Uterine polyps are like lumps that appear on the endometrium (that 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 is important to be monitored because uterine polyps can cause menstrual cycle and fertility problems. So look at the symptoms, possible complications, and treatment options.

What are uterine polyps?

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

They start with the overgrowth of cells in the lining of the uterus and can spread into the uterus. They usually stop there, but there are also cases when they pass the cervix and extend into the vagina.

Depending on how fast and how they grow, their size varies from a few millimeters (the size of millet or sesame seeds) to several centimeters (the size of a ping pong ball or larger).

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

Uterine polyps vs. cyst

Cysts are also a kind of growths, but unlike polyps they are filled with fluid (or semi-solid material) from the reproductive system. While uterine polyps are formed on the lining of the uterus, these cysts appear inside the ovaries - hence the name ovarian cysts, about which we have prepared a whole 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 growths of tissue, cysts are sacs of fluid.

• Impact on menstruation: Polyps are more likely to cause heavy periods than cysts.

• Pain level: Pain is not a common symptom of polyps, while cysts can cause dull or sharp pain.

Uterine polyps vs. fibroma

Uterine fibroids are more like polyps than cysts: they also occur in the uterus and are also benign (non-cancerous). But even in this case there are significant differences, including:

• Composition: polyps contain endometrial tissue, fibroids contain connective tissue and smooth muscle cells.

• Size: Polyps start from the size of seeds and can grow to the size of a golf ball, while fibroids start from the size of apple cores and can grow to the size of a grapefruit or larger.

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

Why do uterine polyps appear - Causes

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

What we do know, however, is that hormones play an important role in the growth of these polyps, and that the 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. How this endometrial tissue thickens certainly has something to do with polyp growth as well.

The higher the level of estrogen in the body, the higher the risk of uterine polyps growing.

Risk factors of uterine polyps

Following on from what I explained to you about estrogen fluctuations, obviously 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
• Hypertension
• Certain breast cancer treatments (tamoxifen)

Symptoms for uterine polyps

Irregular menstrual cycle is the most common symptom of uterine polyps. They can cause a lot of changes in your monthly bleeding, such as:

• Irregular menstrual cycle: You never know when and how heavily your period will come.

• Heavy bleeding: an unusually heavy menstrual flow - this is what in medical terms is 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. More about how to identify these changes we told in our article about the difference between menorrhagia and normal menstruation .

• Intermenstrual bleeding: It can be light bleeding or spotting, which in turn can indicate a health problem or it can be normal. There are plenty of other reasons besides uterine polyps why 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 intercourse

• Bleeding after menopause: pink, red or brown post-menopausal spotting or bleeding. Theoretically, menopause means that the 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 irregular menstrual cycle.

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 (paints, bleaches, plastic) can cause irritation and disturb the vaginal flora, further increasing the discomfort.

Choose to take care of your intimate area with 100% organic ingredients without harmful substances. Enroush pads and tampons are made with super absorbent 100% GOTS certified organic cotton and are pH neutral to protect your vaginal microbiome with the purest ingredients. You are protected day by day not only from leaks, but also from irritations and allergies.

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

It is also possible for uterine polyps to be asymptomatic, meaning that there are no signs that anything is wrong.

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

When should you see a doctor?

In general, if there are no symptoms, you will not know that you have uterine polyps unless they are found by chance during a consultation. But whether or not you know about the existence of uterine polyps, always talk to your doctor if you experience irregular periods and unusual bleeding:

• Spotting or breakthrough 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 known effect is on fertility.

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

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 obviously cancer.

Diagnosis for uterine polyps

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

• The type of medication, if you are undergoing treatment
• Existence of the menstrual cycle: if you still have periods or have entered menopause
• How long and how often 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 he has this background, the gynecologist may order additional tests to confirm the diagnosis. You can have a gynecological consultation, the Babeș Pap test, but also other tests such as:

Transvaginal ultrasound

The test consists of inserting an ultrasound probe into the vagina. This will generate an image of the inside of the uterus so 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 non-invasive procedure that consists of introducing a sterile liquid into the uterus through a thin tube, the liquid causes the uterine cavity to expand to provide an even clearer picture of possible growths formed inside.

Hysteroscopy

It involves inserting a thin and long 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 endometrial biopsy, the gynecologist uses special instruments to collect a sample of the endometrial tissue, which is later tested in the laboratory and allows the detection of abnormal cells, if any.

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

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

• Ovarian cysts

• Uterine fibroids

• Adenomyosis

• ENDOMETRIOSIS

• Bleeding disorders

• Hormonal disorders

• Hypothyroidism

• Obesity

Treatment for uterine polyps

Treatment for uterine polyps differs depending on where you are in life and is not always necessary. The gynecologist's approach depends on how these formations evolve and the symptoms they cause.

Moreover, there are cases when polyps disappear by themselves. We explain below what to do in each situation.

Patient monitoring

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

This means that through periodic checks, the evolution of the polyps will be kept under observation. Further investigations will only be done in certain circumstances, for example if they are increasing 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, they opt for drug treatment. These are treatments with progestogens or gonadotropin-releasing hormone antagonists, which have the role of maintaining hormonal balance.

Hormone therapy can relieve 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 in the surgical removal of endometrial polyps. It is performed during a hysteroscopy and consists in excision of formations to remove them. Although you may feel some pressure during the operation, the doctor will give you medication beforehand so that the procedure is not painful.

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

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

How to prevent uterine polyps

In short, you cannot prevent uterine polyps. The fact that they do not have a clear cause makes it impossible to prevent them. What you can do, however, is to periodically go to the gynecologist to detect it early and keep it under surveillance.