Uterine polyps are like growths that appear on the endometrium (the inner lining of the uterus). Most of the time they are not cancerous, but we chose to talk about them because they can affect women of any age.

It's important to monitor them, as uterine polyps can cause menstrual cycle and fertility problems. So here are the symptoms, possible complications, and treatment options.

What are uterine polyps?

Uterine polyps are growths (tissue growths) that appear on the inner lining of the uterus, known as the endometrium — hence the name endometrial polyps. It is possible to have a single polyp, or multiple polyps.

They start with an overgrowth of cells in the lining of the uterus and can spread into the uterus. They usually stop there, but there are cases where they go beyond the cervix and extend into the vagina.

Depending on the pace and manner in which they grow, their size ranges from a few millimeters (the size of millet or sesame seeds) to a few centimeters (the size of a ping pong ball or larger).

Although they can be cancerous (precancerous polyps), most often they are benign (noncancerous). They can often cause menstrual problems and bleeding, which we will tell you more about in a moment.

Uterine polyps vs. cyst

Cysts are also a type of growth, but unlike polyps, they are filled with fluid (or semi-solid material) from the reproductive system. While uterine polyps form on the lining of the uterus, these cysts occur inside the ovaries ‒ hence the name ovarian cysts, about which we have prepared an entire article with extensive information HERE .

In short, the main differences between uterine polyps and ovarian cysts are:

• Place of formation: polyps appear in the uterus, cysts form on the ovaries.
• Contents: polyps are tissue growths, cysts are fluid-filled sacs.
• Impact on menstruation: Polyps are more likely to cause heavy menstruation than cysts.
• Pain level: Pain is not a common symptom of polyps, while cysts can cause dull or sharp pain.

Uterine polyps vs. fibroids

Uterine fibroids are more similar to polyps than cysts: they also occur in the uterus and are also benign (noncancerous). However, there are still significant differences, including:

• Composition: polyps contain endometrial tissue, fibroids contain connective tissue and smooth muscle cells.
• Size: Polyps start at the size of a seed and can grow to the size of a golf ball, while fibroids start at the size of an apple seed and can grow to the size of a grapefruit or larger.

Symptoms: Although many symptoms are similar, fibroids can cause much more severe pain when they grow and put pressure on the uterus.

Why do uterine polyps occur - Causes

It is not known exactly when and why a polyp may appear on the uterus. Researchers do not currently know the causes that cause these growths to develop.

What we do know, however, is that hormones play an important role in the growth of these polyps, and that polyps respond to fluctuations in estrogen.

Think of it this way: your estrogen levels rise and fall throughout your menstrual cycle, directly impacting how your endometrium thickens each month. The way this thickening of endometrial tissue occurs certainly has something to do with the growth of polyps.

The higher the level of estrogen in the body, the greater the risk that uterine polyps will grow larger.

Risk factors for uterine polyps

Continuing what I explained to you about estrogen fluctuations, it is obvious that the first risk factor is estrogen. The more estrogen the body is exposed to, the greater the risk of uterine polyps. Other risk factors include:

• Perimenopause or postmenopause
• Hormone therapy to treat menopausal symptoms
• Obesity
• High blood pressure
• Certain breast cancer treatments (tamoxifen)

Symptoms for uterine polyps

Menstrual irregularities are the most common symptom of uterine polyps. They can cause a variety of changes in your monthly bleeding, such as:

• Irregular menstrual cycle: you never know when and how heavy your period will be.
• Heavy bleeding: An unusually heavy menstrual flow - this is what is medically called menorrhagia. Although every woman is unique and there is no standard amount of blood lost during menstruation, you can tell if your flow changes based on previous periods. We have told you more about how to identify these changes in our article on the difference between menorrhagia and normal menstruation .
• Intermenstrual bleeding: This can be light bleeding or spotting, which can indicate a health problem or can be normal. There are plenty of other reasons besides uterine polyps that you might notice bleeding outside of your period, and it's not always something to worry about. Read more about intermenstrual bleeding HERE .
• Bleeding after sexual intercourse
• Postmenopausal bleeding: spotting or bleeding with postmenopausal blood, pink, red or brown. Theoretically, menopause means that ovarian functions cease and the menstrual cycle stops, which is why the bleeding disappears. Beyond the medical explanation, however, menopause is a very personal experience and comes with a lot of changes that I told you more about in an article about menopause, symptoms and treatment .
• Infertility: as a result of menstrual cycle disorder.

Regardless of the type of bleeding caused by uterine polyps, we recommend that you always use natural menstrual products that will not make the situation worse. Toxic chemicals in conventional products (dyes, bleaches, plastic) can cause irritation and disrupt the vaginal flora, further increasing discomfort.

Choose to take care of your intimate area with 100% organic ingredients, free of harmful substances. Enroush pads and tampons are made with 100% super absorbent organic cotton and have a neutral pH to protect your vaginal microbiome with the purest ingredients. You are protected day after day not only from leaks, but also from irritations and allergies.

Pain occurs only very rarely. Polyps become painful when they grow very large. Discomfort is felt in the abdominal area or lower back, similar to menstrual cramps.

