Polyps
Endometrial polyps are soft overgrowths of the uterine lining. They are common, usually benign, and often cause no symptoms. When they bleed, removing them usually solves the problem.
Symptoms
Bleeding between periods, heavier periods, bleeding after sex, or bleeding after menopause. Many polyps are found by chance on ultrasound.
Who gets them
Polyps become more common with age. Risk is higher with obesity, tamoxifen use, and menopausal hormone therapy.
Diagnosis
A transvaginal ultrasound may show a polyp. A saline infusion ultrasound, where sterile fluid gently fills the uterus during the scan, outlines polyps more clearly. Hysteroscopy, using a thin camera placed through the cervix, confirms them and can remove them in the same procedure.
Is it cancer?
Most polyps are benign. The chance of precancer or cancer is low, but it is higher after menopause and in polyps that cause bleeding. For that reason, polyps that bleed, and most polyps found after menopause, are usually removed and examined.
Treatment
Hysteroscopic polypectomy is typically an outpatient procedure with a quick recovery. Small polyps that cause no symptoms before menopause can sometimes be watched, because some go away on their own.
Sources
- AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol. 2012;19(1):3–10.
- Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393–408.