Uterine Polyps

Overview

Uterine polyps are growths that develop from the inner lining of the uterus, called the endometrium. They are also known as endometrial polyps. These growths are usually attached to the uterine wall by a small stalk or a broad base and can vary in size. A person may have one polyp or several.

Most uterine polyps are non-cancerous. However, some may contain abnormal cells, and rarely, a polyp may be linked to cancer. For this reason, medical evaluation is important, especially when abnormal bleeding occurs. Uterine polyps can appear before or after menopause and may sometimes affect fertility or pregnancy planning.

Many people with uterine polyps feel well and may not know they have them until they are found during an ultrasound or another gynecological examination.

Symptoms

Uterine polyps may cause no symptoms. When symptoms are present, they are often related to changes in menstrual bleeding or unexpected bleeding.

• Bleeding between menstrual periods
• Heavy menstrual bleeding
• Irregular menstrual cycles
• Bleeding after sexual intercourse
• Bleeding after menopause
• Difficulty becoming pregnant in some cases
• Vaginal discharge, less commonly

Symptoms can overlap with many other gynecological conditions, such as fibroids, hormonal changes, infection, or changes in the cervix. A healthcare professional can help determine the cause.

Causes and Risk Factors

The exact reason uterine polyps form is not always clear. They are thought to be influenced by estrogen, a hormone involved in the growth and shedding of the uterine lining. When areas of the lining grow more than expected, a polyp may develop.

Several factors may increase the likelihood of developing uterine polyps:

• Being in the years around menopause or after menopause
• Having high blood pressure
• Having excess body weight
• Having a history of certain hormone-related conditions
• Using some hormone-based treatments under medical supervision
• Having a previous history of uterine polyps

Having one or more risk factors does not mean a person will definitely develop polyps. Likewise, uterine polyps can occur in people without obvious risk factors.

Diagnosis

Diagnosis usually begins with a discussion of symptoms, menstrual history, pregnancy history, previous gynecological conditions, and any bleeding after menopause. A pelvic examination may also be performed, although uterine polyps are often not visible during a routine exam unless they extend through the cervix.

Common diagnostic methods may include:

• Transvaginal ultrasound: An imaging test that uses sound waves to look at the uterus and endometrium.
• Saline infusion ultrasound: A special ultrasound in which fluid is placed inside the uterus to help show the uterine lining more clearly.
• Hysteroscopy: A procedure in which a thin camera is passed through the cervix to look directly inside the uterus.
• Endometrial sampling: A small sample of tissue may be taken from the uterine lining to examine under a microscope.

In some cases, a polyp can be seen and removed during hysteroscopy. Tissue that is removed is commonly sent for laboratory examination to check for abnormal or cancerous cells.

Treatment Options

Treatment depends on factors such as age, symptoms, polyp size, pregnancy plans, menopausal status, and whether there are risk factors for abnormal cells. Not every uterine polyp requires immediate treatment, especially if it is small and not causing symptoms. In some cases, a doctor may recommend monitoring with follow-up examinations.

If treatment is recommended, options may include:

• Observation: Small polyps without symptoms may be monitored, depending on the individual situation.
• Hormonal management: In selected cases, hormone-based approaches may be considered to help manage bleeding, but they may not remove the polyp itself.
• Hysteroscopic polyp removal: A common procedure in which the polyp is removed using a thin instrument guided by a camera inside the uterus.
• Further evaluation of tissue: Removed tissue is usually examined by a pathologist to confirm the diagnosis and check for abnormal changes.

For people trying to become pregnant, the doctor may consider whether a polyp could be affecting the uterine cavity or embryo implantation. Management is individualized and should be discussed with a gynecologist.

After treatment, some polyps may return over time. Follow-up care may be advised, especially if symptoms continue or return.

When to See a Doctor

It is important to seek medical advice for any abnormal uterine bleeding. This includes bleeding between periods, unusually heavy periods, irregular cycles, bleeding after sexual intercourse, or any bleeding after menopause.

A prompt evaluation is especially important after menopause, because bleeding at this stage should always be assessed. Although uterine polyps are often benign, similar symptoms can be caused by other conditions that may require different care.

People who are planning pregnancy or experiencing difficulty becoming pregnant may also benefit from a gynecological evaluation, particularly if imaging has suggested a possible uterine polyp.

If you have concerns about your menstrual bleeding, pelvic health, or fertility, a gynecology specialist can explain appropriate tests and treatment options based on your personal medical history.