Subcutaneous Progesterone for Endometrial Polyps in Premenopausal Women: A Preliminary Retrospective Analysis

Abstract

Study objective: To investigate the effects of 3 cycles of subcutaneous progesterone administered during the luteal phase on the regression rate of symptomatic and asymptomatic endometrial polyps in premenopausal woman.

Design: A retrospective study (Canadian Task Force classification II-2).

Setting: A department of obstetrics and gynecology in a university hospital.

Patients: One hundred twenty-seven reproductive-aged women presented with endometrial polyps from January to December 2016.

Interventions: A retrospective comparison of patients treated with subcutaneous progesterone and those managed by the "wait and see" approach.

Measurements and main results: Patients were divided into 2 groups: the group treated with subcutaneous progesterone (cases) and the wait and see group (controls). Women in the treatment group were administered 25 mg subcutaneous progesterone during the luteal phase for 7 days for 3 months. The wait and see group included patients refusing progesterone therapy who were reevaluated 3 menstrual cycles after the transvaginal sonographic diagnosis. Both the treatment group (n = 61) and the wait and see group (n = 32) were evaluated with a follow-up ultrasound examination after 3 months. The regression rate of endometrial polyps in women treated with subcutaneous progesterone was compared with the wait and see patients. The regression in the number and/or dimensions of the polyps was greater in the treatment group than the control group. The regression rate was 47.5% and 12.5%, respectively (p < .001).

Conclusion: Progesterone appears to be a valid therapeutic alternative for the management of endometrial polyps. A prospective, randomized study is ongoing at our institution to further validate these findings.

Keywords: Hysteroscopy; Polyps; Therapeutic strategies; Ultrasound; Wait and see approach.