Overview
Uterine polyps are growths that attach to the inner wall of the uterus and expand into the uterus. They are usually noncancerous, but some can be cancerous or precancerous. Uterine polyps vary in size from a few millimeters to several centimeters. They can be single or multiple and can be found inside or outside the uterus. They are more common in women who have gone through or are going through menopause, but they can also occur in younger women. Symptoms of uterine polyps may include vaginal bleeding after menopause.
Understanding the disease
Symptoms
Symptoms of uterine polyps may include vaginal bleeding after menopause, heavy menstrual bleeding, menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation, backache or leg pains. If you experience any of these symptoms, it is recommended to consult your doctor.
Risk Factors
Risk factors for developing uterine polyps include:
- Being perimenopausal or postmenopausal.
- Being obese.
- Taking tamoxifen, a drug therapy for breast cancer.
- Taking hormone therapy for menopause symptoms.
Development
Uterine polyps develop as a result of cells in the lining of the uterus (endometrium) overgrowing. These polyps are usually noncancerous (benign), although some can be cancerous or can turn into cancer (precancerous polyps). They attach to the uterine wall by a large base or a thin stalk. Uterine polyps can vary in size, ranging from a few millimeters to several centimeters. They usually stay within the uterus, but they can slip through the opening of the uterus (cervix) into the vagina. Uterine polyps are more common in people who are going through or have completed menopause, but younger individuals can also develop them.
Assessment and Diagnosis
Triage
You should see a doctor if you experience symptoms such as vaginal bleeding after menopause, as this may indicate the presence of uterine polyps. In such cases, it is important to consult a healthcare provider for proper diagnosis and treatment.
Diagnosis
To diagnose uterine polyps, doctors may use the following tests:
- Transvaginal ultrasound
- Hysteroscopy
- Endometrial biopsy These tests can help identify the presence of polyps or thickened endometrial tissue. A tissue sample from the removed polyp is also analyzed for signs of cancer. The choice of diagnostic test depends on the individual case and the doctor's assessment of the patient's symptoms and risk factors.
Management and Treatment
Complications
Potential complications of uterine polyps include infertility, irregular menstrual bleeding, and frequent abnormal uterine bleeding. In some cases, uterine polyps may also be associated with precancerous changes or cancer. Additionally, the presence of polyps can make it difficult for an embryo to implant, potentially causing infertility.
Treatment
There are several treatment options for uterine polyps, depending on the size, location, and whether they are causing any symptoms. Some options include:
- Watchful waiting: For smaller polyps that aren't causing any symptoms, your healthcare provider may recommend waiting and monitoring them periodically through ultrasound or other imaging tests.
- Medications: Hormonal medications, such as progestin-releasing intrauterine devices (IUDs) or progestin therapy, can help shrink or reduce the size of the polyps.
- Surgical removal: If the polyps are causing symptoms, very large, or suspected to be cancerous, they may need to be surgically removed. This can be done through a procedure called hysteroscopy, where a thin, lighted tube is inserted into the uterus to remove the polyp. In some cases, a procedure called dilation and curettage (D&C) may be performed to remove the polyp. It's important to discuss the potential benefits, risks, and side effects of each treatment option with your healthcare provider to determine the best course of action for your specific situation.
Preparing for medical consultation
To prepare for an appointment regarding uterine polyps, you should:
- Make a list of any symptoms you're experiencing, even if they seem unrelated to the issue.
- Create a list of all medications, vitamins, supplements, or herbal medications you're taking, including doses.
- Bring a family member or friend along for support and to help remember information discussed during the appointment.
- Write down any questions you have for your doctor, such as:
- What could be causing my symptoms?
- What tests might I need?
- Are medications available to treat my condition?
- Under what circumstances do you recommend surgery?
- Could uterine polyps affect my ability to become pregnant?
- Will treatment of uterine polyps improve my fertility? Remember to be open and honest with your doctor about your concerns, and don't hesitate to ask any questions that come up during the appointment.