Uterine polyps

Description

Uterine polyps are growths attached to the inner wall of the uterus to expand in the uterus. Uterine polyps, also called endometrial polyps, are formed as a result of the cells in the lining of the uterus (endometrium) overgrowth. These polyps are usually noncancerous (benign), although some can be cancerous or can turn into cancer (precancerous polyps).

Uterine polyps range in size from a few millimeters — no bigger than a sesame seed — several-centimeter — golf-ball size or larger. Adhere to the wall of the uterus by a large base or a thin stalk.

There can be one or many of the uterine polyps. Usually remain within the uterus, but can slip through the opening of the uterus (cervix) into your vagina. Uterine polyps are more common in people who are going through or have completed menopause. But younger people can get them, too.

Symptoms

The signs and symptoms of uterine polyps are:

  • Vaginal bleeding after menopause.
  • Bleeding between periods.
  • Frequent and unpredictable periods whose lengths and heaviness vary.
  • Very heavy periods.
  • The infertility.

Some people have only a slight bleeding or spotting; the others are free of symptoms.

When to see a doctor

Seek medical attention if you have:

  • Vaginal bleeding after menopause.
  • Bleeding between periods.
  • Irregular menstrual bleeding.

Causes

Hormonal factors appear to play a role. Uterine polyps are sensitive to estrogen, which means that they grow in response to estrogen in the body.

Risk factors

Risk factors for the development of polyps in the uterus are:

  • Is close to menopause or post-menopausal.
  • Being obese.
  • Taking tamoxifen, a drug therapy for breast cancer.
  • Hormonal therapy for menopause symptoms.

Complications

Uterine polyps may be associated with infertility. If you have uterine polyps, and you are unable to have children, the removal of polyps can be allowed to become pregnant, but the data are not conclusive.

Uterine polyps

Diagnosis

The following tests can be used to diagnose uterine polyps:

  • Transvaginal Ultrasound.A slender, wandlike device placed in the vagina emits sound waves and creates an image of the uterus, including its interior. A polyp can be clearly present, or there may be an area of thickening of the endometrial tissue. A related procedure, known as hysterosonography (his-tur-o-suh-NOG-ruh-fee), also called sonohysterography (son-oh-his-tur-OG-ruh-fee) — means having a salt water (saline solution) was injected into the uterus through a small tube that is placed through the vagina and cervix. The saline solution expands the uterus, which gives a clearer view of the inside of the uterus during the ultrasound.
  • The hysteroscopy. This involves inserting a thin, flexible, lighted telescope (hysteroscope) through the vagina and cervix into the uterus. Hysteroscopy allows you to see the inside of the uterus.
  • The biopsy of the endometrium. A suction catheter inside the uterus to collect a sample for lab testing. Uterine polyps may be confirmed by an endometrial biopsy, but the biopsy could also miss the polyp.

Transvaginal Ultrasound. A slender, wandlike device placed in the vagina emits sound waves and creates an image of the uterus, including its interior. A polyp can be clearly present, or there may be an area of thickening of the endometrial tissue.

A related procedure, known as hysterosonography (his-tur-o-suh-NOG-ruh-fee), also called sonohysterography (son-oh-his-tur-OG-ruh-fee) — means having a salt water (saline solution) was injected into the uterus through a small tube that is placed through the vagina and cervix. The saline solution expands the uterus, which gives a clearer view of the inside of the uterus during the ultrasound.

Most uterine polyps are benign tumors. This means they are not cancer. However, some precancerous changes of the uterus called endometrial hyperplasia or uterine cancer appear as uterine polyps. A tissue sample of the removed polyp is tested for signs of cancer.

Treatment

The treatment of uterine polyps may include:

  • Watchful waiting. Small polyps without symptoms may resolve on their own. Treatment of small polyps is unnecessary for those who are not in risk of cancer of the uterus.
  • The medication. Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, can relieve the symptoms of polyps. But taking these medications is usually a short-term solution in the best-of-the — symptoms tend to recur once the medication is stopped.
  • The surgical removal. During the hysteroscopy instruments inserted through the device that is used to observe the interior of the uterus (hysteroscope) make it possible to remove the polyps. The removed polyp will likely be sent to a laboratory for analysis.

If a polyp uterine contains cancer cells, your doctor will talk with you about the next steps in evaluation and treatment.

Rarely, uterine polyps can recur. If they do, they will need more treatment.

Preparing for your appointment

Your first appointment will probably be with your primary care provider or gynecologist. Have a family member or friend to go with you, if possible. This can help you remember information that it receives.

What you can do

Make a list of the following:

  • Their symptoms, even those who do not think they are related, and when they began.
  • All the drugs, vitamins, and supplements you are taking, including dosage.
  • Questions to ask your provider.

For uterine polyps, some basic questions to ask include:

  • What could be causing my symptoms?
  • What tests might I need?
  • The availability of medications to treat my condition?
  • Under what circumstances is it recommended to the surgery?
  • Could uterine polyps affect my ability to get pregnant?
  • It will be the treatment of uterine polyps improve my fertility?
  • Can uterine polyps be cancerous?

Do not hesitate to ask other questions.

What to expect from your doctor

Some of the questions your doctor may ask include:

  • How often do you have symptoms?
  • How severe are the symptoms?
  • Nothing seems to improve the symptoms?
  • Does anything seem to make your symptoms worse?
  • Have you been treated for uterine polyps, or cervical polyps before?
  • Has had fertility problems? Do you want to become pregnant?
  • Does your family have a history of cancer of the breast, colon, or endometrial cancer?
Symptoms and treatment of Uterine polyps