Uterine polyps are a common gynecological concern. Abnormal uterine bleeding is a very common symptom associated with uterine polyps, often prompting individuals to seek medical attention. Understanding these growths and their potential effects is important for managing reproductive health.
What Are Uterine Polyps?
Uterine polyps, also known as endometrial polyps, are overgrowths of the tissue lining the inside of the uterus, called the endometrium. These growths attach to the uterine wall either by a broad base or a thin, elongated stalk, extending into the uterine cavity. They vary significantly in size, from a few millimeters to several centimeters. While polyps can be solitary, multiple polyps can also form within the uterus.
Most uterine polyps are non-cancerous. However, a small percentage can show precancerous changes or be cancerous. The risk of a polyp being cancerous is low, estimated to be around 1-2% in premenopausal individuals and slightly higher at 5-6% in those who have gone through menopause.
Uterine Polyps and Bleeding Patterns
Abnormal bleeding is the most frequently reported symptom associated with uterine polyps. This bleeding can manifest in various ways. One common pattern is irregular menstrual bleeding, which involves bleeding or spotting between regular menstrual periods. Individuals might also experience heavy menstrual bleeding, characterized by unusually heavy or prolonged periods.
Bleeding after menopause, known as postmenopausal bleeding, is another indicator linked to uterine polyps. Additionally, some individuals may notice bleeding after sexual intercourse. This bleeding occurs because polyps contain numerous small, fragile blood vessels that can easily rupture. Hormonal fluctuations, inflammation within the uterine lining, or mechanical irritation, such as during intercourse, can all contribute to the breakdown of these vessels and subsequent bleeding.
Other Indicators of Uterine Polyps
While bleeding is the most common sign, uterine polyps can present with other indicators. One impact is on fertility. Polyps located near the fallopian tubes or within the uterine cavity may interfere with the process of conception by hindering sperm migration or preventing a fertilized egg from implanting successfully into the uterine lining. Some studies suggest that removing polyps can improve pregnancy rates for individuals experiencing infertility.
Other less common symptoms can include pain or cramping, particularly if polyps are large or if they begin to protrude through the cervix into the vagina. Additionally, some individuals might notice an unusual vaginal discharge. Many uterine polyps are asymptomatic and are sometimes discovered incidentally during medical examinations for other conditions.
Diagnosing and Managing Uterine Polyps
When uterine polyps are suspected, healthcare providers employ several diagnostic methods. An initial step involves a transvaginal ultrasound, where a small device creates images of the uterus. For a more detailed view, sonohysterography, also known as saline-infusion sonography (SIS), may be performed. This procedure involves injecting sterile saline fluid into the uterus during an ultrasound, which helps to expand the uterine cavity and provide clearer images of any growths. Sonohysterography is effective in identifying endometrial polyps.
Hysteroscopy is a primary method for both diagnosing and treating uterine polyps. During this procedure, a thin, flexible tube with a camera and light source, called a hysteroscope, is inserted through the vagina and cervix into the uterus, allowing direct visualization of the uterine lining. If polyps are identified, removal, known as polypectomy, is recommended. This procedure is typically performed hysteroscopically, where surgical instruments are passed through the hysteroscope to remove the polyp(s).
Polyp removal is advised to alleviate symptoms like abnormal bleeding, improve fertility outcomes, and for tissue analysis to rule out precancerous or cancerous cells. After removal, the polyps are sent to a laboratory for pathological examination. It is important to consult a healthcare provider for any abnormal vaginal bleeding, especially if it occurs after menopause, as prompt investigation is needed to determine the underlying cause.