Uterine polyps, also referred to as endometrial polyps, are growths on the inner wall of the uterus that extend into the uterine cavity.¹ Countless women live without noticeable symptoms, while others experience symptoms that warrant medical attention. In this article, Caldera Medical will discuss what uterine polyps feel like and when to be concerned. 

What Are Uterine Polyps?

Uterine polyps are overgrowths in the lining of the uterus, aka endometrium. They form when the endometrial tissue grows excessively, creating small protrusions into the uterine cavity.¹ Polyps can be as small as a sesame seed and can range from a golf ball or bigger. A woman can have one or multiple polyps simultaneously. 

 

What do Uterine Polyps Feel Like? 

The majority of women do not necessarily “feel” polyps in the traditional sense due to their location. Unlike ovarian cysts or fibroids, uterine polyps typically won’t cause sharp or localized pain.¹

That doesn’t mean there aren’t symptoms that women feel, including:

• Unexplained spotting 
• Light bleeding between periods
• Distinct changes in period flow
• A sense of fullness or mild pressure in the lower abdomen – most common with larger polyps
• Bleeding after menopause 
• Challenges getting pregnant.¹  

Since these symptoms overlap with those of other gynecological conditions, if you experience any of these or similar symptoms, consult your healthcare provider. Generally, you need not overly worry about uterine polyps, as only about 5% of cases are cancerous.¹ 

The risk rises for postmenopausal women or those experiencing abnormal bleeding. In some cases, a benign polyp can look similar to uterine cancer (endometrial sarcomas) or precancerous tissue (endometrial hyperplasia). If there’s any uncertainty, your healthcare provider can perform a biopsy to rule out cancer. For those at higher risk, polyps can be safely removed, and the procedure carries a low risk of complications.

 

What Causes Uterine Polyps?

The exact cause of uterine polyps remains unknown. Most uterine polyps happen to women in their 40s and 50s, around or after menopause, but they can happen at any age. Doctors say that the following can contribute to the risk of uterine polyps: 

1. Polyps are sensitive to estrogen, so too much can make the endometrium grow excessively.
2. Around or after menopause, when hormone levels fluctuate.
3. Being overweight or obese, having high blood pressure, or having certain genetic syndromes can increase the risk.
4. Taking tamoxifen, a breast cancer drug, or receiving high-dose estrogen hormone replacement therapy.³

 

Uterine Polyps VS Fibroids 

Both polyps and fibroids are unwanted, usually benign growths in or on the uterus, but that’s where the similarities end. Uterine polyps are small, soft overgrowths of the endometrial lining, typically linked to hormonal imbalances. They can cause irregular menstrual bleeding, spotting, or infertility. 

Uterine fibroids, in contrast, are noncancerous muscle and connective tissue growth within the uterine wall. 

Both can impact fertility and menstrual health, but fibroids are generally larger, firmer, and more symptomatic than polyps, with treatment depending on severity and symptoms.

 

When to Be Concerned About Uterine Polyps 

Uterine polyps are typically benign; however, in some instances warrant medical attention. 

When to see a doctor for uterine polyps 

You should consider speaking to a doctor about your polyps if you experience any of the following symptoms, or if they suddenly worsen: 

Abnormal Uterine Bleeding

• Bleeding between periods.
• Very heavy or prolonged menstrual periods.
• Bleeding after menopause.

Infertility/Difficulty Conceiving

• Polyps can interfere with implantation, so if you’ve been trying to get pregnant without success, a doctor may recommend an evaluation.

Unexplained Pelvic Pain

• While polyps don’t normally cause pain, persistent or unexplained pelvic discomfort should be looked into.

Post-Menopausal Symptoms

• Bleeding and spotting after menopause should prompt medical attention to rule out polyps or other conditions. ³

 

Diagnosis of Uterine Polyps 

Your healthcare provider will first review your medical history, understand any medications you are taking, and ask about your symptoms. If you are post-menopausal, they may ask if you’ve had any bleeding or spotting. 

If you’re menstruating, your provider will want to know about length, frequency, and any irregularities, and may discuss family planning. The doctor will perform a gynecological exam, typically a pelvic exam and a pap smear. 

To confirm polyps, there may be additional tests: 

• A transvaginal ultrasound, whereby a small ultrasound probe is inserted into the vagina and uses sound waves to create images of the uterus to reveal any abnormalities.
• A hysteroscopy, whereby a thin, lighted tube with a camera called a hysteroscope is moved through the vagina and cervix to the uterus, allowing uterine lining. 
• An endometrial biopsy is performed, whereby a soft, flexible instrument collects a tissue sample from the uterine lining for further testing. 
• A curettage, whereby an instrument is used to remove tissue or polyps from the uterine lining for further testing.³

Uterine polyps removal results are highly positive! Studies state that 75% to 100% of people experience symptom relief after their removal, and recurrence is uncommon. In the rare case they return, your healthcare provider can suggest further treatment. Removing polyps may also improve fertility, though more research is needed.

Treatment of uterine polyps 

The treatment for polyps depends entirely on the individual situation and could include: 

• Watchful waiting: With mild symptoms and a low cancer risk, your doctor may recommend monitoring without active treatment. Sometimes, small polyps shrink or disappear on their own.
• Medications: Certain drugs, such as progestins or gonadotropin-releasing hormone (GnRH) agonists, can help with hormone balance, easing symptoms. However, symptoms are studied to return after medication is stopped.
• Surgical removal (hysteroscopic polypectomy): If polyps are symptomatic or an active cancer concern, a hysteroscopic polypectomy, a minimally invasive procedure without any external incisions, is performed. Most patients can be discharged the same day.

Uterine polyps are not preventable, but steps can be taken to catch them early to avoid complications or unpleasant symptoms. Getting regular gynecological checkups allows your provider to catch polyps early.

 

Protecting Your Reproductive Health

Despite most being asymptomatic and benign, understanding the signs of uterine polyps will have a meaningful impact on your health as a woman. Early intervention and appropriate management can help avoid complications while protecting reproductive health. Women concerned by unusual uterine bleeding, persistent pelvic discomfort, or difficulty conceiving should seek medical evaluation for effective polyp treatment. To learn more, check out the Caldera Medical website.