Impact of Short-Term Estrogen Therapy on Endometrial Polyps Recurrence in Women with Intrauterine Adhesion and...

To investigate whether short-term postoperative estrogen-related therapy is associated with recurrence of intrauterine adhesions (IUA), endometrial polyps (EPs), and pregnancy outcomes in women with concomitant IUA and EPs.

This single-center retrospective cohort study included women (18-45 years) diagnosed with both IUA and EPs who underwent concurrent hysteroscopic transcervical resection of adhesions (TCRA) and polypectomy from January 2019 to June 2024. Patients were grouped by postoperative regimen: (1) estradiol-dydrogesterone sequential therapy (Femoston; estradiol 2 mg/dydrogesterone 10 mg; 2-3 months), (2) combined oral contraceptive (Yaz; ethinylestradiol 0.02 mg/drospirenone 3 mg; 3 months), or (3) no hormonal therapy. Recurrence was confirmed by transvaginal ultrasound and/or hysteroscopy.

A total of 166 women were included (sequential therapy, n=47; COC, n=32; no hormone, n=87). Baseline polyp multiplicity differed among groups (P=0.003), with a higher proportion of multiple EPs in the COC group. Postoperative IUD/balloon placement also differed among groups (P=0.012). Overall recurrence rates were 6.6% for IUA and 4.8% for EPs. No statistically significant differences were observed among groups in postoperative menstrual changes, recurrence rates, time to recurrence, or pregnancy outcomes (all P>0.05). Follow-up duration did not differ significantly among groups.

In this retrospective cohort, no statistically significant differences were observed among short-term sequential estrogen-progestin therapy, COC use, and no hormonal therapy with respect to IUA recurrence, EP recurrence, or pregnancy outcomes. Short-term estradiol-dydrogesterone therapy was not associated with increased EP recurrence in women with IUA and a single EP. These findings are observational and should be confirmed in prospective studies.