Impact of Progesterone Therapy on Treatment Outcomes and Recurrence After Hysteroscopic Polypectomy

One of the concerns after transcervical resection of endometrial polyps (TCRP) is the recurrence of polyps post-surgery. Some studies have shown that hormone therapy with progesterone may reduce the risk of recurrence. This clinical trial aimed to investigate the effect of progesterone treatment after hysteroscopic polypectomy.

In this clinical trial, 40 patients diagnosed with endometrial polyps were randomly and equally assigned to two groups: intervention and control. TCRP surgery was performed for both groups. In the intervention group, medroxyprogesterone was administered one week after surgery at a dose of 10 mg twice daily from the 5th day of the menstrual cycle for 21 days, over four cycles. The recurrence rate at 3 and 6 months post-surgery, endometrial thickness, hemoglobin levels, and menstrual status before and six months after surgery were compared between the two groups.

None of the patients had a recurrence of endometrial polyps in the first three months, while three patients in the control group had a recurrence six months post-surgery (Relative Risk (RR) = 7.0, CI: 0.38-12.73). Regarding menstrual disorders, one patient in the control group had a menstrual disorder in the first three months (RR = 3.0, CI: 0.12-69.51), while six months post-surgery, 11 patients in the control group and one patient in the intervention group had menstrual disorders (RR = 11.55, CI: 1.63-81.45). Endometrial thickness six months post-surgery was significantly lower in the intervention group (5.5 ± 1.2 mm vs. 8.0 ± 2.5 mm, P = 0.001). The mean hemoglobin level six months post-surgery was higher in the intervention group, but it was not statistically significant.

Progesterone administration after TCRP surgery may be effective due to improved menstrual status, reduced endometrial thickness, and possibly lower recurrence rates of endometrial polyps.