The Symptoms of Uterine Polyps

Almost a quarter of all females experience uterine polyps, an overgrowth of tissue in the endometrium. While many people experience abnormal uterine bleeding, the fact is that uterine polyps are often asymptomatic.

Uterine polyps, also called endometrial polyps, are usually small, bulb-shaped masses of endometrial tissue attached to the uterus by a stalk. They are soft, as opposed to uterine fibroids, which can grow much bigger and are made of hard muscle.

Symptoms

When symptoms of uterine polyps are apparent, they're similar to those of more serious conditions, such as endometrial cancer. If you have these symptoms it's important that you see a healthcare provider to rule out cancer. The symptoms may include several types of abnormal uterine bleeding such as:

• Heavy menstrual bleeding
• Spotting between periods
• Bleeding after intercourse
• Bleeding after menopause

Uterine Polyps and Infertility

Infertility is defined as the inability to conceive after one year of trying. One study noted that the prevalence of diagnosing unsuspected intrauterine abnormalities during hysteroscopy prior to in vitro fertilization was between 11% and 45%. If a person is experiencing abnormal vaginal bleeding, it's more likely that polyps are present.

Uterine polyps can prevent a fertilized egg from implanting in the uterine wall. They can also block the area where the fallopian tube connects to the uterine cavity, preventing sperm from traveling into the tube to meet the egg.

Similarly, they can block the canal of the cervix, which would prevent sperm from entering the uterus at all. Polyps may also play a role in miscarriage for some people.

Who Is at Risk?

The exact cause of uterine polyps is unknown, but they are sensitive to the hormone estrogen. You may be more likely to develop polyps if you are:

• Age 40 to 50
• Pre- or peri-menopausal
• Obese
• Currently or formerly taking an anti-estrogen drug

Diagnosis

Your healthcare provider may recommend one of several methods for finding out whether you have uterine polyps:

• Hysterosalpingogram (HSG): This exam using an X-ray, in which a radiologist injects a contrast dye into the uterus and fallopian tubes to make it easier to see polyps and other tissue.
• Ultrasound: This involves insertion of a wand-like device into the vagina that sends out high-frequency sound waves to create images.
• Sonohysterogram: This is a special type of ultrasound in which the radiologist fills the uterine cavity with saline using a narrow catheter. The saline distends the cavity (like a balloon) and creates a space between the walls. This aids in visualizing polyps that may be missed with traditional ultrasound.
• Hysteroscopy: This procedure uses a scope inserted through the vagina into the uterus to view the polyps and determine their size and extent. Part or all of a polyp can also be removed for microscopic examination by inserting instruments through the hysteroscopic tube.
• Excision through traditional methods: A sample of a polyp may be obtained through curettage (scraping or scooping) or biopsy (removing tissue via an instrument resembling a drinking straw), or after a hysterectomy (removal of the uterus).

Examination of tissue under a microscope is the only way to reliably determine whether a polyp is benign (noncancerous) or malignant (cancerous).

Treatment

Some polyps disappear on their own. When removal is necessary to control bleeding, to increase pregnancy odds, or to check for cancer, curettage guided by a hysteroscope is often recommended. A more conventional method, dilation and curettage (D&C), or scraping the uterine lining, is also still in use.

Hysteroscopy is generally performed using either local or no anesthesia, but general anesthesia is sometimes used as well.

After hysteroscopy, you may experience slight bleeding and mild cramps, but you should be able to resume normal activities right away, with the possible exception of intercourse, which you may need to avoid for a week or two if your healthcare provider advises.

When cancer is found, a hysterectomy may be recommended.

There is no specific method for preventing uterine polyps, although keeping yourself at a healthy weight and watching your blood pressure are the best methods of lessening your risk factors.