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Uterine polyps: Causes, symptoms and treatment
What are uterine polyps, and how can you treat them?
Top things to know
Uterine polyps are abnormal growths on the inside lining of the uterus (1)
The exact cause is unknown, but estrogen may play a role in forming lumps in the uterine lining (1)
Uterine polyps may cause infertility (1)
Common symptoms of uterine polyps are long, heavy periods or spotting in between menstruation (2,3)
If you experience vaginal bleeding outside of your normal pattern, it could be caused by uterine polyps or overgrowths of cells in the uterine cavity (1). The good news is if your polyps don’t resolve on their own, they are treatable (4). Here’s what you need to know.
What are uterine polyps?
Uterine polyps are atypical growths on the inner lining of the uterus (the endometrium) (4). They are sometimes called endometrial polyps and can cause symptoms such as irregular vaginal bleeding (1,5). They affect both premenopausal and postmenopausal people (1).
How common are uterine polyps?
Uterine polyps are very common. Up to 3 in 10 people with a uterus may develop polyps at some point in their lives, and your chance of developing one increases with age (6).
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What are the common signs of uterine polyps?
Signs and symptoms of endometrial polyps include:
Spotting between periods (2)
Difficulty getting pregnant (7)
Small endometrial polyps generally cause no symptoms and can go away on their own (1,5). In other cases, untreated polyps may cause symptoms that affect your quality of life and can carry a small chance of becoming cancerous cells (1,3).
They may also cause infertility (7). Polyps may make it more difficult for the embryo to implant on the endometrial tissue because the polyp occupies this space (1). Removing polyps through a hysteroscopic polypectomy, an operation where the polyp is removed through the vagina instead of a separate surgical opening, may improve infertility (7).
What causes uterine polyps?
The exact cause of uterine polyps is unknown, but it is thought that too much estrogen may be a risk factor (4). Estrogen regulates the growth phase of the endometrial tissue, which may trigger the tissue to grow into polyps (8). Researchers believe there’s also a genetic component, meaning some people are more prone to developing uterine polyps than others (4).
Uterine polyps occur when cells of the uterine lining multiply too many times without shedding during menstruation, forming lumps that often resemble hanging sacs (1). Polyps can range in size from a few millimeters to filling the entire uterine cavity (1). They can be numerous or few, and some people might only have one (1,2).
Some people are more likely than others to develop uterine polyps due to certain risk factors, such as age, weight, and using certain medications (1). Anyone can have polyps, but they’re most commonly found in people aged 40–49 years old (4). Obesity also makes people significantly more likely to develop polyps, due to higher circulating levels of estrogen (9).
Another contributing factor may be taking the breast cancer drug tamoxifen, or if you are on hormone replacement therapy (1,10). More research is needed to understand why uterine polyps occur after taking these medications (10).
Uterine polyps are not to be confused with uterine fibroids. While both can occur at the same time within the uterus and can cause similar symptoms, they are structurally different (11). Both fibroids and polyps may affect fertility and cause changes in menstrual bleeding (1,12, 13). The main difference between these two growths lies in where they form and how they’re managed. Fibroids form from muscle tissue in the uterus, while polyps form in the endometrium (1,14). Both uterine fibroids can be managed with medical and surgical options (11,15).
What are the diagnosis and treatment options for uterine polyps?
Uterine polyps are typically diagnosed by a healthcare provider that specializes in gynecology. Polyps without symptoms may not need treatment (4). Symptomatic polyps may be managed with surgery and sometimes medication (1,2), however, non-invasive surgery is usually considered the best option (16).
How can a healthcare provider diagnose my uterine polyps?
A gynecologist will probably ask questions about your symptoms and medical and menstrual history and perform a simple physical exam (3). If they suspect you have uterine polyps, they may also perform a:
Transvaginal ultrasound: This is an imaging procedure used for diagnosing uterine polyps (2).
Hysteroscopy polypectomy: This is when a small camera is inserted into the uterus that can also remove polyps with a hysteroscope (2). A hysteroscope is a small tool that can take tissue samples (16).
How are uterine polyps treated?
If you are postmenopausal and have no symptoms, you and your healthcare provider may choose to leave small polyps untreated, because they may go away on their own (5). Almost 1 in 3 uterine polyps resolve without treatment (17). Your healthcare provider may choose watchful waiting before they treat them, which means they will observe your condition to see if your uterine polyp resolves on its own (4).
Tracking your symptoms in Clue, such as period tracking and spotting, may help you understand if you are experiencing changes to your period, indicating that you may have a polyp. Having this information can be useful during a visit to the healthcare provider (18). When polyps do become symptomatic, there are different options for managing them, and for preventing their future formation (4).
What kind of medication treats uterine polyps?
Medications may not be the most effective long-term treatment method for uterine polyps, because if you stop taking the medication, the uterine polyp may return (2). More research is needed to support effective treatment with medications.
Hormonal medications are sometimes prescribed to treat the symptoms of uterine polyps (2). Among hormonal therapy, a combination of both estrogen and progesterone is the most effective medication, but it can also cause them to return (19). Researchers believe large doses of progesterone could work directly on the endometrium to reduce the prevalence of polyps by shedding the layer that covers them (19). This medication won’t prevent polyps from regrowing from their original location, because it doesn’t eradicate them completely (19).
What are the surgical options for treating uterine polyps?
A surgical process called hysteroscopic polypectomy is the standard treatment for removing polyps, regardless of size or number (4). Removing polyps can decrease bleeding, reduce recurrence, and improve fertility (1). Typically, the risk of complications from a hysteroscopic polypectomy is low (4), and almost 8 in 10 people with polyps found their symptoms improved after this procedure (20).
There is another surgical method called dilation and curettage, however, this procedure should only be considered when hysteroscopy is not available (4). During this procedure, healthcare providers remove the uterine polyps without being able to visualize the area (7), therefore over half of all polyps can be missed through this procedure (1). It also risks thinning the cervix, which could negatively affect future pregnancy rates (7). Luckily, there are other options in women’s health for treating uterine polyps.
What happens if I don’t get my uterine polyps treated?
Small uterine polyps are often asymptomatic and can go away on their own (5). Some untreated polyps, however, may cause symptoms that affect quality of life and can lead to complications such as anemia (17). Anemia is a condition where the body doesn’t have enough healthy red blood cells to function properly (21). This can happen when uterine polyps cause abnormal uterine bleeding, such as heavy menstrual bleeding (17).
In rare cases, some uterine polyps carry a small chance of becoming uterine cancer (4). They may also affect the ability to get or stay pregnant, but more research is needed on this topic (7).
FAQs
What are the main causes of uterine polyps?
Too much estrogen may play a role in causing cells to multiply into uterine polyps, however, more research needs to be done in this area (7). Some people are more likely than others to develop uterine polyps due to certain risk factors, such as age, weight, and using certain medications (1).
Is it necessary to remove uterine polyps?
Asymptomatic polyps do not necessarily need to be removed, but some people may decide to remove them due to potential risks of infertility, abnormal uterine bleeding, or the rare chance of cancer (1). Talk to your healthcare provider about what is best for you.
How long does it take to recover from surgery after uterine polyp removal?
You can expect to recover and return to normal life quickly from this outpatient surgical procedure, sometimes in 24 hours (2,16). Complications from surgery are rare, but the most common one is uterine perforation, which takes longer to recover from (4,16).
