Cervical polyps are common, generally non-cancerous growths that form on the cervix, the narrow passage connecting the uterus to the vagina. These growths are frequently found during routine gynecological examinations, often before they cause any noticeable symptoms. This article explores the frequency of cervical polyps, their biological nature, the signs they may present, and the procedures used for their diagnosis and removal.
Prevalence and Associated Risk Factors
Cervical polyps are a frequent finding in gynecological practice, affecting between 2% and 5% of women in the general population. They are the second most common type of polyp found in the female reproductive tract, following endometrial polyps. The incidence peaks in women between the ages of 40 and 60.
These growths are most common in women who have had multiple pregnancies (multiparous women). They are rare in premenarchal girls. While polyps can occur at any age during the reproductive years, the risk is higher for women who are premenopausal or perimenopausal.
What Cervical Polyps Are
A cervical polyp is an overgrowth of the glandular tissue of the cervix, typically described as a small, elongated tumor. They are usually soft, fragile, and tear-shaped, often attached to the cervical wall by a thin stalk called a pedicle. Their appearance can vary, but they are generally smooth and range in color from bright red or purplish to grayish-white.
The exact mechanism behind their formation is not fully known, but growth is suspected to result from a combination of factors. One primary theory involves hormonal influences, specifically an abnormal response to elevated estrogen levels. This hormonal link explains why they are more common during the reproductive years and during pregnancy, periods when estrogen naturally peaks.
Another element is chronic inflammation or infection of the cervix. This ongoing irritation can lead to the localized overgrowth of tissue, a process called focal hyperplasia, which forms the polyp. Infections, such as sexually transmitted infections or bacterial vaginosis, can trigger the inflammation that encourages polyp formation.
Recognizing the Signs
Most cervical polyps do not produce any symptoms and are discovered incidentally during a routine pelvic exam or Pap test. When symptoms occur, they are usually related to the polyp’s fragile surface, which is prone to bleeding when touched or irritated. The most common symptom is abnormal vaginal bleeding.
This bleeding may manifest as spotting between menstrual periods, heavier menstrual flow, or bleeding after sexual intercourse. Bleeding that occurs after a woman has gone through menopause should also be promptly evaluated. Patients may also notice an unusual vaginal discharge, which is often mucoid, yellow, or white, and can sometimes be tinged with blood.
Diagnosis and Removal Procedures
Cervical polyps are typically diagnosed through a visual examination when a healthcare provider uses a speculum to view the cervix. The polyp’s distinct appearance as a smooth, finger-like projection is usually enough for initial identification. All polyps must be sent for laboratory testing after removal to confirm their nature.
The removal procedure, known as a polypectomy, is generally a simple, quick, office-based procedure. The provider typically grasps the polyp’s stalk with specialized forceps and removes it by twisting or cutting it at the base. Most patients experience only mild discomfort or brief cramping during the removal. Minor bleeding at the removal site can often be managed with a chemical cautery agent like silver nitrate.
The primary reason for removal and subsequent tissue analysis (histopathology) is to exclude malignancy. Cervical polyps are overwhelmingly benign, meaning they are not cancerous. However, a small percentage, ranging from about 0.1% to 0.2%, may contain cancerous cells, a risk that is slightly higher in postmenopausal women. The pathology report confirms the non-cancerous nature of the growth and ensures that no rare malignant transformation has occurred, providing reassurance and informing any necessary follow-up care.