Objective To observe the effect of mirena combined with oral progesterone on postoperative sex hormones and recurrence rate in patients with endometrial polyps. Methods: 100 patients with endometrial polyps admitted to our hospital from January 2023 to January 2024 were selected as the research subjects. The patients were divided into the control group and the observation group by random number table method, with 50 cases in each group. The control group was treated with oral dydrogesterone, while the observation group was combined with Mirena on the basis of the control group. The menstrual indicators (menstrual volume, menstrual cycle), endometrial thickness, sex hormones [luteinizing hormone (LH), estradiol (E2) and follicle-stimulating hormone (FSH)], adverse reactions and recurrence of the two groups were analyzed and compared. Results: After treatment, the menstrual volume, menstrual cycle and endometrial thickness of both groups were significantly lower than those before treatment, and the menstrual volume, menstrual cycle and endometrial thickness of the observation group were significantly lower than those of the control group (P < 0.05). After treatment, there were no significant differences in the levels of LH, FSH and E2 between the two groups compared with those before treatment, and there were no significant differences between the groups (P > 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). The postoperative recurrence rate of the observation group was significantly lower than that of the control group (P < 0.05). Conclusion: Oral progesterone combined with mirena iUD after endometrial polyp surgery can improve the menstrual disorder symptoms of patients, inhibit endometrial hyperplasia, reduce the risk of polyp recurrence, and has high safety.