Uterine Polyps

Uterine polyps overview

• Uterine polyps are endometrial tissue growths that attach to the uterine wall.
• Sizes range from a few millimeters (less than a half inch) to several centimeters (an inch or more).
• Uterine polyps commonly occur in women experiencing menopause or who have already experienced menopause.
• Polyps can prevent implantation of an embryo in the uterus.
• Polyp symptoms can mimic symptoms of endometrial cancer, which include irregular periods and abnormal bleeding, so it’s important to seek medical help soon at the first signs.

Cause of uterine polyps

The exact cause of uterine polyps is unknown. Fluctuations in hormones may be a factor. The hormone estrogen causes the endometrium to thicken each month and appears to be linked to the growth of uterine polyps.

Women in their 40s are more susceptible to polyps than women in their 20s. The odds of developing polyps increase in women who are overweight, have hypertension (high blood pressure), or take tamoxifen (a drug for treating breast cancer).

Diagnosing & treating polyps

Doctors have several methods to diagnose and treat uterine polyps.

• In a hysterosalpingogram (HSG) a radiologist injects dye into the uterus and fallopian tubes in order to see different kinds of tissue and to determine size and extent of any polyps.
• A hysteroscopy is a procedure in which a doctor inserts a scope through the vagina and into the uterus to examine for polyps. By inserting instruments through the hysteroscopic tube, a doctor can also take polyp samples for examination under a microscope. The doctor can also use the tube and a special instrument for a procedure called curettage, in which the polyps are removed by scraping the uterine wall.
• A transvaginal ultrasound can create images of the uterine area and help identify polyps. For this technique, a doctor inserts a wand into the vagina and high-frequency sound waves from the wand then project images of the uterine area on a monitor.
• A sonohysterogram is a similar procedure in which a radiologist injects a saline solution into the uterine area in order to inflate the uterus like a balloon. This approach sometimes reveals polyps that may have been overlooked in a standard ultrasound.

In milder cases, other options may include:

• Simply waiting – small polyps without symptoms may resolve on their own and may not impact fertility, making treatment unnecessary.
• Hormone medication – certain medications can help shrink a uterine polyp and lessen symptoms. Medication treatments are usually for a short period of time and symptoms often recur after the patient stops taking medication.

A uterine polyp can contain cancerous cells. If that’s the case, your doctor will talk to you about the next steps for treatment. However, less than 1 percent of polyps are associated with cancer.

Yet symptoms of uterine polyps are similar to symptoms of endometrial cancer and other serious conditions. For this reason, it’s important to see a doctor whenever symptoms first occur.

Uterine polyps rarely recur after treatment. But when they do they require more treatment.

Uterine polyps & infertility

Uterine polyps can act as a contraceptive in the same way as an intrauterine device (IUD), by preventing an embryo from implanting in the uterus.

Doctors are not certain why this happens, although some evidence suggests that the body attacks polyps as foreign elements. This attack may lead to inflammation, thus making it more difficult for implantation.

Polyps can also create a blockage where the fallopian tube enters the uterine cavity, preventing sperm from finding an egg to fertilize. Polyps can also block the canal of the cervix, directly blocking the uterus. Polyps may also contribute to miscarriages.

In any case, polyps can play a major role in infertility. In a 2005 study published in the medical journal Human Reproduction, women who had polyps removed were able to achieve pregnancy through artificial insemination at about twice the rate as those who did not undergo removal.