Most endometrial polyps represent focal, accentuated, benign hyperplastic processes. Their histologic architecture is charac-teristic and may commonly be found in association with other types of endometrial hyperplasia or even carcinoma.
Polyps occur most frequently in perimenopausal or imme-diately postmenopausal women, when ovarian function is characterized by persistent estrogen production due to chronic anovulation. The most common presenting symp-tom is abnormal bleeding. Small polyps may often be inci-dentally found as part of endometrial sampling or curettage done for evaluating AUB. Rarely, a large polyp may begin to protrude through the cervical canal. Such cases present with bleeding irregularities, and low, dull, midline pain, as the cervix is slowly dilated and effaced. In these cases, surgical removal is necessary to reduce the amount of bleeding and to prevent infection developing within the exposed endometrial surface. Less than 5% of polyps showmalignant change, and when they do, they may represent anyendometrial histologic variant. Polyps in postmenopausal women or women taking tamoxifen are more likely to be associated with endometrial carcinoma than those found in reproductive-age women.