Uterine polyps

Uterine polyps

Definition:

Uterine polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps).

The sizes of uterine polyps range from a few millimeters — no larger than a sesame seed — to several centimeters — golf ball sized or larger. They attach to the uterine wall by a large base or a thin stalk.

You can have one or many uterine polyps. They usually stay contained within your uterus, but occasionally, they may slip down through the opening of the uterus (cervix) into your vagina. Uterine polyps most commonly occur in women who are going through or have completed menopause (peri- and postmenopausal women), although younger women can get them, too.

Symptoms:

Signs of uterine polyps include:

• Irregular menstrual bleeding — for example, having frequent, unpredictable periods of variable length and heaviness
• Bleeding between menstrual periods
• Excessively heavy menstrual periods
• Vaginal bleeding after menopause
• Infertility

Some women may experience only light bleeding or spotting or may even be symptom-free.
When to see a doctor
Seek medical care if you have:

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

Causes:
 Although the exact cause of uterine polyps is unknown, hormonal factors appear to play a role. Uterine polyps are estrogen-sensitive, meaning that they respond to estrogen in the same way that the lining of your uterus does — growing in response to circulating estrogen.


Complications:

Uterine polyps may be associated with infertility. If you have uterine polyps and you experience infertility, removal of the polyps might allow you to become pregnant.

Uterine polyps also may present an increased risk of miscarriage in women who undergo in vitro fertilization (IVF). If you're considering IVF treatment and you have uterine polyps, your doctor may recommend polyp removal before embryo transfer.


Treatments and drugs:

For uterine polyps, your doctor might recommend:

• Watchful waiting. Small polyps without symptoms (asymptomatic) may resolve on their own. Treatment is unnecessary unless you're at risk of uterine cancer.
  
• Medication. Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may shrink a uterine polyp and lessen symptoms. But taking such medications is usually a short-term solution at best — symptoms typically recur once you stop taking the medicine.
  
• Curettage. Your doctor uses a long metal instrument with a loop on the end to scrape the inside walls of your uterus. This may be done to collect a specimen for lab testing or to remove a polyp. Your doctor may perform curettage with the assistance of a hysteroscope, which allows your doctor to view the inside of your uterus before and after the procedure.
  
• Surgical removal. During hysteroscopy, instruments inserted through the hysteroscope — the device your doctor uses to see inside your uterus — make it possible to remove polyps once they're identified. The removed polyp may be sent to a lab for microscopic examination.

If a uterine polyp contains cancerous cells, your doctor will talk with you about the next steps in evaluation and treatment.
Rarely, uterine polyps can recur. If they do, you might need more treatment.