Uterine polyps are growths attached to inner wall of the uterus and protruding into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps. The sizes of uterine polyps range from a few millimeters — no larger than a sesame seed — to several centimeters — golf ball sized or larger. They are attached to the uterine wall by a large base or a thin stalk.
You can have one or many uterine polyps. They usually stay contained within your uterus, but occasionally, they may slip down through the opening of the uterus (cervix) into your vagina. Although they can happen earlier, uterine polyps most commonly occur in women in their 40s and 50s.
Although the exact cause of uterine polyps is unknown, hormonal factors appear to play a role. Uterine polyps are estrogen-sensitive, meaning that they respond to estrogen in the same way that the lining of your uterus (endometrium) does — growing in response to circulating estrogen.
Symptoms of uterine polyps
It’s possible to have uterine polyps without signs or symptoms.
Signs of uterine polyps include:
- Irregular menstrual bleeding — for example, having frequent, unpredictable periods of variable length and heaviness
- Bleeding between menstrual periods
- Excessively heavy menstrual periods
- Vaginal bleeding after menopause
Uterine polyps can develop in pre- or postmenopausal women. Postmenopausal women may experience only light bleeding or spotting.
If your doctor suspects that you have uterine polyps, he or she might perform one of the following tests or procedures:
- Transvaginal ultrasound. A slender, wand-like device placed in your vagina sends out sound waves and creates an image of your uterus, including its interior. A related procedure, known as hysterosonography, involves having salt water (saline) injected into your uterus through a small tube (catheter) threaded through your vagina and cervix. The saline expands your uterine cavity, which gives the doctor a clearer view of the inside of your uterus.
- Hysteroscopy. Doctors may perform a procedure called hysteroscopy to diagnose and treat uterine polyps. In a hysteroscopy, your doctor inserts a thin, flexible, lighted telescope (hysteroscope) through your vagina and cervix into your uterus. Hysteroscopy allows your doctor to examine the inside of your uterus and remove any polyps that are found. This eliminates the need for a follow-up procedure.
- Curettage. Your doctor uses a long metal instrument with a loop on the end (curet) to scrape the walls of your uterus. This may be done to collect a specimen for laboratory testing (biopsy) or to remove a polyp. Curettage may be performed on its own (blind curettage) or with the guidance of a hysteroscope.
Most uterine polyps are noncancerous (benign). However, some precancerous changes of the uterus (endometrial hyperplasia) or uterine cancers (endometrial carcinoma) appear as uterine polyps. Your doctor may send a tissue sample for laboratory analysis to be certain you don’t have uterine cancer.
Treatment for uterine polyps
Possible treatments for uterine polyps include:
- Watchful waiting. Small, asymptomatic polyps may resolve on their own. Treatment is unnecessary unless you’re at risk of uterine (endometrial) cancer.
- Medication. Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may shrink a uterine polyp and lessen symptoms. But taking such medications is usually a short-term solution at best — symptoms typically recur once you stop taking the medicine.
- Surgical removal (excision). If you undergo hysteroscopy, instruments inserted through the hysteroscope — the device your doctor uses to see inside your uterus — make it possible to cut away and remove polyps once they’re identified. The removed polyp may be sent to a laboratory for microscopic examination.
- Hysterectomy. If closer examination reveals that a uterine polyp contains cancerous cells, surgery to remove your uterus (hysterectomy) becomes necessary.
Uterine polyps, once removed, can recur. It’s possible that you might need to undergo treatment more than once if you experience recurring uterine polyps.
Risks of developing uterine polyps
You’re at greater risk of developing uterine polyps if: