Nearly a quarter of women experience uterine polyps, an overgrowth of tissue in the endometrium. While many girls undergo abnormal uterine bleeding, the simple fact is that uterine polyps tend to be asymptomatic.
Uterine polyps, also known as endometrial polyps, are often small, bulb-shaped masses of endometrial tissue connected to the uterus by a stalk.
They’re soft, rather than uterine fibroids, which may grow much bigger and are made of hard muscle.
Symptoms of Uterine Polyps
When symptoms of uterine polyps are evident, they’re similar to those of more serious illnesses, such as endometrial cancer. In case you’ve got these symptoms it is important that you find a physician. The symptoms may contain several types of abnormal uterine bleeding for example:
- Heavy menstrual bleeding
- Spotting between periods
- Bleeding after intercourse
- Bleeding after menopause
Who’s at Risk?
The exact cause of uterine polyps is unknown, however they are sensitive to the hormone estrogen. You may be more likely to develop polyps if you are:
- Age 40 to 50
- Pre- or peri-menopausal
- Currently or previously taking an anti-estrogen drug
Fewer than 1 percent of uterine polyps are associated with cancer.
Uterine Polyps and Infertility
Infertility is defined as the inability to conceive after one year of trying.
If a woman is sterile and has no symptoms of esophageal polyps, the possibility that she has asymptomatic polyps is between three percent and five percent, according to the Jones Institute of Reproductive Medicine. If she’s experiencing abnormal bleeding, then it is more likely that polyps are found.
Uterine polyps can act like a normal intrauterine device (IUD), preventing a fertilized egg from implanting in the uterine wall.
They can also block the region where the fallopian tube connects to the uterine cavity, preventing sperm from traveling to the tube to meet with the egg. Likewise, they can block the canal of the uterus, which might prevent sperm from getting into the uterus at all. Polyps may also play a part in miscarriage for a number of women.
In a study published in 2005 in the Journal of Human Reproduction, women undergoing artificial insemination after having their polyps removed became pregnant at about twice the rate of women who didn’t possess their polyps removed. In reality, the women who had their polyps removed frequently became pregnant with no artificial insemination.
Diagnosis and Therapy
Your doctor may recommend one of several methods for finding out if you have uterine polyps:
- Hysterosalpingogram (HSG). An exam utilizing an x-ray, in which a radiologist injects a contrast dye into the uterus and fallopian tubes to make it a lot easier to see polyps and other tissues.
- Ultrasound. Insertion of a wand-like apparatus into the vagina which sends out high-frequency sound waves to make images.
- Sonohysterogram. A special type of ultrasound in which the radiologist matches the uterine cavity with saline with a narrow catheter. The saline distends the cavity (like a balloon) and produces a distance between the walls. This assists in visualizing polyps which could be missed with conventional ultrasound.
- Hysteroscopy. A process employing a scope inserted through the vagina into the uterus to observe the polyps and ascertain their size and extent. Part or all of a polyp may also be removed for microscopic examination by inserting instruments through the hysteroscopic tube.
- Excision through conventional methods. A sample of a polyp may be obtained through curettage (scraping or scooping) or biopsy (removing tissue through a tool resembling a drinking straw), or following a hysterectomy (removal of the uterus).
Evaluation of tissue under a microscope is the only way to determine whether a polyp is benign (noncancerous) or malignant (cancerous).
Some polyps disappear on their own. When removal is necessary to control bleeding, to raise pregnancy chances, or to check for cancer, curettage guided by a hysteroscope is often recommended. A more conventional method, dilation, and curettage (D&C), or scraping the uterine lining, can be still in use.
Hysteroscopy is generally performed using either local or no anesthesia, but general anesthesia is sometimes used too. Once hysteroscopy, you may experience small bleeding and mild cramps, but you need to be able to resume normal activities right away, with the potential exception of sex, which you might need to avoid to get a week or two if your doctor advises.
If polyps are too many for hysteroscopic removal, a hysterectomy may be recommended.
There’s no specific method for preventing uterine polyps, although keeping yourself in a healthy weight and watching your blood pressure are the most effective methods of reducing your risk factors.