Uterine Polyps: Causes, Symptoms, Diagnosis, and Treatment

Polyps, in general, are a growth or mass of tissue that develops in the lining of an organ. Then, what is a uterine polyp, and should we be concerned about it?

• Uterine polyps are growths that develop on the inner wall of the uterus and grow into the cavity of the uterus. They are also called endometrial polyps because they are caused by an overgrowth of cells in the uterus lining (endometrium).
• Uterine polyps are usually not cancerous. However, some may turn out to be cancerous. Therefore, proper monitoring is important.
• The size of uterine polyps varies from small to large. They grow from the uterus wall and are attached to it by a stalk or a base.
• These polyps usually stay inside the uterus. However, they may also enter the vagina through the opening that connects to the uterus (cervix). They often develop in women who are going through menopause or women who are past menopause.

Symptoms of Uterine Polyps:

Uterine polyps do not always result in symptoms. Some women may experience mild symptoms like light bleeding and spotting. Others may experience more marked symptoms.

If you experience uterine polyps symptoms, it is best to get it checked by a gynaecologist or OB/GYN. They will help you understand whether it is serious or not. This is also important because it enables you to find out whether the polyp is cancerous or not.

The symptoms of uterine polyps include the following:

• Erratic menstrual bleeding – unpredictable timing of periods and varying length of period
• Bleeding or spotting between periods
• Very heavy bleeding during periods
• Lighter bleeding than normal during periods
• Bleeding even after menopause
• Infertility

Causes of Uterine Polyps:

Medications: Certain drugs with high doses of estrogen, such as those used in hormone replacement therapy or treating breast cancer, can increase the risk of uterine polyps.

Family History: If there is a family history of Lynch syndrome or Cowden syndrome, then also the chances of uterine polyps may increase.

Complications of Uterine Polyps:

Uterine polyps may lead to certain complications. These include the following:

• Infertility—polyps may affect fertility and make it difficult for you to become pregnant.
• Cancer—sometimes, uterine polyps can be cancerous or turn out to be cancerous.

However, with early intervention and regular monitoring, the complications can be avoided.

Risk Factors of Uterine Polyps:

• Women during perimenopause, menopause, and post-menopause
• Being overweight 
• A side effect of any hormone therapy
• A side effect of a drug or any other medicine used to treat other conditions

Diagnosis Methods for Uterine Polyps:

When diagnosing uterine polyps, your gynaecologist or OB/GYN will ask you about your menstrual cycle, the duration of your periods, and how often you get them. They will also ask about the kind of bleeding you experience.

Make sure to mention any relevant symptoms, such as spotting between periods, unusually light or heavy flow, or if you are facing difficulty in getting pregnant. The gynaecologist or OB/GYN will then perform a pelvic exam and will perform or suggest certain diagnostic tests.

Uterine polyps are diagnosed using different diagnostic techniques. These include the following:

Transvaginal Ultrasound –

Your gynaecologist or OB/GYN may use an ultrasound test to examine your uterus and its interior. This helps with identifying the presence of polyps.

Hysteroscopy –

In this test, a telescopic instrument called a hysteroscope is inserted into your uterus through your vagina. This allows the gynaecologist to examine your uterus.

Endometrial Biopsy – 

In this test, a plastic instrument is inserted inside the uterus to collect tissue from the endometrium. This sample is then tested to check for any abnormalities that could indicate the presence of polyps.

Curettage –

• In this procedure, your gynaecologist or OB/GYN will use a slim, long metal instrument (a curette) to collect tissue from the walls of the uterus.
• This procedure is not just used to check for polyps but is also used to remove them.
• It has a loop at the end that is used to scrape the polyps off the uterus walls.
• The tissue or the polyps removed can then be tested to check if they are cancerous.

Treatment Options for Uterine Polyps:

• A uterine polyp does not always require treatment.
• Your gynaecologist may suggest watchful waiting if it is a small polyp and you are not facing any major symptoms. This involves monitoring your symptoms and having regular check-ups to monitor the polyp.
• Small polyps can resolve by themselves and may not require treatment unless they are cancerous.
• However, if the polyp is large or causing significant symptoms, you may have to get it treated.

Uterine polyp treatment includes the following methods:

Medication –

Hormonal medications can provide temporary relief for the symptoms of a polyp. These would include hormones like progestins. However, the symptoms will usually resume once the medication is stopped.

Hysteroscopy –

In this treatment, the gynaecologist will use a surgical instrument through the hysteroscope to remove polyps.

Curettage –

Using the hysteroscope to examine the uterus, the gynaecologist will also use a curette to scrape off polyps.

Further Surgery –

Further surgery may be required if the polyp cannot be removed using the above methods.

In case the polyps are cancerous, a hysterectomy may be required. In this procedure, the uterus is removed by surgery. It can then be replaced with a healthy uterus.

However, this is major surgery and will only be suggested if other methods cannot remove the polyp or if it is cancerous and removal of the uterus is required.

Conclusion

Uterine polyps are not always a cause for concern. However, if you are experiencing significant symptoms, you should visit a gynaecologist or OB/GYN to check for polyps. They can affect your fertility and make it difficult for you to become pregnant.

If you are experiencing difficulty in becoming pregnant or if you are concerned about your fertility, you can visit a fertility specialist. A fertility specialist can suggest appropriate tests to understand what is affecting your fertility. They can also suggest the most suitable course of treatment for you and your partner.

FAQs:

Should I Be Worried if I Have a Polyp in My Uterus?

No, a polyp is not necessarily a cause for concern. Most polyps are not cancerous. Small polyps usually do not cause major symptoms and may resolve independently. However, if you experience major symptoms such as excessive bleeding, very erratic periods, or difficulty becoming pregnant, it is best to get it checked. It will need to be treated as soon as possible if it is cancerous. Even if a polyp is not cancerous, it may still affect your ability to become pregnant, in which case treatment is advised.

What Causes Polyps in the Endometrium?

What exactly causes polyps to develop in the endometrium is not certain. However, hormone levels and imbalances may contribute to the development of polyps. Estrogen levels may be a contributing factor. Estrogen is the hormone that causes the uterus to thicken every month.

Are Endometrial Polyps Painful?

Endometrial polyps are usually not painful. However, if they grow in size, they may become uncomfortable and painful to live with. They may also cause very heavy periods, which may lead to more severe pelvic or abdominal pain during periods.

What is Worse: Fibroids or Polyps?

Fibroids can be worse in terms of pain and discomfort. Fibroids may grow to larger sizes and can cause more pain, discomfort, and bloating of the abdomen. Polyps do not grow to as large sizes. However, polyps can carry the risk of cancer. Fibroids tend not to be cancerous, and a cancerous fibroid is rare.