Can Uterine Polyps Develop in Just Three Days? A Gynecological Inquiry

Can polyps suddenly develop in the uterus after three days? Is a hysteroscopy necessary?

Hello, I started my menstrual bleeding on September 5th.
For the first 3-4 days, the bleeding was not at a normal volume, but then it returned to normal until September 18th.
After two weeks, I went to the clinic for an abdominal ultrasound, which showed normal structures but a thickened endometrium.
I was given a three-day course of hemostatic medication, but I continued to bleed after finishing it.
As of September 22nd, the bleeding has decreased.
After another abdominal ultrasound at the hospital, a polyp was identified (though it was also suggested it could be a blood clot).
I was prescribed Provera and after returning home, I only had a faint red discharge left.
Is it possible that the polyp developed in the three days since my last ultrasound? The doctor asked if I had experienced similar issues in previous cycles, and I replied that I have occasional irregularities every 2-3 months.
The doctor prescribed Provera and advised me to monitor my condition for 2-3 more cycles before deciding on surgery.
However, I have not had many irregularities in the past three years, and I lack experience with transvaginal ultrasounds.
Should I consider immediate polyp removal and biopsy? Currently, my menstrual bleeding is minimal; is it advisable to stop taking Provera? Thank you!

Xin, 30~39 year old female. Ask Date: 2023/09/23

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Please take the medication as prescribed and trust your attending physician.
If you have any concerns, please return for a consultation.
Thank you.

Reply Date: 2023/09/23

More Info

Uterine polyps are growths that occur on the inner lining of the uterus (endometrium) and can vary in size. They are often benign (non-cancerous) but can sometimes lead to complications such as abnormal bleeding or infertility. Your inquiry about whether uterine polyps can develop in just three days is quite pertinent, especially given your recent experiences with menstrual irregularities and ultrasound findings.

To address your question directly: it is highly unlikely that a uterine polyp could develop in just three days. Polyps typically take time to grow, often developing over weeks or months. The appearance of a polyp on an ultrasound after a short period of time may suggest that it was already present but not detected earlier, or it could be a different type of abnormality, such as a blood clot or a thickened endometrial lining, which can also appear similar on imaging studies.

In your case, the timeline of your menstrual cycle and the ultrasound findings suggest that you may be experiencing a combination of hormonal fluctuations and possible endometrial changes. The thickened endometrium you mentioned could be a result of hormonal influences, particularly if you have had irregular cycles. The use of medications like Provera (medroxyprogesterone acetate) is often prescribed to help regulate the menstrual cycle and manage abnormal bleeding. It can help to shed the thickened endometrial lining, which may alleviate some of your symptoms.

Regarding your question about whether to proceed with polyp removal or to continue with Provera, it is essential to consider a few factors:
1. Observation Period: Your doctor has suggested observing your condition for a few more cycles. This is a reasonable approach, especially if your symptoms are improving and the bleeding is decreasing. Monitoring can help determine if the polyp is causing significant issues or if it resolves on its own.

2. Symptoms: If you continue to experience abnormal bleeding, pain, or other concerning symptoms, it may warrant further investigation, including a possible hysteroscopy to visualize the uterine cavity directly and remove any polyps.

3. Medical History: Given your history of irregular cycles and the recent ultrasound findings, it is crucial to maintain open communication with your healthcare provider. They can provide personalized advice based on your overall health, menstrual history, and any other relevant factors.

4. Decision on Medication: If your menstrual flow has significantly decreased and you are feeling better, you might discuss with your doctor the possibility of discontinuing Provera. However, this decision should be made in consultation with your healthcare provider, who can assess your specific situation.

In summary, while uterine polyps are a concern that should be monitored, their rapid development in just a few days is unlikely. It is essential to follow your doctor's recommendations, keep track of your symptoms, and consider further evaluation if necessary. Regular follow-ups and open discussions with your healthcare provider will be key in managing your gynecological health effectively.

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