Uterine polyps are growths that occur in the inner lining of the uterus called the endometrium. Therefore, they are sometimes referred to as endometrial polyps.

Uterine polyps are formed due to the excessive growth of the endometrial tissue. Polyps can be round or oval in shape and can range in size from a few millimeters to several centimeters (the size of a golf ball) or larger. They can occur as single polyps or multiple polyps. Uterine polyps are usually benign (non-cancerous), but they can cause problems related to menstruation or fertility.

What Are the Symptoms of Uterine Polyps?

The symptoms of uterine polyps include:

• Irregular menstruation
• Unusually heavy bleeding during menstrual periods
• Bleeding or spotting between periods
• Vaginal spotting or bleeding after menopause
• Infertility

The most common symptom of uterine polyps is irregular or unpredictable menstrual periods. Menstruation usually occurs approximately every 28 days but can vary between 21 and 35 days. About half of women with uterine polyps do not have this regularity.

Other symptoms may include prolonged or excessive menstrual bleeding (menorrhagia), bleeding between periods, and bleeding after menopause or after sexual intercourse.

Difficulty getting pregnant or completing a pregnancy can also be signs that uterine polyps are present.

Who is Affected by Uterine Polyps?

Uterine polyps are more common in women between the ages of 40 and 50 than in younger women. Uterine polyps are rarely seen in women under the age of 20.

If you are overweight or obese, have high blood pressure (hypertension), or are using tamoxifen for breast cancer treatment, you may have an increased risk of developing uterine polyps.

What Causes Uterine Polyps?

The exact cause of polyp formation is unknown, but fluctuations in hormone levels may be a factor. Estrogen, which causes the thickening of the endometrium every month, also appears to be associated with the growth of uterine polyps.

How Are Uterine Polyps Diagnosed?

Your doctor will ask about your menstrual history, including how long your periods last and how often you have them. You should mention any unusual symptoms you experience during your periods, such as excessive bleeding or spotting. Your doctor will also ask if you are having difficulty getting pregnant. Your doctor will perform a gynecological examination and may request additional tests or procedures.

These tests may include:

• Transvaginal ultrasound: This is a procedure in which a handheld device called a transducer is inserted into the vagina. The device emits sound waves that provide a view of the uterine interior, including any abnormalities present.
• Sonohysterography: This is a related procedure that can be done after a transvaginal ultrasound. A sterile fluid called a contrast medium is injected into the uterus through a thin tube called a catheter. The fluid causes the uterus to expand, providing a clearer image of any growths in the uterine cavity during the ultrasound procedure.
• Hysteroscopy: This can be used to diagnose or treat uterine polyps. During this procedure, the doctor inserts a long, thin tube with a lighted telescope called a hysteroscope through the vagina and cervix into the uterus. The hysteroscope allows the doctor to examine the inside of the uterus. Hysteroscopy is sometimes used in conjunction with surgery to remove polyps.
• Endometrial biopsy: The doctor uses a soft plastic instrument to collect tissue samples from the inner walls of the uterus. The samples are sent to a laboratory for testing to determine if there are any abnormalities.
• Dilation and curettage (D&C): This can be done in an operating room and can both diagnose and treat polyps. The doctor uses a long metal instrument called a curette to scrape the endometrium and remove polyps. The curette has a small loop that allows the doctor to scrape off tissue or polyps, which can be sent to a laboratory for testing to determine if cancer cells are present.

How Are Uterine Polyps Treated?

If polyps do not cause any symptoms, treatment may not be necessary. However, if they cause heavy bleeding during menstrual periods, are suspected to be precancerous or cancerous, or cause problems such as miscarriage during pregnancy or infertility in women trying to conceive, they should be removed. If a polyp is found after menopause, it should also be removed.

Treatment methods include:

• Medications: Medications that help regulate hormonal balance, such as progestins or gonadotropin-releasing hormone agonists, can be used as temporary treatment. These medications help relieve symptoms, but symptoms usually return after discontinuation of the medications.
• Hysteroscopy: This can also be used as a treatment method. The doctor will insert surgical instruments into the hysteroscope to remove the identified polyps.
• Dilation and curettage (D&C): This can be performed in conjunction with hysteroscopy. While using the hysteroscope to view the inside of the uterus, the doctor uses a curette to scrape the endometrium and remove polyps. The polyps can be sent to a laboratory to determine whether they are benign or cancerous. This technique is effective for smaller polyps.

If a polyp cannot be removed using other methods or if the polyps are cancerous, additional surgery may be required. Hysterectomy is a surgical procedure in which the entire uterus is removed when cancerous cells are found in uterine polyps.