What are uterine polyps?

Uterine polyps are small tissue growths that either lie inside the uterus or protrude through the cervix. Polyps are almost always benign (non-cancerous).  About 2 to 5% of women have cervical polyps and they can be caused by chronic inflammation or infection.

What are the causes and risk factors for the development of uterine polyps?

The exact causes of uterine polyps are not known, but several factors may increase the risk of developing them. Here are some common causes and risk factors for uterine polyps:

• Hormonal imbalances: Uterine polyps are often associated with hormonal imbalances, particularly an excess of estrogen compared to progesterone. This hormonal imbalance can cause thickening of the endometrium, leading to the development of polyps.
• Age: Uterine polyps are more common in women who are approaching or have entered menopause. This is probably due to hormonal changes that occur during this period.
• Obesity: Women who are obese may be more likely to develop uterine polyps, as excess fatty tissue can produce extra oestrogen.
• Family history: There may be a genetic predisposition to developing uterine polyps, as women with a family history of polyps or other types of uterine abnormalities are more likely to develop them too.
• Endometrial hyperplasia: Women with a condition called endometrial hyperplasia, which causes the endometrium to thicken, may be more likely to develop uterine polyps.
• Tamoxifen: Women who have been treated for breast cancer with the drug tamoxifen may be at increased risk of developing uterine polyps because of the drug's estrogen-like effects on the uterus.

While the exact causes of uterine polyps are not known, these risk factors may increase the likelihood of developing them. Women who experience symptoms such as abnormal bleeding or infertility should discuss their concerns with their gynecologist to determine if further evaluation is needed.

What are the most common symptoms caused by uterine polyps?

Most cervical polyps do not cause any symptoms. However, when they do cause symptoms these include : 

• Abnormal uterine bleeding: The most common symptom of uterine polyps is abnormal bleeding, which may include heavy or prolonged periods, bleeding between periods or bleeding after menopause.
• Infertility: Uterine polyps can affect fertility by blocking the fallopian tubes or interfering with the implantation of a fertilised egg.
• Pelvic pain: Some women with uterine polyps may experience pelvic pain or pressure, especially during sexual intercourse.
• Irregular menstrual cycles: Women with uterine polyps may experience irregular menstrual cycles, with periods occurring more frequently or less frequently than usual.
• Anemia: Heavy or prolonged bleeding caused by uterine polyps can lead to anaemia, a condition in which the body does not have enough red blood cells to carry oxygen to the tissues.

It is important for women who experience these symptoms to talk to their gynaecologist, as they may indicate other gynaecological conditions. A thorough history taking and examination can help determine the cause of the symptoms and appropriate treatment.

How are uterine polyps diagnosed?

Uterine polyps are usually diagnosed by the following methods:

→ Medical history and physical examination: The gynaecologist will ask about the patient's history and symptoms and will perform a gynaecological examination.

→Ultrasound: Ultrasound imaging can help detect the presence of polyps. Transvaginal ultrasound, in which an ultrasound head is inserted into the vagina, is often used to examine the uterus in detail.

→Hysteroscopy: Hysteroscopy is a minimally invasive surgical procedure in which a small camera is inserted into the uterus through the cervix to visualise the inside of the uterus and detect any polyps or other lesions.

→Biopsy: A biopsy involves removing a sample of tissue from the polyp and examining it under a microscope for evidence of abnormal growth or cancer. Women should discuss their symptoms and concerns with their gynecologist to determine the best diagnostic approach for their individual needs.

How are uterine polyps treated?

Treatment for uterine polyps depends on several factors, such as the size and location of the polyp, age, the woman's desire to have children and the severity of her symptoms. Here are some common treatment options:

Monitoring: Small, asymptomatic polyps may not need treatment and the gynaecologist may recommend simple monitoring of the polyp to ensure it is not growing in size or causing complications.

Medication: Hormonal medications, such as birth control pills or progesterone, can help regulate the menstrual cycle and shrink the polyp in some cases.

Hysteroscopic polypectomy: A hysteroscopic polypectomy is a minimally invasive surgery in which the polyp is removed through a small camera inserted into the uterus through the cervix. This procedure can be done in an outpatient setting and usually has a quick recovery time.