Uterine Polyps: Symptoms, Causes, Treatment

What are the symptoms of uterine polyps?

Symptoms of uterine polyps can vary, but common signs include:

• Irregular menstrual bleeding: This is the most common symptom and may include unpredictable cycles, heavier-than-normal periods, or spotting between periods.
• Bleeding after menopause: Postmenopausal bleeding can be a sign of uterine polyps.
• Bleeding between periods: Spotting or light bleeding between periods can occur.
• Heavy menstrual periods (menorrhagia): Some people may experience unusually heavy bleeding during their periods.
• Infertility: Uterine polyps can sometimes cause difficulty in getting pregnant.

Some people with uterine polyps may be asymptomatic, meaning they do not experience any noticeable symptoms.

What are the causes of uterine polyps?

The exact cause of uterine polyps is not fully understood, but several factors and conditions can contribute to their development:

• Hormonal imbalances: Uterine polyps are sensitive to estrogen and often grow in response to fluctuations in estrogen levels. High levels of estrogen can stimulate the growth of the endometrial lining, leading to polyp formation.
• Age: Uterine polyps are more common in people who are in their 40s and 50s, particularly during perimenopause, when hormone levels fluctuate significantly.
• Obesity: Excess body fat can lead to higher estrogen levels, which can increase the risk of developing uterine polyps.
• Hypertension (high blood pressure): Some studies suggest a link between high blood pressure and the formation of uterine polyps.
• Tamoxifen use: Tamoxifen, a medication used to treat breast cancer, can increase the risk of developing uterine polyps due to its effects on estrogen receptors in the uterus.
• Other health conditions: Conditions like polycystic ovary syndrome (PCOS) and endometrial hyperplasia, which involve abnormal hormone levels, can also contribute to the development of polyps.

Genetic factors and family history may also play a role in the development of uterine polyps.

What is the treatment for uterine polyps?

Treatment options for uterine polyps vary depending on the symptoms, size of the polyps, and the patient’s overall health. Common treatments include:

• Watchful waiting: If the polyps are small, asymptomatic, and not cancerous, monitoring them over time without immediate treatment may be an option.
• Medications: Hormonal medications, such as progestins or gonadotropin-releasing hormone (GnRH) agonists, may help shrink polyps and manage symptoms temporarily. However, the polyps often return once the medication is stopped.
• Hysteroscopy and polypectomy: A hysteroscopy allows the doctor to directly visualize the uterine cavity and remove polyps using specialized instruments. This is the most common and effective procedure for removing polyps.
• Dilation and curettage (D&C): During this procedure, the cervix is dilated, and the uterine lining is scraped to remove polyps. It may be done in conjunction with hysteroscopy.
• Hysterectomy: In rare cases, if polyps are recurrent, cause severe symptoms, or are associated with cancer, a hysterectomy (removal of the uterus) may be recommended.

After removal, polyps are usually sent for biopsy to rule out any signs of cancer or precancerous changes. Regular follow-up may be necessary to monitor for recurrence.