Uterine Polyps: Causes, Symptoms, and Diagnosis

What are uterine polyps?

Uterine polyps, also known as endometrial polyps, are soft growths that develop in the endometrium, the inner lining of the uterus. These polyps are usually benign (noncancerous) and can range in size from a few millimetres to several centimetres. They are typically attached to the uterine wall by a thin stalk or a broad base.

Uterine polyps are made up of endometrial tissue, which includes glands, blood vessels, and connective tissue. In some cases, uterine polyps can contain smooth muscle cells as well. While most polyps are benign, a small percentage (less than 5%) may be precancerous or develop into cancer.

Who is affected by uterine polyps?

Uterine polyps can affect women of all ages but are most common in those going through or after menopause, with the highest occurrence between ages 40 and 50. Younger women can also develop polyps, especially if they have risk factors such as obesity, high blood pressure, or tamoxifen therapy for breast cancer. Hormone replacement therapy (HRT) and a family history of genetic disorders like Lynch syndrome may also increase the risk. While often benign, uterine polyps causes could include irregular bleeding or fertility issues. Early detection and medical evaluation are essential for appropriate treatment and management.

Are uterine polyps common?

Uterine polyps are a relatively common gynaecological condition. According to research, they occur in approximately 10% of women. The likelihood of developing uterine polyps increases with age, peaking in the fifth decade of life. After menopause, the incidence gradually declines. Uterine polyps causes are rarely seen in women under 20 years old.

What are the symptoms of uterine polyps?

While some women with uterine polyps may not experience symptoms, others can develop noticeable signs. The most common uterine polyps symptom is abnormal uterine bleeding, which may include heavy or irregular periods, spotting between cycles, or prolonged menstruation. Postmenopausal bleeding is another key concern, as any vaginal bleeding after menopause should be promptly evaluated to rule out polyps or more serious conditions like endometrial cancer.

In some cases, uterine polyps can contribute to infertility by interfering with embryo implantation. Additionally, some women may experience unusual vaginal discharge, which can be watery or blood-tinged. These symptoms can vary in severity, and while uterine polyps are often benign, they can impact quality of life and reproductive health.

If you notice persistent abnormal bleeding, unexpected vaginal discharge, or fertility concerns, it’s essential to consult a healthcare provider. Early uterine polyps diagnosis through ultrasound, hysteroscopy, or biopsy can help determine the appropriate uterine polyps treatment and ensure better health outcomes.

Are uterine polyps painful?

In most cases, uterine polyps do not cause significant pain. However, some women with larger polyps may experience mild discomfort or a feeling of heaviness in the lower abdomen or pelvis. Rarely, uterine polyps can twist or become infected, leading to acute pain. If you have severe or persistent pelvic pain, seek prompt medical attention.

What causes uterine polyps?

Exact uterine polyps causes are not fully understood, but several factors may contribute. Hormonal imbalances, particularly high oestrogen levels from obesity or hormone therapy, are a key factor. Genetic mutations, such as those linked to Lynch syndrome, can also increase risk. Additionally, chronic inflammation of the endometrium is another potential uterine polyps cause.

How are uterine polyps diagnosed?

Uterine polyps diagnosis involves a combination of imaging tests and tissue sampling to confirm their presence and rule out other conditions. If a healthcare provider suspects the condition based on uterine polyps symptoms such as abnormal bleeding or infertility, they may recommend several diagnostic procedures.

A transvaginal ultrasound is often the first step, using sound waves to create images of the uterus and detect polyps. For a more detailed view, a hysteroscopy may be performed, where a thin, lighted tube is inserted through the cervix to directly examine the uterine lining. An endometrial biopsy may also be conducted, where a small tissue sample is taken from the uterus for laboratory analysis to determine whether the polyp is benign or cancerous. Another option is saline infusion sonohysterography (SIS), which involves injecting sterile saline into the uterus before an ultrasound to enhance visibility.

Once a uterine polyps diagnosis is confirmed, appropriate uterine polyps treatment, such as medication or surgical removal, can be recommended based on the patient’s condition and symptoms. The choice of diagnostic method depends on the individual's medical history, symptoms, and overall health to ensure accurate detection and effective management.

How are uterine polyps treated?

