What Are Uterine Polyps?

Uterine polyps are small, soft growths on the inside of the uterus, or womb. They come from the tissue that lines the uterus, called the endometrium. That’s why they’re also called endometrial polyps.

Their size can vary, from as small as a sesame seed to as big as a golf ball. You may have just one polyp or many of them at once.

Most uterine polyps aren’t cancer, and for many women, they don’t cause symptoms. Some don’t need treatment right away. But when they do, there are many reliable ways doctors can find and remove them.

Causes

Doctors don’t know exactly why women get uterine polyps, but it may be related to changes in hormone levels. Each month, your estrogen levels rise and fall, directing the lining of the uterus to thicken and then shed during your period. It’s an overgrowth of that lining that makes a polyp.

Some things make you more likely to have polyps, though. One is age -- they’re more common in your 40s or 50s. That may be due to the changes in estrogen levels that happen right before and during menopause.

Obesity, high blood pressure, and taking the breast cancer drug tamoxifen can also raise your chances for uterine polyps.

Symptoms

You may not have any symptoms, especially if you have small polyps or just one. But the most common sign is bleeding. Tell your doctor if you have:

Should You Worry If You Have Uterine Polyps?

Most uterine polyps are not cancer. But a small percentage turn into cancer later on. The chances of that are higher if you’ve gone through menopause. The symptoms of polyps are similar to those of uterine cancer, so if you have any signs, it’s important to follow up with your doctor so she can find out what’s going on.

Polyps can also cause problems with fertility. They may keep you from getting pregnant or make you more likely to miscarry. That’s because they can keep a fertilized egg from attaching to your uterus or block the fallopian tubes or cervix. Treatment may make a difference, though. Some studies have found that removing polyps can help women get pregnant, but there’s no clear proof that it works for everyone.

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Diagnosis

If your doctor thinks you have uterine polyps, she’ll need to look inside your uterus to know for sure. There are a few different tests she can use. If she sees polyps during the exam, she may be able to remove them at the same time.

Ask her whether you’ll need to take antibiotics, pain relievers, or medicines to dilate your cervix beforehand.

Transvaginal ultrasound. Your doctor puts a slender wand-like device inside your vagina. It gives off sound waves and sends them to a computer to create images of the inside of your uterus.

Hysterosonography or sonohysterography. Your doctor can use this procedure during a transvaginal ultrasound. She puts a thin tube called a catheter inside your vagina and injects salt water into your uterus. The liquid expands the uterus and gives her a better view of it during the ultrasound.

Hysteroscopy. Your doctor puts a thin, flexible, lighted telescope, called a hysteroscope, through your vagina and cervix and into your uterus. It lets her look at the tissue lining the inside. If she sees polyps, she can use surgical tools to remove them at the same time.

Endometrial biopsy. Your doctor will use a soft plastic tool to take a piece of tissue from the lining of your uterus. She’ll send that tissue sample, called a biopsy, to a lab to test it for cancer cells.

Curettage. You have this procedure in an operating room. Your doctor uses a metal instrument with a small loop on one end, called a curette, to get a piece of a polyp or the tissue in the uterus for testing. She can also use the curette to remove polyps.

Treatments

Watchful waiting. You may not need treatment if you don’t have any symptoms and the polyp isn’t cancer. You can wait and see if it goes away on its own. But if you’re past menopause or you have a higher chance of uterine cancer, your doctor will recommend removing it.

Medications called progestins and gonadotropin-releasing hormone agonists help control your hormone levels. They may shrink polyps and ease symptoms, like heavy bleeding. But the symptoms often return when you stop taking the drug.

Surgery. Doctors can often remove polyps during the same procedures they use to diagnose them, such as hysteroscopy or curettage. Instead of making a cut in your belly, they can insert a curette or other surgical tools through your vagina and cervix to take the polyps out. If your polyps have cancer cells, you may need surgery to remove your entire uterus, called a hysterectomy.

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Uterine Polyps or Fibroids?

Polyps and fibroids are similar, but there are a few differences. Fibroids are overgrowths of the muscle inside the walls of the uterus, not the tissue lining the inside. Like polyps, they can cause heavy bleeding, but they can also cause pain, constipation, and trouble peeing. The same tests can find fibroids and polyps. Your doctor will be able to see which one you have and recommend the best treatment.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 25, 2018

Sources

SOURCES:

Baylor College of Medicine: “Endometrial Polyps.”

Mayo Clinic: “Uterine Polyps,” “Uterine Fibroids.”

Cleveland Clinic: “Uterine Polyps.”

Annan, J. The Obstetrician & Gynaecologist, January 2012.

Loma Linda University Center for Infertility: “Uterine Polyps.”

AAGL Practice Committee/AAGL Guideline Development Committee for the Management of Endometrial Polyps. Journal of Minimally Invasive Gynecology, January/February 2012.

Fibroid Treatment Collective: “Uterine Polyps vs. Fibroids.”

Surgery Research and Practice: “Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review.”

University of Colorado Gynecologic Oncology: “Endometrial Polyps (Uterine Polyps),” “Uterine Fibroids, Endometrial Polyps and Ovarian Cysts.”

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