Uterine polyps are common, non-cancerous growths developing within the inner lining of the uterus. While often benign and sometimes asymptomatic, they can lead to various issues, including pain. This article clarifies what uterine polyps are and their potential effects.
What Are Uterine Polyps?
Uterine polyps, also known as endometrial polyps, are an overgrowth of the tissue that lines the inside of the uterus, called the endometrium. These growths can vary significantly in size, from a few millimeters to several centimeters. They can be attached to the uterine wall by a thin stalk (pedunculated) or a broad base (sessile).
Most uterine polyps are benign. However, a small percentage (0.5% to 5%) can contain cancerous or pre-cancerous cells, with the risk slightly higher in postmenopausal individuals or those experiencing abnormal bleeding. While they can occur at any age, uterine polyps are more common in women in their 40s and 50s.
Uterine Polyp Symptoms
While many uterine polyps are asymptomatic, they frequently cause a range of symptoms, including various types of pain. Pain can manifest as cramping, dull aches in the abdomen or lower back, or discomfort during sexual intercourse. This pain may occur because larger polyps can cause the uterus to contract in an attempt to expel them, or they can create pressure within the uterine cavity. If a polyp protrudes through the cervix, it might also lead to pain.
Beyond pain, the most common symptom is abnormal uterine bleeding. This can include irregular menstrual periods, bleeding or spotting between periods, or unusually heavy menstrual flow. Postmenopausal bleeding, which is any vaginal bleeding after menopause, is another significant symptom that warrants medical attention. Some individuals may also notice unusual vaginal discharge. Uterine polyps can also contribute to difficulty conceiving or an increased risk of miscarriage, as their presence can interfere with embryo implantation.
Diagnosing Uterine Polyps
Identifying uterine polyps typically involves several diagnostic methods to visualize the inside of the uterus. Transvaginal ultrasound is often the initial imaging technique used, where a slender device placed in the vagina emits sound waves to create images of the uterus. This can reveal a polyp as a thickened area of endometrial tissue.
A more detailed view can be obtained with saline infusion sonography (SIS), also known as sonohysterography. This procedure involves injecting sterile saline solution into the uterus to gently expand the cavity, providing clearer images of any growths during an ultrasound.
Hysteroscopy is often considered the gold standard for diagnosis; a thin, lighted telescope with a camera (hysteroscope) is inserted through the vagina and cervix into the uterus, allowing direct visualization of the polyps. During hysteroscopy, a biopsy may be taken to examine the tissue for cancerous or pre-cancerous cells.
Treating Uterine Polyps
Treatment for uterine polyps is often recommended when they cause symptoms, are large, or raise concerns for malignancy. For symptomatic polyps, surgical removal is the primary approach, typically performed through hysteroscopic polypectomy. This minimally invasive procedure involves inserting a hysteroscope into the uterus, through which specialized instruments can be passed to precisely cut and remove the polyp while preserving the uterus.
The removed polyp is then sent to a laboratory for examination to rule out the presence of cancer cells. In some cases, for small, asymptomatic polyps, especially in premenopausal individuals, a “watch and wait” approach might be considered, as some polyps can regress on their own. However, for postmenopausal individuals or those with symptoms, removal is generally advised.
When to Seek Medical Advice
If you experience persistent or concerning symptoms that might suggest uterine polyps, consult a healthcare professional. This includes any type of unusual bleeding, such as heavy periods, bleeding between periods, or any vaginal bleeding after menopause. Pelvic pain or discomfort that is new or worsening should also prompt a medical evaluation. A medical professional can accurately diagnose your symptoms and recommend the appropriate course of action.