Uterine Polyps
A Comprehensive Guide to Symptoms and Treatment
If you have been experiencing unpredictable spotting or unusually heavy periods, you may have uterine polyps. While the word "growth" can be intimidating, uterine polyps are a very common gynaecological finding and are most often benign (non-cancerous). Understanding what they are and how they affect your body is the first step toward reclaiming your comfort and health.
What Are Uterine Polyps?
Uterine polyps, also known as endometrial polyps, are growths attached to the inner wall of the uterus that extend into the uterine cavity. They form when there is an overgrowth of cells in the lining of the uterus (the endometrium). These polyps are attached to the endometrium by a thin stalk or a broad base.
They can range in size from a few millimetres to several centimetres. While most polyps remain within the uterus, in some cases, they can slip through the opening of the uterus (cervix) into the vagina.
What Symptoms Should I Look For?
The hallmark of a uterine polyp is irregularity. Because polyps are rich in blood vessels, they tend to bleed easily. You should monitor for:
Irregular Menstrual Bleeding: Periods that occur at unpredictable intervals or vary greatly in length.
Intermenstrual Spotting: Bleeding or spotting between your regular periods.
Excessively Heavy Periods: Menorrhagia (heavy flow) is a frequent symptom of larger polyps.
Postmenopausal Bleeding: Any vaginal bleeding after you have reached menopause is considered abnormal and should be evaluated immediately.
Infertility Challenges: Polyps can act as a mechanical barrier or cause inflammation that prevents an embryo from implanting correctly.
What Causes Uterine Polyps?
While the exact cause isn't always known, hormonal factors play a significant role. Uterine polyps are sensitive to oestrogen, meaning they grow in response to the hormone circulating in your body. Risk factors include:
Being perimenopausal or postmenopausal.
Having high blood pressure (hypertension).
Obesity (which can increase oestrogen levels).
Taking tamoxifen, a drug therapy for breast cancer.
How Do We Diagnose Them?
If you present with irregular bleeding, I will typically use one of three primary methods to confirm a diagnosis:
Transvaginal Ultrasound: This provides a baseline view of the uterine lining thickness.
HyCoSy: This involves injecting a small amount of sterile saline into the uterus to expand the cavity, allowing for a much clearer view of any growths on the ultrasound.
Diagnostic Hysteroscopy: I insert a thin, lighted telescope (hysteroscope) through your cervix to view the inside of your uterus directly. This is the most accurate "gold standard" for diagnosis.
Treatment: Do They Always Need Removal?
The management of polyps depends on your symptoms, your age, and your future fertility plans.
Watchful Waiting: Small, asymptomatic polyps in premenopausal women may be monitored to see if they resolve on their own.
Medication: Certain hormonal medications may shrink polyps and reduce symptoms, though this is often a temporary solution.
Surgical Removal (Polypectomy): This is usually performed during a Hysteroscopy. It is a minimally invasive "day procedure" where the polyp is removed and sent to pathology for testing. This is the most effective way to stop symptoms and ensure the growth is benign.
Personalised Care for Your Menstrual Health
As a highly qualified gynaecologist, I understand that any change in your menstrual cycle can be a source of significant anxiety. My approach is centred on listening—taking the time to understand your unique symptoms and how they impact your daily life. Whether we explore medical management, lifestyle adjustments, or advanced surgical options, your treatment plan will be entirely individualized. I am committed to providing you with the highest standard of evidence-based care to ensure you feel supported and informed at every stage of your journey.