Uterine Polyps: Causes, Symptoms & Treatment Options

What are Uterine Polyps?

Uterine polyps are growths that develop from the inner lining of the uterus. They occur when endometrial tissue grows excessively, forming a small projection into the uterine cavity.

Polyps can vary in size and shape:

• As small as a few millimetres or as large as several centimetres
• Single or multiple
• Flat (sessile) or attached by a thin stalk (pedunculated)

Most uterine polyps are non-cancerous, but a small percentage may show abnormal or precancerous changes, making evaluation important.

What Causes Uterine Polyps?

Uterine polyps are most often linked to hormone imbalance, particularly higher or uneven levels of oestrogen.

Other factors associated with uterine polyps include:

• Hormonal Changes: Fluctuations in oestrogen during the reproductive years or around perimenopause.
• Thickening of the Uterine Lining: Repeated endometrial growth without complete shedding during periods.
• Uterine Inflammation: Long-term irritation may contribute to abnormal tissue growth.
• Blood Vessel Changes: Unusual development of blood vessels in the endometrial lining.
• Obesity: Higher body weight can raise oestrogen levels, increasing risk.
• Certain Medications: Tamoxifen, used in breast cancer treatment, can increase the likelihood of polyps.

What Symptoms Do Uterine Polyps Cause?

Not everyone with uterine polyps experiences symptoms. Some are discovered incidentally during routine scans or fertility evaluations. When symptoms occur, they may include:

• Heavy or Prolonged Periods: Bleeding may be stronger or last longer than usual. Clots can appear because the polyp affects how the uterine lining sheds.
• Bleeding Between Periods: Light spotting or unexpected bleeding outside your normal cycle.
• Irregular Cycles: Periods may become unpredictable, shorter, longer or inconsistent month to month.
• Bleeding After Menopause: Polyps can cause postmenopausal bleeding and should always be evaluated by a doctor.
• Difficulty Getting Pregnant: Polyps may interfere with sperm movement or embryo implantation, making conception more challenging.

Can Uterine Polyps Affect Fertility?

Uterine polyps can sometimes make it more difficult to conceive. They may affect fertility in several ways:

• Preventing Embryo Implantation: A polyp can block or alter the area where an embryo would normally attach, reducing the chances of implantation.
• Causing Local Inflammation: Polyps can create inflammation in the uterus, making the environment less supportive for embryo development.
• Altering Blood Flow: Changes in blood supply to the endometrial lining caused by polyps can impact how well the lining supports a fertilised egg.

How Are Uterine Polyps Diagnosed?

If you notice unusual bleeding or are concerned about uterine polyps, your doctor may recommend tests to examine the uterus. Common diagnostic methods include:

• Transvaginal Ultrasound: Usually the first test. It uses sound waves to create images of the uterus and can detect abnormal growths.
• Saline Infusion Sonography: Saline is introduced into the uterus to make the lining easier to see, helping to identify polyps more clearly.
• Hysteroscopy: A thin camera is inserted to view the uterine lining directly. Polyps can sometimes be removed during this procedure.
• Endometrial Biopsy: A small tissue sample may be taken if bleeding appears unusual, allowing for the assessment of abnormal or precancerous changes.

What Treatment Options Are Available for Uterine Polyps?

Treatment depends on your symptoms, the size of the polyps and whether you are planning a pregnancy. Common approaches include:

• Observation: Small, asymptomatic polyps may simply be monitored. Follow-up check-ups or ultrasounds ensure they are not growing or causing problems.
• Medication: Hormonal treatments can help reduce symptoms such as heavy or irregular bleeding. Medications do not remove polyps, and growths can return once treatment stops.
• Surgery: Hysteroscopic polypectomy is the most effective method. A thin camera is used to view the uterus, and polyps are carefully removed while preserving surrounding tissue.
• Choosing the Right Approach: Your doctor will recommend a treatment based on your symptoms, fertility plans and overall health.

Is Surgery Always Required for Uterine Polyps?

No, surgery is not always needed. It is usually recommended if:

• You have persistent or heavy abnormal bleeding.
• You are trying to conceive and the polyp may affect fertility.
• The polyp is large or continues to grow.
• There is concern about abnormal or precancerous cells.

When Should You See a Doctor?

Seek medical advice if you notice unusual bleeding or have fertility concerns. Consult a healthcare professional if you experience:

• Bleeding between periods
• Bleeding after menopause
• Heavy or prolonged periods
• Difficulty conceiving after regular attempts

Conclusion

Uterine polyps are common and usually non-cancerous, but they can affect your periods or fertility. Understanding the role of hormones and recognising potential symptoms helps you take control of your health. Many polyps are easily detected and treated, often with minimally invasive procedures. Paying attention to unusual bleeding or fertility challenges and seeking timely medical advice can prevent complications, reduce anxiety and help you make informed decisions about your reproductive health. Being proactive ensures that even if polyps occur, they rarely disrupt your overall well-being.