Growth of an endometrial polyp in a postmenopausal patient using raloxifene

Abstract

Objective To describe the association of raloxifene use with the development of an endometrial polyp in a postmenopausal patient. Design Case report study. Results Hysterosonography and hysteroscopy showed the occurrence of an endometrial polyp in a postmenopausal patient who had been using raloxifene for 8 months. Pathological investigation showed the presence of simple hyperplasia in the polyp. Oestrogen receptors were present in both the polyp and the atrophic endometrium. Progesterone receptors, on the other hand, were detected mainly in the atrophic endometrium. There was a focal p53 overexpression in the glandular epithelium of the polyp. Conclusion Raloxifene stimulated the development of an endometrial polyp in this postmenopausal patient. The presence of progesterone receptors in the atrophic endometrium suggests an agonistic action of raloxifene on this tissue.

Gynecologic and hormonal effects of raloxifene in premenopausal women

“…The resulting elevated E 2 and P levels may contribute to myoma growth, endometrial hyperplasia, and cancer (10-13). In postmenopausal women, several studies have shown that raloxifene does not stimulate the endometrium (14-18); however, endometrial hyperplasia and endometrial polyps were reported after raloxifene use in three postmenopausal women (19,20).Few data are available regarding the gynecological effects of raloxifene in premenopausal women. In one small, shortterm study by Baker et al (21), endometrial biopsies in the follicular phase of the menstrual cycle showed a decrease in gland mitosis compared with baseline, indicating that raloxifene may not stimulate the endometrium of premenopausal women.…”

“…The resulting elevated E 2 and P levels may contribute to myoma growth, endometrial hyperplasia, and cancer (10-13). In postmenopausal women, several studies have shown that raloxifene does not stimulate the endometrium (14-18); however, endometrial hyperplasia and endometrial polyps were reported after raloxifene use in three postmenopausal women (19,20).…”