Uterine polyps

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.

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What is it?

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 into your vagina. Although they can happen in younger women, uterine polyps most commonly occur in women in their 40s and 50s.

Symptoms

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
  • Infertility

Uterine polyps can develop in pre- or postmenopausal women. Postmenopausal women may experience only light bleeding or spotting.

Causes

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 does — growing in response to circulating estrogen.

Risk factors

You're at greater risk of developing uterine polyps if:

  • You're obese
  • You take tamoxifen, a drug therapy for breast cancer
  • You have high blood pressure (hypertension)

Complications

Whether uterine polyps lead to infertility remains controversial. However, if you have uterine polyps and you've been experiencing infertility, removal of the polyps might boost your fertility. In one study, infertile women who underwent surgical polyp removal (hysteroscopic polypectomy) had much higher pregnancy rates — 63 percent versus 28 percent — after intrauterine insemination (IUI) than did women with uterine polyps who underwent IUI alone.

Uterine polyps also may present an increased risk of miscarriage in women undergoing in vitro fertilization (IVF). If you're undergoing IVF treatment and you have uterine polyps, your doctor will probably recommend polyp removal before embryo transfer.

Diagnosis

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 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. During curettage, your doctor uses a long metal instrument with a loop on the end to scrape the inside walls of your uterus. This may be done to collect a specimen for laboratory testing or to remove a polyp. Your doctor may perform curettage with the assistance of a hysteroscope, which allows your doctor to view the inside of your uterus before and after the procedure. When performed on its own without the aid of a hysteroscope, the procedure is known as blind curettage.

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 & Management Strategies

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