polyps being cancerous.

Now then, as for your question “will removing it increase my chances of getting pregnant?” An excerpt from the Mayo Clinic site on the subject may be of interest-
“Complications
By Mayo Clinic Staff

Uterine polyps may be associated with infertility. If you have uterine polyps and you experience infertility, removal of the polyps might allow you to become pregnant.

Uterine polyps also may present an increased risk of miscarriage in women who undergo in vitro fertilization (IVF). If you’re considering IVF treatment and you have uterine polyps, your doctor may recommend polyp removal before embryo transfer. ”

http://www.mayoclinic.org/diseases-conditions/uterine-polyps/basics/complications/con-20027472

According to the article-
“Prognosis and complications
Endometrial polyps are usually benign although some may be precancerous or cancerous.[2] About 0.5% of endometrial polyps contain adenocarcinoma cells.[9] Polyps can increase the risk of miscarriage in women undergoing IVF treatment.[2] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant.[2] Although treatments such as hysteroscopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent.[6] Untreated, small polyps may regress on their own.[10]”

Hope this helps. Good luck and let me know if you have any more questions. Thanks

David Emerson

Hi BC survivor-

I am sorry to read of your breast cancer diagnosis however it sounds as though you are doing well. I have excerpted several paragraphs from studies that I think speak to your question “due to the tamoxifen is there any chance of the polyp being benign?”

If I understand the studies, the polyp is likely to be benign and a small risk that the polyp is cancerous. I would proceed with both your MRI and a biopsy.

Let me know if you have any questions or concerns. Good luck- David Emerson

“Uterine sarcomas consisting of leiomyosarcoma, carcinosarcoma, high-grade endometrial stromal sarcoma, adenosarcoma, and sarcoma not otherwise specified, are rare and estimated to comprise 8% of all invasive uterine cancer cases (8). In a review of all National Surgical Adjuvant Breast and Bowel Project breast cancer treatment trials, the rate of sarcoma in women treated with tamoxifen was 17 per 100,000 patient years versus none in the placebo group (7).”

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Tamoxifen-and-Uterine-Cancer

“In standard dosages, tamoxifen may be associated with endometrial proliferation, hyperplasia, polyp formation, invasive carcinoma, and uterine sarcoma.

Most studies have found that the increased relative risk of developing endometrial cancer for women taking tamoxifen is two to three times higher than that of an age-matched population (1–3). The level of risk of endometrial cancer in women treated with tamoxifen is dose and time dependent. Studies suggest that the stage, grade, histology, and biology of tumors that develop in individuals treated with tamoxifen (20 mg/d) are no different from those that arise in the general population (3, 4). However, some reports have indicated that women treated with a higher dosage of tamoxifen (40 mg/d) are more prone to develop more biologically aggressive tumors (5).”
“Gibson et al [19] recently reported the results of a retrospective review of endometrial pathology found at dilatation and curettage (D&C) performed in 240 breast cancer patients. Seventy-five (31%) of these patients had received tamoxifen, 20 mg/day, for a mean duration of 26 months as therapy for their breast cancer. Patients in this study were stratified as symptomatic (abnormal bleeding) or asymptomatic (curettage performed as part of another procedure or due to the presence of a thickened endometrial stripe on ultrasound examination).

Among tamoxifen users who were symptomatic at the time of D&C, the incidence of endometrial polyps was 15%; hyperplasia, 2%; and adenocarcinoma, 11%; compared with an incidence of 13%, 4%, and 11%, respectively, for nonusers. Among asympto- matic patients receiving tamoxifen, the incidence of polyps, hyperplasia, and adenocarcinoma was 9%, 0%, and 0%, while nonusers had an incidence of 5%, 4%, and 0%, respectively. All of the cases of endometrial carcinoma were associated with abnormal vaginal bleeding. The 11% incidence of endometrial carcinoma in this study was comparable to what has been reported for all patients presenting with postmenopausal bleeding in the general population [20].

The mean duration of tamoxifen use in those patients found to have adenocarcinoma was 44 months, compared with 18 months in those patients with polyps, and 19 months in the patient with hyperplasia. This difference was not statistically significant, possibly due to small numbers. The authors concluded that short-term tamoxifen use at the 20 mg/day dosage level was not associated with a higher incidence of abnormal pathology, as detected at the time of D&C in breast cancer patients.”

