When Should Endometrial Polyps Be Treated?

Endometrial polyps are localized intrauterine overgrowths of endometrial glands and stroma covered by a surface epithelium. They occur singularly or in multiples, may be sessile or pedunculated, and range from a few millimeters to several centimeters in size. They are common, present in 7.8%–41% of women. Their detection has increased with the advent of high-resolution transvaginal sonography, saline-infusion ultrasonography, and hysteroscopy. Polyps are encountered in both premenopausal and postmenopausal women. Many women are asymptomatic, while others present with abnormal bleeding patterns. Most polyps are benign, but hyperplastic and malignant polyps also may occur. Appropriate management of endometrial polyps includes observation, medication, and surgery. Treatment of these lesions should be tailored to each patient based on their symptoms, menopausal status, risk of malignancy, and fertility desires.