ENDOMETRIAL POLYPS IN POST-MENOPAUSAL WOMEN: A REVIEW OF PATHOGENESIS, MALIGNANCY RISK, EVIDENCE-BASED MANAGEMENT STRATEGIES AND PREVENTION

Endometrial polyps are frequent intrauterine lesions with considerable clinical importance. This is especially true for postmenopausal women, who face an increased chance of premalignant and malignant changes. This systematic review combines the evidence of 12 major studies, including meta-analyses, observational cohorts, molecular studies, and international guidelines. It assesses the pathogenesis, risk of malignancy, management, and prevention of endometrial polyps. The results show that hormonal effects, molecular changes (such as PTEN and KRAS), and metabolic risk factors contribute to polyp development and malignancy potential. Among postmenopausal women, the risk of malignancy is 5 %. Key predictors include obesity, age, and exposure to tamoxifen. The gold standard treatment is hysteroscopic polypectomy, which is highly effective and has a low recurrence rate. Levonorgestrel intrauterine systems can be used as an adjunct to these high-efficacy treatments. Prevention includes metabolic risk reduction, hormonal therapy, and monitoring. The results highlight the need for individualized, evidence-based methods in the diagnosis, management, and long-term prevention for postmenopausal women.