– See more at: http://www.cancernetwork.com/oncology-journal/effect-tamoxifen-endometrium#sthash.C1oysaCn.dpuf

According to the article “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. The women ranged in age from 22 to 78 years. Factors considered in this analysis were location of polyp, time interval between studies, menopausal status, abnormal bleeding, blood flow, endometrial thickness, and patient age.

You are post menopausal but what is the location of you “likely polyp,” bleeding, if any, endometrial thickness and age? Based on these answers you can use the article above to decide to treat or to watch and wait.

David

Hi Gee-
I don’t mean to sound wishy-washy but everything has risks and benefits. I don’t believe that doctors purposely mislead. I think that recommendations are all based on percentage risks. The article outlines the risks so you have access to some basic information. Consider asking the doctor who wants to do fertility tests what the possible outcomes will be with and without the testing. I have always found drs to be hardworking clinicians but asking the right question helps both dr. and patient to understand the risks and benefits of any procedure. Let me know if you have any other questions. Thanks. David

Hi Gee-

thanks for posting to my blog about endometrial polyp over-diagnosis.

thanks

David Emerson

I am 64 yrs. old and have breast cancer. I am treating the cancer naturally and have made progress. I recently had a transvaginal ultrasound and the report said I had a 2.6 cm cyst on my ovary and polyp or polyps in my uterus. Right now I chose to try castor oil packs, flaxseed with warm water on an empty stomach and epsom salts bath with a drop or two of pure lavender to shrink it do away with the cyst and polyps. I am going to repeat the ultrasound the end of November and see if there are any changes. I am on a clean diet, take supplements and exercise. I don’t want surgery or a hysteroscopy. I would like to treat naturally. Any suggestions? Thanks.

Hi Margaret- thanks for posting to my blog about endometrial polyp over-diagnosis.

thanks

David Emerson

My name is Vanessa. I am sure I have these polyps. I have passed two over the course of the last year. The bleeding in-between periods have increased to the point where I am losing so much blood every month I am now anemic. I am consistently tired and weak. My hormone’s are up and down so much I feel bipolar most of the time. I do not have access to health insurance and have been told by a gynecologist that it is probably a sign of premenopaus but as I started looking into this more, I have found that it could be a sign of cancer. I am 32 years old but early menopause runs in my family, usually triggered by a hysterectomy but typical women in my family will enter in their 30’s without the hysterectomy. Multiple types.of female cancer also runs in my family, All the women on my mothers side has has some form of cancer that invaded their reproductive systems. My question has two parts, the first being does the fact female cancers run in my famil, do I have a much higher risk of my polyps being cancerous than a regular woman and if so, since I am done having children, should I just get a hysterectomy?? Or should I just have a hysterectomy to help even out my hormones? I don’t know what to do or the cost associated with any procedures.

Hello! My name is Veronica and my doctor told me I had a polyp because I was complaining about spotting during/after intercourse. I want to know if I should get the D&C or try and let it dissolve on its own. Or by chance could it be something else because she really didn’t really get into it. Just told me I had a polyp and to get it removed, no information that would be helpful whatsoever

Hi. I’m 43 years old. A year ago at inspection at me have found out a polyp endometrium 6.3mm one. At the same time nothing disturbed me.I have not experienced bleeding. The doctor offered to remove. But I refused. And every 3 months was examined. Yesterday, at the next examination the doctor found 3 polyps, the largest of which is the size of 2mm. My question is: how one polyp of 6.3 mm could turn into three small? And whether it is necessary remove these polyps? Are the chances of endometrial polyps becoming cancer?

Margaret, I too had high estrogen levels. I have cut out most chemicals that we’re surrounded with (shampoo, soap, makeup, cleaning supplies). I make my own laundry soap, use vinegar for the rinse instead of fabric softener (w/3 wool balls in the dryer), use glycerin bar soap for the shower, and healthy hand soap. I also apply Progessence Essential Oil to my neck 3x/wk. I had applied it nightly for 4 months before my polyp was removed. I noticed a huge difference in my estrogen level as my breasts used to be dense and they weren’t after a month of doing this nightly. I will continue keeping the chemicals as much as I can out of my life, and so out of my system. Read up on it.