This week, we’ll explain what uterine polyps are, why they form, and what to do about them
What is a uterine polyp?
Uterine polyps are growths on the inner walls of the uterus. They range in size from a sesame seed to a golf ball, and usually attach to the uterine wall with a base or a stalk. You can have one at a time, or many. While usually benign, some can be cancerous or precancerous.
Symptoms of a uterine polyp:
- Irregular periods, especially if they are frequent or unpredictable
- Bleeding between periods
- Really heavy periods
- Bleeding after menopause
- Potentially cramping between periods
What causes uterine polyps?
Polyps form out of overgrown cells in the lining of the uterus. The jury is still out on their exact cause, but they seem to be influenced by hormonal factors, growing in response to circulating estrogen. They are most common in peri and postmenopausal women. Other risk factors include high blood pressure, obesity, and taking tamoxifen, which is a drug used to treat breast cancer.
How are polyps diagnosed?
Your doctor will likely use one of the three following methods to diagnose a uterine polyp:
1. Transvaginal ultrasound
The doctor inserts a thin, wand-like device into your vagina. The wand uses sound waves to make an image of the inside of your uterus, and is used to locate irregular growths.
The doctor inserts a thin, lighted tube called a hysteroscope into your vagina to examine the inside of your uterus. This device
3. Endometrial biopsy
Your doctor may use a catheter to take a cell sample from your uterus for testing. This sample might confirm the presence of a uterine polyp, but could also miss it.
Treatment for uterine polyps
There are also three main tactics for treating polyps:
Treatment for polyps usually isn’t necessary unless you are at risk for uterine cancer. As we said above, most polyps are usually benign. Small ones that don’t cause many symptoms might go away on their own. Your doctor will still likely want to keep tabs on them just to make sure they don't grow any larger.
Sometimes, doctors will prescribe hormonal medicines like progestins to reduce symptoms. However, this is not a long term solution as symptoms often return as soon as you stop taking the medicine.
3. Surgical removal
The symptoms of a polyp can often be very uncomfortable, so your doctor might recommend a polypectomy to remove it. In this case, your doctor may send the polyp the to a lab for testing. If it contains cancerous cells, your doctor may initiate further conversations about treatment.
Connection to fertility
As indicated above, infertility can be a symptom of uterine polyps. The association between polyps and infertility is controversial, and many women with polyps go on to have successful pregnancies.
However, there is growing evidence suggesting that polyps do play a role in fertility, and the outcome of fertility treatments. Because polyps can range in size and attach themselves to the uterine wall, they might interfere with sperm transport, embryo implantation, or early pregnancy development. Essentially, they physically block a pregnancy from getting going. Research indicates that getting polyps removed does seem to improve rates of spontaneous pregnancy and success with IUI.
In the case of IVF, polyps are the most common issue reported in people who have repeated issues with implantation. Doctors usually suggest the removal of a polyp before beginning hormonal treatments, but more research is needed to determine the best way of managing polyps in relation to IVF.
Navigating uterine polyps can be stressful, but we are here to help! If you have any further questions, comments, or just want to chat, you can always reach out to one of our healthcare professionals via our chat portal, or schedule a telehealth consultation here.