Uterine polyps, also known as endometrial polyps, are non-cancerous growths that develop from an overgrowth of the inner uterine lining (endometrium), extending into the uterine cavity. Common in women in their 40s and 50s, especially around or after menopause, they can occur at any age.
Appearance to the Eye
Uterine polyps exhibit a range of physical characteristics visible during medical examination or imaging. Their size can vary significantly, from a few millimeters (like a sesame seed) to several centimeters (like a golf ball). Polyps are often described by their shape; many are “pedunculated,” meaning they are attached to the uterine wall by a thin stalk, similar to a mushroom. Others are “sessile,” which means they have a broad, flat base directly attached to the uterine lining.
The color typically matches the surrounding endometrial tissue, appearing pinkish, reddish, or purplish, though some may be paler or darker if they contain small blood vessels. A person can have single or multiple polyps. These growths generally possess a soft and fragile consistency. While primarily residing within the uterine cavity, pedunculated polyps can occasionally extend through the cervix and into the vagina.
How Polyps Present
From a patient’s perspective, uterine polyps most commonly manifest through changes in menstrual patterns. Abnormal uterine bleeding is the most frequent symptom, including heavy periods (menorrhagia), bleeding between periods, or irregular menstrual bleeding. Vaginal bleeding after menopause is another common sign, as is bleeding that occurs after sexual intercourse. While less common, uterine polyps can sometimes cause pelvic pain, particularly if they are large or if they lead to uterine cramping.
Beyond bleeding and discomfort, polyps can also impact fertility. They may interfere with conception by preventing a fertilized egg from attaching to the uterine wall or by blocking the fallopian tubes or cervix. The presence of polyps has also been associated with an increased risk of miscarriage.
Confirming Polyp Presence
Medical professionals utilize several methods to visually identify and confirm the presence of uterine polyps. Transvaginal ultrasound (TVS) is often the initial imaging technique employed, where a slender device is inserted into the vagina to generate images of the uterus and its lining. While TVS can indicate thickened endometrial tissue or the presence of a polyp, sonohysterography (saline-infusion sonography) often provides a clearer view. During sonohysterography, a sterile saline solution is gently introduced into the uterus, which expands the cavity and allows for better visualization of polyps on the ultrasound.
Hysteroscopy is considered the most definitive method for diagnosing uterine polyps. This procedure involves inserting a thin, lighted telescope (hysteroscope) through the vagina and cervix directly into the uterus. Hysteroscopy provides a direct visual inspection of the uterine interior, enabling the physician to see the polyps firsthand. During hysteroscopy, tissue samples can also be taken for further analysis. An endometrial biopsy, which involves collecting a small tissue sample from the uterine lining, can also be performed to analyze cells, though it might not always definitively identify a polyp without direct visualization.
Are Polyps Concerning?
The vast majority of uterine polyps are benign (non-cancerous). However, a small percentage of polyps, typically ranging from 1% to 5%, can be cancerous or precancerous. The risk of a polyp being cancerous increases slightly with age, particularly for women who have gone through menopause. Obesity, high blood pressure, and the use of tamoxifen (a medication for breast cancer) are also associated with an increased risk for developing uterine polyps and, in some cases, a higher likelihood of cancerous changes. Due to this small but present risk, medical evaluation is important to differentiate between benign and potentially malignant polyps, ensuring appropriate management and peace of mind.