Uterine polyps are small, soft nodules that can grow along the inside of the uterus (endometrium). Polyps are usually less than 1 cm in size but can grow to several centimetres. While uterine polyps are relatively common, they are rarely cancerous. However, they can cause problems, such as:

• heavy bleeding during the period
• pain
• infertility
• postmenopausal bleeding

If you have symptoms such as abnormal bleeding or vaginal discharge, it is important to see a specialist to determine if you have uterine polyps or another condition that may be causing similar symptoms.

What causes uterine polyps?

Currently, there is no official cause for the development of uterine polyps, but it is thought that high levels of oestrogen may play a role. Obesity may also be a risk factor, due to higher amounts of estrogen being released from the body's fat cells. Age may also play a role in the development of uterine polyps. Polyps are rare in women under the age of 20, and their incidence peaks between the ages of 40 and 49. While the risk of developing uterine polyps decreases after menopause as estrogen levels decrease, you may be at risk of developing polyps if you are treated with tamoxifen. In fact, it is estimated that between 8-36% of postmenopausal women who receive this treatment develop uterine polyps. It is also possible to have multiple uterine polyps and some may grow along the lower part of the uterus and protrude out through the cervix.

What are the symptoms?

Uterine polyps are known to cause abnormal vaginal bleeding. This can lead to the following symptoms:

• spotting or bleeding between periods
• unusual vaginal discharge
• heavier menstruation
• bleeding after menopause
• cramps or period-like pain

For any abnormal bleeding or discharge you should contact your doctor immediately, especially if you have been experiencing symptoms for more than 2 weeks or have already entered menopause. While these symptoms may be associated with uterine polyps, it is important to rule out uterine cancer.

How are uterine polyps diagnosed and how are they treated?

If uterine polyps are suspected on the vaginal ultrasound, the doctor will perform a hysteroscopy, in which a thin camera is inserted through the vagina and cervix. With this procedure it can be removed and then sent to a laboratory for further analysis. Also the doctor should rule out other conditions that may contribute to heavier than normal or unusual vaginal bleeding, such as:

• fibroids of the uterus
• ovarian cysts
• endometriosis and adenomyosis
• haemophilia and other bleeding disorders
• hypothyroidism
• certain medicines, such as blood thinners
• hormonal changes that can occur during puberty and perimenopause

How is hysteroscopic polyp removal performed?

The removal of uterine polyps is done with the help of a hysteroscope. A diathermy hook called a resectoscope or special scissors may be used. Depending on the location and number of polyps, the procedure can be performed under local or general anesthesia.

Summarizing

Uterine polyps can occur at any age but the risk is higher after the age of 40. Irregular bleeding is the most common symptom, although in some cases they cause no symptoms at all. Many of their symptoms are similar to other conditions. This is why you should see a doctor if you experience any abnormal bleeding, including longer or heavier periods or vaginal bleeding after menopause. Uterine polyps can be removed surgically. It is also possible for these polyps to recur, so you should talk to your doctor if you see that you are experiencing the same symptoms again.