14683 Uterine Polyps

Overview

Uterine polyps are soft, usually non-cancerous growths that attach to the inner wall of the uterus and hang down into the uterine cavity. They are sometimes called endometrial polyps and can vary in size from a sesame seed to a golf ball.

Uterine polyps are fairly common, especially in people in their 40s and 50s, though they can occur at any age after puberty.

They most often affect people who are going through or have completed menopause, but they can also develop in younger people who are still having periods.

Symptoms

Common symptoms

• Bleeding between periods
• Heavier than usual menstrual bleeding
• Bleeding after sexual intercourse
• Irregular periods that vary in length and flow
• Spotting or bleeding after menopause
• Sometimes no symptoms at all

Symptoms in children

• Uterine polyps are extremely rare in children. Abnormal vaginal bleeding in a child is not normal and should always be evaluated by a doctor.

Symptoms in older adults

• In older adults, the most common symptom is vaginal bleeding after menopause. Any postmenopausal bleeding needs a medical check-up.

Causes

Main causes

• The exact cause is not fully known, but uterine polyps can form when the lining of the uterus grows too much.
• Hormone changes, particularly higher levels of estrogen, appear to play a key role in their growth.

Risk factors

• Being between 40 and 60 years old
• Obesity, because extra body fat can raise estrogen levels
• High blood pressure
• Taking certain medicines that act like estrogen or affect hormones, such as hormone therapy or breast cancer treatments
• A family history of uterine polyps or related conditions

When to see a doctor

See a doctor urgently if:

• You have bleeding after menopause.
• You have very heavy bleeding or bleeding that lasts many days.
• You have bleeding between periods that happens for more than a cycle or two.

Book a routine appointment if:

• You have mild, occasional spotting and want to discuss it with your doctor.
• You notice a change in your periods and it is not urgent.
• You have pain or pressure in your pelvis that does not get better.

Diagnosis

To diagnose a uterine polyp, a doctor usually starts by asking about your symptoms and medical history. A pelvic exam can sometimes feel a polyp, but often imaging tests are needed to see inside the uterus.

Tests that may be done

• Transvaginal ultrasound – a small wand placed in the vagina uses sound waves to create a picture of the uterus.
• Saline infusion sonography (also called sonohysterography) – a saltwater solution is put into the uterus to expand it, making polyps easier to see on ultrasound.
• Hysteroscopy – a thin, flexible tube with a camera is inserted through the cervix into the uterus to look at the lining directly.
• Endometrial biopsy – a small sample of tissue is taken from the uterine lining and checked in a laboratory.

What to expect at your appointment

Most tests are done in a doctor's office or clinic and do not require surgery. You may feel mild cramping. A biopsy or hysteroscopy can be slightly uncomfortable but is usually quick and safe.

Treatment

Treatment depends on the size of the polyp, your symptoms, whether you plan to become pregnant, and your overall health. Many polyps are harmless and may not need treatment. If they do cause problems, a doctor can help you choose the best option.

Self-care at home

• Keep track of your symptoms, including the date, length, and amount of bleeding, to share with your doctor.
• Use pain relief methods like a warm bath or a heating pad for mild cramping, as long as your doctor says it is safe.
• Eat iron-rich foods like leafy greens, beans, and lean meats if you have heavy bleeding, and ask your doctor about checking for low iron.

Medical treatments

Medical treatment may involve medicines that help balance hormones, such as hormonal contraceptives or other hormone-regulating medicines. These do not cure polyps but can help manage symptoms like heavy or irregular bleeding. Doctors may also suggest a procedure to remove the polyp. The choice of medicine or procedure depends on your individual situation.

When is surgery considered?

If a polyp is large, or if it causes heavy bleeding or other problems, a doctor may recommend removing it. This is often done with hysteroscopy, a procedure where a small instrument is passed through the cervix to remove the polyp. In some cases, a dilation and curettage (D&C) or other surgery may be needed. Removing the polyp usually relieves symptoms, and the tissue is sent to a lab to be checked.

Living with this condition

For many people, uterine polyps cause no daily problems. If you do have symptoms, keeping a symptom diary can help you and your doctor track changes. Planning for periods by having supplies on hand can help if bleeding is heavy.

Lifestyle tips

• Maintain a healthy weight if you can, since extra weight can affect hormone levels.
• Stay active with regular exercise, which can help manage stress and weight.
• Avoid tobacco use, which may affect hormone balance and overall health.

Diet and exercise

Eating a balanced diet with plenty of fruits, vegetables, and whole grains supports overall health. Regular physical activity can help with weight management and reduce the risk of conditions linked to polyps, such as high blood pressure. If heavy bleeding has made you tired, ask your doctor about checking for low iron.

Mental health and emotional wellbeing

Dealing with abnormal bleeding can be stressful and may affect sleep, relationships, or how you feel about your body. It is normal to worry. Talking with someone you trust, such as a friend, partner, or counselor, can help. Your doctor can also provide reassurance and answer questions.

Prevention

There is no known way to prevent uterine polyps. However, managing your weight, staying active, and controlling blood pressure may help reduce your risk. Regular pelvic exams and reporting any abnormal bleeding can help find problems early.

Complications

If left untreated

• Heavy bleeding can lead to anemia, which can cause tiredness and weakness.
• Polyps can interfere with fertility in some people who are trying to become pregnant.
• While most polyps are benign, a small number may be precancerous or contain cancer cells. This is rare but is why polyps should be checked by a doctor.

Long-term outlook

The outlook for uterine polyps is generally very good. Most polyps are non-cancerous, and symptoms can often be managed or cured with treatment. Even for polyps that return, there are many safe and effective options. Regular follow-up with your doctor can help you stay healthy and reassured.

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