Uterine growths are common, with polyps and fibroids being frequently encountered. While both can develop within the uterus and present with similar symptoms, they are distinct conditions originating from different tissues. Understanding their fundamental differences is important for accurate diagnosis and effective management.
Uterine Polyps
Uterine polyps are an overgrowth of the endometrial tissue, the lining of the uterus. They attach to the uterine wall by a thin stalk or a broad base, extending into the uterine cavity. Polyps vary significantly in size, from a few millimeters to several centimeters, and may appear as single growths or in clusters.
These growths are typically soft and finger-like. While mostly non-cancerous, a small percentage can contain precancerous or cancerous cells. The risk of a polyp being cancerous is low, estimated at about 1-2% in premenopausal women and 5-6% in postmenopausal women. Evaluating any diagnosed polyp is important due to this potential for malignancy.
Uterine Fibroids
Uterine fibroids, also known as leiomyomas, are non-cancerous growths developing from the muscle tissue of the uterus. Unlike polyps, fibroids are firm and rubbery. They range widely in size, from microscopic to as large as a melon. Most fibroids are benign and do not increase the risk of uterine cancer.
Fibroids can grow in various locations within the uterine wall, including within the muscular wall (intramural), on the outer surface (subserosal), or just beneath the uterine lining (submucosal). Some can also be pedunculated, attached by a stalk. Fibroids are very common, with estimates suggesting 70% to 80% of women may develop them by age 50.
Polyp Versus Fibroid
The primary distinction between uterine polyps and fibroids lies in their tissue composition and origin. Polyps arise from an overgrowth of endometrial tissue, the inner lining of the uterus. Fibroids are composed of smooth muscle cells and connective tissue from the muscular wall of the uterus. This fundamental difference dictates many of their varying characteristics.
Common symptoms can also differ. Polyps frequently cause irregular menstrual bleeding, including spotting between periods, and bleeding after menopause. Fibroids, especially larger ones, are more often associated with heavy and prolonged menstrual bleeding, pelvic pressure or pain, frequent urination, and back pain. Both can impact fertility and lead to anemia due to significant blood loss.
Regarding malignancy risk, polyps carry a small but present risk of being or becoming cancerous, particularly in postmenopausal individuals. Fibroids, conversely, are almost always benign; transformation to cancerous leiomyosarcoma is exceedingly rare, occurring in less than 0.1% of cases. The presence of benign fibroids does not increase the risk of developing malignant fibroids.
Diagnosis often involves similar imaging techniques, but with different findings. Both can be detected through transvaginal ultrasound, which can show thickened endometrial tissue for polyps or a mass within the muscular wall for fibroids. Hysteroscopy, involving a small camera inserted into the uterus, allows for direct visualization and differentiation. An endometrial biopsy may be performed to analyze tissue, especially for polyps, to rule out cancerous cells.
Treatment approaches also vary. Polyps are often removed through hysteroscopic polypectomy, a procedure where the polyp is excised using instruments inserted through the hysteroscope. This removal often resolves symptoms, and polyps rarely recur.
For fibroids, management options range from watchful waiting for asymptomatic cases to medications that help control symptoms or shrink them temporarily. Surgical options include myomectomy, which removes fibroids while preserving the uterus, or uterine artery embolization, which blocks blood flow to shrink them. Hysterectomy, the removal of the entire uterus, is a definitive treatment for severe cases or when childbearing is not desired.
When to Seek Medical Advice
Any unusual gynecological symptoms warrant a consultation with a healthcare provider. Self-diagnosis of uterine conditions is not advisable due to potential for overlapping symptoms with other, sometimes more serious, health issues. A medical professional can accurately determine the nature of any uterine growth.
Symptoms such as abnormal bleeding (heavy or prolonged periods, bleeding between periods, or any vaginal bleeding after menopause) should prompt a medical evaluation. Pelvic pain or pressure, changes in urinary habits, or difficulties with fertility can also be signs of underlying uterine conditions. An accurate diagnosis ensures appropriate treatment, addressing the specific condition and improving overall well-being.