Uterine polyps are growths that connect to the uterine inner wall and extend into the uterine cavity. Overgrowth of cells in the uterine lining (endometrium) results in the creation of uterine polyps, also known as endometrial polyps. These polyps are normally noncancerous (benign), although some can be cancerous or progress to malignancy (precancerous polyps).
Uterine polyps range in size from a few millimeters (about the size of a sesame seed) to several centimeters (about the size of a golf ball). They have a big base or a slender stalk that attaches to the uterine wall.
There can be one or several uterine polyps. They typically stay within your uterus, but they can occasionally escape through the opening of the uterus (cervix) into your vagina. Uterine polyps are most frequent in women who are going through or have passed menopause, but they can occur in younger women as well.
WHAT ARE THE SYMPTOMS OF UTERINE POLYPS?
Uterine polyps can cause the following symptoms:
- Menstrual irregularities, such as having frequent, unpredictable cycles of varying length and heaviness
- Bleeding in between menstrual cycles
- Menstrual cycles that are abnormally heavy
- Menopausal vaginal bleeding
- Infertility
Some women experience just minor bleeding or spotting, while others are symptom-free.
WHAT ARE THE CAUSES OF UTERINE POLYPS?
Hormonal variables appear to be involved. Uterine polyps are estrogen-sensitive, which means they grow in reaction to estrogen in the body.
WHAT ARE THE RISK FACTORS FOR UTERINE POLYPS?
The following are risk factors for acquiring uterine polyps:
- Perimenopausal or postmenopausal status
- Blood pressure that is too high (hypertension)
- Being overweight
- Tamoxifen, a medication used to treat breast cancer
WHAT ARE THE COMPLICATIONS OF UTERINE POLYPS?
Uterine polyps may be linked to infertility. If you have uterine polyps and are unable to conceive, removing the polyps may assist you to conceive, although the data is equivocal.
HOW ARE UTERINE POLYPS DIAGNOSED?
If your doctor suspects you have uterine polyps, he or she may do one or more of the following procedures:
- Transvaginal ultrasound: A thin, wand-like instrument inserted into your vagina generates sound waves and provides an image of your uterus, including its contents. Your doctor may observe a visible polyp or diagnose a uterine polyp as an area of thickened endometrial tissue.
A related treatment called hysterosonography, also known as sonohysterography, involves injecting salt water (saline) into your uterus via a tiny tube threaded between your vagina and cervix. The saline widens your uterine cavity, allowing the doctor to see inside your uterus more clearly during the ultrasound.
- Hysteroscopy: Your doctor inserts a thin, flexible, illuminated telescope (hysteroscope) into your uterus through your vagina and cervix. Your doctor can inspect the inside of your uterus using hysteroscopy.
- Endometrial biopsy: A suction catheter inside the uterus may be used by your doctor to obtain a specimen for lab testing. An endometrial biopsy can confirm uterine polyps, however it can also miss the polyp.
The majority of uterine polyps are not malignant (benign). Some precancerous uterine alterations (endometrial hyperplasia) or uterine tumors (endometrial carcinomas) manifest as uterine polyps. Your doctor would almost certainly propose removing the polyp and sending a tissue sample for lab analysis to ensure you don't have uterine cancer.
WHAT ARE THE TREATMENTS FOR UTERINE POLYPS?
Your doctor may suggest the following for uterine polyps:
- Watchful waiting: Small polyps that do not cause symptoms may disappear on their own. Small polyps should not be treated unless you are at risk of uterine cancer.
- Medication: Certain hormonal drugs, such as progestins and gonadotropin-releasing hormone agonists, may alleviate polyp symptoms. However, taking such medications is usually only a temporary remedy – symptoms frequently return soon you stop taking the medication.
- Surgical removal: Instruments put via the hysteroscope — the equipment your doctor uses to see into your uterus — allow polyps to be removed during hysteroscopy. The polyp that was removed will most likely be submitted to a lab for microscopic inspection.
If a uterine polyp contains malignant cells, your doctor will discuss the following stages in assessment and treatment with you.
Uterine polyps can recur in rare cases. If they do, you may require more treatment.