Uterine Polyps

Dr. Panagiotis Polyzos MD PhD MSc

Obstetrician Gynaecologist
Doctor of Medicine, University of Athens Medical School

Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.

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Uterine Polyps

What are uterine polyps?

Uterine polyps are abnormal, excessive growths (hyperplasia) of the glands and stroma of the uterus that extend inward and protrude into the uterine cavity. The overgrowth of endometrial cells leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually benign, although some may be cancerous or can eventually become malignant (precancerous polyps). Uterine polyps range in size from a few millimeters — as small as a sesame seed — to several centimeters — similar to the size of a golf ball or larger. They may attach to the uterine wall by a broad base or a thin stalk.

A woman may have one or multiple uterine polyps. They are most commonly found in the uterine cavity, but in some cases, they may occur in the cervix and even the vagina. Uterine polyps most often appear in women who are going through or have completed menopause with your gynecologist, although younger women may also develop them.

What are the symptoms?

Symptoms of uterine polyps may include:

  • Abnormal uterine bleeding — such as frequent, unpredictable periods of varying duration and intensity
  • Intermenstrual bleeding
  • Heavy menstrual bleeding (menorrhagia)
  • Infertility

What are the causes?

Hormonal factors appear to play a major role. Uterine polyps are estrogen-dependent, meaning they grow in response to circulating estrogen.

Risk factors

Risk factors for developing uterine polyps include:

Are there any complications?

Uterine polyps may be associated with infertility. If you have uterine polyps and are struggling to conceive, removing them may improve the chances of pregnancy — although scientific data remains mixed.

How are Uterine Polyps diagnosed?

If your doctor suspects uterine polyps, one or more of the following diagnostic tests may be performed:

  • Transvaginal ultrasound: The doctor may detect a clearly visible polyp or identify thickened endometrial tissue suggesting a polyp.
  • Saline infusion sonography (SIS): Sterile saline is infused into the uterine cavity during ultrasound to improve visualization.
  • Hysteroscopy: A thin flexible telescope with a light (hysteroscope) is inserted through the vagina and cervix to inspect the inside of the uterus.
  • Endometrial biopsy: A sample of endometrial tissue is collected for laboratory analysis. Polyps can be confirmed through histological examination.

Most uterine polyps are benign. However, some precancerous endometrial changes (endometrial hyperplasia) or endometrial cancer may initially appear as polyps. Your doctor will likely recommend polyp removal so the tissue can be examined to rule out cancer.

What is the proper treatment? Can polyps be removed?

Depending on your condition, your doctor may recommend:

  • Watchful waiting: Small asymptomatic polyps may resolve on their own. Treatment may not be necessary unless there is a cancer risk.
  • Medication: Hormonal therapies such as progesterone or gonadotropin-releasing hormone agonists may reduce symptoms. However, this is usually only a short-term solution, as symptoms often recur once treatment is discontinued.
  • Surgical removal: Polyps can be excised during hysteroscopy. If cancerous cells are detected, your doctor will discuss further treatment options with you.
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Do polyps recur?

In rare cases, polyps may recur. The use of a hormonal intrauterine device (IUD) that causes endometrial thinning or an endometrial ablation using diathermy (for women who no longer wish to become pregnant).

In women undergoing tamoxifen treatment, management is more complex and must be carefully individualized.

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