There is also the possibility that uterine polyps are asymptomatic, meaning that there are no signs indicating that anything is wrong.

In this case, there are two ways in which the gynecologist could discover them: either they detect them by chance during a consultation to diagnose another problem, or the polyps become visible after they slide through the cervix.

When should you see a doctor?

Generally, if there are no symptoms, you won't know you have uterine polyps unless they're discovered incidentally during a checkup. But whether or not you know you have uterine polyps, always talk to your doctor if you experience menstrual irregularities and unusual bleeding:

• Spotting or intermenstrual bleeding
• Spotting or bleeding after menopause
• Unusually heavy and unpredictable menstrual flow

Complications of uterine polyps

There are not many complications that this condition can cause, but the most well-known effect is on fertility.

Infertility and miscarriage are sometimes associated with uterine polyps. The logical explanation is that, growing on the endometrial tissue, they can prevent the fertilized egg from attaching properly. They can also block the cervix and fallopian tubes. Removing them may increase the chances of getting pregnant, but the data is inconclusive on this point.

Cancer can also be a result of these formations. As a rule, polyps are non-cancerous (i.e. benign), but there are also cases in which they become malignant, the complication being cancer.

Diagnosis for uterine polyps

If you suspect you have uterine polyps, your doctor will first evaluate the symptoms you have noticed. So you may be asked questions about:

• Type of medication, if you are undergoing treatment
• Existence of menstrual cycle: whether you are still menstruating or have entered menopause
• How long and how frequent are your periods, if you still have them?
• Intermenstrual bleeding or spotting
• Any pain or discomfort
• Changes in menstrual flow: if it is heavier than usual
• Bleeding or spotting, if you are already in menopause

Once the doctor has this background, he or she may request additional tests to confirm the diagnosis. This may include a gynecological consultation, a Pap smear, and other tests such as:

Transvaginal ultrasound

The test involves inserting an ultrasound probe into the vagina. This will generate an image of the inside of the uterus so that the doctor can see if there are any abnormal growths or formations.

Transvaginal ultrasound can also be followed by sonohysterography. It is a painless and noninvasive procedure that consists of introducing a sterile liquid into the uterus through a thin tube, a liquid that causes the uterine cavity to expand to provide an even clearer image of possible growths formed inside.

Hysteroscopy

It involves inserting a long, thin tube called a hysteroscope through the vagina and cervix into the uterus. It is a special optical instrument that allows the gynecologist to look inside the uterus and make a correct diagnosis.

Endometrial biopsy

Biopsy means collecting a sample and evaluating it in a laboratory. In the case of an endometrial biopsy, the gynecologist uses special instruments to collect a sample of endometrial tissue, which is then tested in a laboratory and allows the detection of abnormal cells, if any.

You should also keep in mind that there are many other conditions that can cause abnormal vaginal discharge and bleeding. Because the tests listed above allow for the evaluation of the uterus as a whole, they can also identify other causes, including cysts or fibroids.

All of these problems must be ruled out first, and only then can uterine polyps be diagnosed. So before evaluating and treating polyps, other possible conditions will be cured:

• Ovarian cysts
• Uterine fibroids
• Adenomyosis
• ENDOMETRIOSIS
• Bleeding disorders
• Hormonal disorders
• Hypothyroidism
• Obesity

Treatment for uterine polyps

Treatment for uterine polyps varies depending on the stage you are in throughout your life and is not always necessary. Your gynecologist's approach depends on how these growths develop and the symptoms they cause.

Furthermore, there are cases when polyps disappear on their own. Below we explain what to do in each situation.

Patient monitoring

This is the most common approach for women who are still menstruating. If you have no symptoms, and the polyps are not causing you discomfort or affecting your menstrual cycle, your doctor will not treat them, but will only monitor them.

This means that through periodic check-ups, the evolution of the polyps will be kept under observation. Further investigations will only be carried out in certain circumstances, for example if they increase in size or if there is a risk of uterine cancer.

Drug treatment

Especially in the case of women who have reached menopause and who have symptoms, drug treatment is opted for. These are treatments with progestins or gonadotropin-releasing hormone antagonists, which have the role of maintaining hormonal balance.

Hormone therapy can improve bleeding and shrink polyps, but it is only a temporary solution. Once treatment is stopped, symptoms usually return.

Surgical treatment

It is called uterine polypectomy and consists of surgically removing endometrial polyps. It is performed during a hysteroscopy and consists of excising the formations to remove them. Although you may feel some pressure during the operation, your doctor will give you medication beforehand so that the procedure is not painful.

Surgical removal of polyps is especially recommended if unusual bleeding occurs after menopause or if it negatively affects pregnancy or the ability to become pregnant.

After polypectomy, the polyps may be sent to a lab and tested for signs of cancer. If cancerous cells are identified, a hysterectomy, which is the surgical removal of the uterus, may be necessary.

How to prevent uterine polyps

In short, you can't prevent uterine polyps. The fact that they don't have a clear cause makes them impossible to prevent. What you can do, however, is to go to your gynecologist regularly to detect them early and keep them under surveillance.