Uterine polyps are growths on the endometrium, the inner lining of the uterus. They vary in size, ranging from a few millimeters to several centimeters. While often benign, they can sometimes cause various symptoms that prompt medical attention. This article explores whether uterine polyps cause pain, their symptoms, diagnosis, and management.
What Are Uterine Polyps
Uterine polyps, also known as endometrial polyps, are overgrowths of endometrial cells originating from the inner lining of the uterus. They attach to the uterine wall by a thin stalk or a broad base, extending into the uterine cavity. Their size ranges from that of a sesame seed to a golf ball or larger. They can be solitary or multiple.
Hormonal factors, particularly estrogen levels, play a role in their development, though the exact cause is not fully understood. Estrogen thickens the endometrium each month; an overgrowth of this tissue can lead to polyp formation. Though typically benign, a small percentage of uterine polyps can be pre-cancerous or cancerous.
Do Uterine Polyps Cause Pain
Many uterine polyps do not cause any symptoms and are discovered incidentally. However, some individuals may experience pain. When pain occurs, it can manifest as a dull ache in the abdomen or lower back, similar to menstrual cramps.
The pain can also include cramping during menstruation. Polyps protruding through the cervix into the vagina may also cause pain. The size and location of the polyp influence whether it causes pain, with larger polyps more likely to cause pain.
Beyond Pain Other Symptoms
Beyond pain, the most common symptom is abnormal uterine bleeding. This can present as unusually heavy menstrual bleeding (menorrhagia), irregular bleeding or spotting between periods (intermenstrual bleeding), or any vaginal bleeding after menopause. These bleeding patterns are often unpredictable in timing and flow.
Uterine polyps can also contribute to difficulty conceiving or an increased risk of miscarriage. This occurs because polyps can interfere with fertilized egg implantation or block the fallopian tubes or cervix. While less common, some individuals might also experience unusual vaginal discharge.
Diagnosis and Management
Diagnosing uterine polyps involves imaging techniques and direct visualization of the uterine cavity. A transvaginal ultrasound, using a slender device inserted into the vagina, is often the initial diagnostic tool to create images of the uterus. For enhanced visualization, saline infusion sonography (SIS), also known as hysterosonography, involves injecting sterile fluid into the uterus for clearer viewing.
Hysteroscopy allows direct examination of the uterine interior. A thin, flexible tube with a camera (hysteroscope) is inserted through the vagina and cervix into the uterus during this procedure. Identified polyps can often be removed during the same hysteroscopy, a process known as polypectomy. Removed tissue is sent for laboratory analysis to rule out cancerous cells.
Treatment often involves surgical removal, especially if polyps cause symptoms like pain or abnormal bleeding, or if malignancy is a concern. For small, asymptomatic polyps, watchful waiting is an option, as some polyps can resolve on their own. Medications like progestins can sometimes manage symptoms by controlling hormone levels, but these are usually short-term solutions, as symptoms often return once stopped. Removal of polyps can significantly alleviate symptoms, including pain and bleeding.