Uterine polyps

Overview

Uterine polyps are small, soft growths that form on the inside lining of the uterus (womb). They are usually not cancerous (benign) and range in size from a few millimetres to a few centimetres.

Yes, uterine polyps are quite common. They affect about 10-20% of adults with a uterus at some point in their lives.

They most often affect people during their 40s and 50s, especially around the time of menopause. They can also happen in younger people, particularly if they have fertility problems.

Symptoms

Common symptoms

• Irregular vaginal bleeding between periods
• Heavy or long periods
• Bleeding after menopause
• Spotting or bleeding after sexual activity
• Fertility difficulties (trouble getting pregnant)
• Lower abdominal pain or cramping

Symptoms in children

• Uterine polyps are very rare in children before puberty. If symptoms like abnormal bleeding occur, it may be due to other causes, and a doctor should be seen right away.

Symptoms in older adults

• In people after menopause, the main symptom is unexpected bleeding (even a small amount). This should always be checked by a doctor.

Causes

Main causes

• The exact cause is not fully understood, but polyps are linked to hormone changes, especially high levels of oestrogen.
• They may grow when the lining of the uterus (endometrium) gets extra signals from hormones to thicken.

Risk factors

• Being in your 40s or 50s
• High blood pressure
• Obesity (being very overweight)
• Taking certain breast cancer treatments that affect hormones
• Having a family history of uterine polyps or endometrial cancer

When to see a doctor

See a doctor urgently if:

• Bleeding after menopause – even just spotting
• Heavy bleeding that interferes with your daily life or causes low iron (anaemia)
• Pain or bleeding that does not stop with simple measures

Book a routine appointment if:

• Bleeding between periods or a change in your usual period pattern that lasts for more than a few cycles
• If you are having trouble getting pregnant and have no other obvious cause

Diagnosis

Your doctor will start by asking about your symptoms and medical history. They may do a pelvic exam to check for any lumps. The main way to diagnose a polyp is with an imaging test called an ultrasound, often a special one called a transvaginal ultrasound (a small probe placed gently inside the vagina to get a clear picture).

Tests that may be done

• Transvaginal ultrasound (ultrasound via vagina)
• Hysteroscopy (a thin, lighted tube with a camera inserted through the cervix to look directly inside the uterus)
• Biopsy (taking a small sample of tissue to check for cancer) – often done during hysteroscopy

What to expect at your appointment

The ultrasound is painless but may feel a bit uncomfortable. If a polyp is found, your doctor might recommend a hysteroscopy to confirm and possibly remove it. This can be done in the clinic or as a short day-case procedure. You may have mild cramping or spotting afterward, which usually settles quickly.

Treatment

Treatment depends on your age, symptoms, and whether you plan to have children. Many polyps are non-cancerous and may not need treatment if they cause no problems. If they do cause symptoms, the most common approach is to remove them surgically.

Self-care at home

• Keep a note of your bleeding pattern (dates, flow level) to discuss with your doctor
• Use over-the-counter pain relievers for mild cramping (always follow the label and ask your pharmacist if unsure)
• Rest if bleeding is heavy

Medical treatments

Hormonal treatments, such as a type of medicine called progestins (a synthetic version of the hormone progesterone), can help shrink polyps or reduce bleeding. These may be given as a pill, injection, or an intrauterine device (a small implant placed in the uterus). Your doctor will discuss the best option for you. Note: Hormonal treatments are not a cure – the polyp may grow back after stopping treatment.

When is surgery considered?

Surgery is usually recommended if the polyp is large, causing heavy bleeding, or if it might be cancer. The most common procedure is a 'hysteroscopic polypectomy' – a small instrument is passed through the cervix to remove the polyp. This is often done as a day case and does not require a cut in your tummy. In rare cases, if polyps keep coming back or are very complex, a hysterectomy (removal of the uterus) may be discussed, though this is usually a last resort.

Living with this condition

If you have a small, symptom-free polyp, you can live a normal life without any restrictions. Regular check-ups with your doctor may be recommended to monitor the polyp. If you have symptoms like heavy bleeding, plan ahead – carry spare pads or tampons and a change of underwear.

Lifestyle tips

• Maintain a healthy weight – this helps balance hormones and may reduce the risk of new polyps
• Stay active with regular exercise – it can help with overall hormone balance
• If you smoke, talk to your doctor about quitting – smoking may increase oestrogen levels

Diet and exercise

A balanced diet rich in fruits, vegetables, and whole grains supports overall health. There is no specific diet that treats polyps, but avoiding too much sugar and processed foods may help hormone balance. Regular moderate exercise like walking or swimming can improve well-being.

Mental health and emotional wellbeing

Dealing with abnormal bleeding or fertility concerns can be stressful and worrying. It's normal to feel anxious. Many people find it helpful to talk to a trusted friend, partner, or a professional counsellor. Remember that most uterine polyps are not cancer and treatment is usually simple and effective.

Prevention

There is no proven way to prevent uterine polyps. But maintaining a healthy weight, keeping blood pressure under control, and staying physically active may lower your risk.

Complications

If left untreated

• Persistent heavy bleeding can lead to anaemia (low iron, causing tiredness and weakness)
• Some polyps may become cancerous over time, but this is very rare – less than 1% of cases

Long-term outlook

The outlook for uterine polyps is excellent. Most are benign, and treatment is usually simple and effective. Even if a polyp is found to be cancerous (very rare), it is often caught early and can be treated successfully. After removal, polyps can sometimes come back, but regular check-ups help catch them early.

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