Uterine Polyps: Symptoms and Treatment Options

Uterine polyps are growths that develop along the inner lining of the uterus. Although most uterine polyps are benign, they can cause abnormal bleeding, affect fertility, and create other gynecologic concerns. Some women have noticeable symptoms, while others discover a polyp during an examination or imaging performed for another reason. An OB-GYN can evaluate uterine polyps, determine whether treatment is necessary, and recommend an approach based on symptoms, age, reproductive goals, and other individual factors.

Uterine polyps, also called endometrial polyps, form when tissue from the uterine lining grows excessively and creates a projection into the uterine cavity. A woman may develop a single polyp or several at the same time, and their size can vary considerably.

Polyps are more common around and after menopause, although they can occur during the reproductive years as well. Hormonal factors, particularly estrogen activity, are believed to contribute to their development.

Abnormal uterine bleeding is one of the most common signs of uterine polyps. Women may experience irregular menstrual periods, unusually heavy periods, bleeding or spotting between periods, or bleeding after menopause.

Some polyps cause no symptoms at all. In other cases, they may be associated with difficulty becoming pregnant. Because abnormal bleeding can have many possible causes, an OB-GYN evaluation is important rather than assuming that a polyp is responsible.

Evaluation generally begins with a discussion of symptoms, menstrual history, medications, and other relevant health information. A pelvic examination may also be performed.

An OB-GYN may recommend a transvaginal ultrasound to examine the uterus and identify possible abnormalities. Additional procedures, such as saline infusion sonography or hysteroscopy, can provide a more detailed view of the uterine cavity. An endometrial biopsy may sometimes be recommended to collect tissue for laboratory examination.

Not every uterine polyp requires immediate removal. Small polyps that are not causing symptoms may sometimes be monitored, depending on the patient's individual circumstances.

When treatment is appropriate, hysteroscopic polypectomy is commonly used to remove uterine polyps. During this procedure, a thin instrument with a camera allows the physician to see inside the uterus and remove the growth. Removed tissue can then be examined by a laboratory to confirm the diagnosis and check for abnormal cells.

Treatment recommendations may differ for women experiencing abnormal bleeding, fertility concerns, or bleeding after menopause.

Changes in menstrual bleeding should be discussed with an OB-GYN, particularly when periods become unusually heavy or irregular. Bleeding between periods and any vaginal bleeding after menopause also warrant medical evaluation.

While uterine polyps are usually noncancerous, determining the cause of abnormal bleeding is important for protecting reproductive and gynecologic health. An OB-GYN can identify whether uterine polyps or another condition may be responsible and recommend appropriate treatment based on the findings.