Uterine polyps treatment varies based on factors like age, symptoms, and the size and location of the polyps. If polyps are small, asymptomatic, and the patient is premenopausal, a doctor may suggest watchful waiting, where the polyps are monitored over time without immediate intervention. However, if uterine polyps symptoms such as abnormal bleeding or fertility issues occur, removal may be necessary.

One common procedure is hysteroscopic polypectomy, a minimally invasive surgery where a hysteroscope is used to visualise and remove the polyps. This procedure is typically performed under general or local anaesthesia with sedation. Another option is dilation and curettage (D&C), where the uterine lining and polyps are scraped away. In cases of multiple or recurrent polyps, hormonal medications like progestins or gonadotropin-releasing hormone agonists (GnRHa) may be prescribed to shrink polyps and reduce the chance of regrowth. While medication can help manage symptoms, it is not always a permanent solution, and polyps may return once treatment stops.

Following uterine polyps treatment, doctors may recommend follow-up visits or imaging tests to monitor for recurrence. Regular check-ups are especially important for postmenopausal women or those with risk factors for endometrial abnormalities to ensure long-term reproductive and overall health.

Do uterine polyps need to be removed?

The decision to remove uterine polyps depends on several factors, including:

• Symptoms: If you are experiencing abnormal bleeding, infertility, or other symptoms related to polyps, removal is usually recommended.
• Size and location: Large polyps or those that are causing obstruction may need to be removed.
• Age and menopausal status: Postmenopausal women with polyps are at a higher risk of precancerous or cancerous changes, so removal is often advised.
• Fertility concerns: Polyps can interfere with fertility, so removal may be recommended for women trying to conceive.

Is uterine polyp removal painful?

If your doctor recommends surgical removal of uterine polyps, a common concern is whether the procedure will hurt. Fortunately, uterine polyp treatment via polypectomy is usually performed under anaesthesia, greatly reducing discomfort. Some women report mild cramping or light bleeding afterwards, but significant post-procedure pain is rare.

Can uterine polyps be prevented?

Currently, there are no proven ways to completely prevent the development of uterine polyps. However, you can take steps to reduce certain risk factors by maintaining a healthy weight to minimise excess estrogen exposure. You should also engage in regular physical activity, eat a balanced diet rich in fruits, vegetables, and whole grains, and discuss hormone replacement therapy risks and benefits with your doctor.

What can we expect if we have uterine polyps?

If diagnosed with uterine polyps, you may experience irregular menstrual bleeding, postmenopausal bleeding, or infertility. However, some women have no symptoms, and polyps are often found during routine exams. They vary in size, with larger polyps more likely to cause bleeding. Uterine polyps treatment typically involves surgical removal, especially if they cause symptoms or appear abnormal. Your doctor will tailor a treatment plan based on your age, symptoms, and reproductive goals.

Should we worry about uterine polyps?

While finding out you have uterine polyps can feel alarming, it's important to know that around 95% of polyps are noncancerous. However, in rare cases, polyps can contain precancerous or cancerous cells. This is more likely after menopause. Any vaginal bleeding after menopause should be promptly evaluated.

What percentage of uterine polyps are cancerous?

Although any abnormal growth can feel worrisome, the vast majority of uterine polyps - more than 95% - are benign. Actual cancer is found in only about 1-5% of polyps.

However, the risk is higher for postmenopausal women. Around 5-6% of uterine polyps in women after menopause contain precancerous or cancerous cells. Certain factors like obesity and high blood pressure can also increase the likelihood of malignancy.

When to see a doctor?

Be sure to consult your healthcare provider if you experience vaginal bleeding after menopause, irregular menstrual bleeding, such as heavy periods or spotting between cycles, bleeding after intercourse, or difficulty getting pregnant. These issues can stem from various gynaecological conditions, including uterine polyps.

Conclusion

Uterine polyps are a common gynaecological condition that can cause abnormal bleeding, infertility, and other symptoms. If you suspect you may have the condition, don't hesitate to consult with your healthcare provider. They can help you determine the best course of action, whether it's watchful waiting or uterine polyps removal surgery.

At Metropolis Healthcare, we understand the importance of accurate diagnosis and personalised care. Our team of skilled phlebotomists can perform at-home sample collection for various tests, ensuring your comfort and convenience. With our state-of-the-art diagnostic laboratories and commitment to delivering reliable results, you can trust Metropolis Healthcare to support you on your journey to better reproductive health.