Uterine polyps are overgrowths of cells in the lining of the uterus. Uterine polyps are usually benign, although some can be malignant or eventually turn into cancer. The size of uterine polyps can range from the size of a sesame seed to the size of golf ball or larger. Uterine polyps tend to stay within the uterus, though they may occasionally move down through the cervix into the vagina. They are rarely found in women younger than 20 years of age, and the incidence of polyps rises as a woman gets older, peaking in the 40s and declining after menopause.
Symptoms of uterine polyps
The most common symptoms of uterine polyps are irregular, acyclic bleeding, which is reported in approximately 50 percent of symptomatic cases. Other less common symptoms include post-menstrual spotting, post-menopausal bleeding, heavy menstrual bleeding, and breakthrough bleeding during hormonal therapy.
Uterine polyps are usually diagnosed by microscopic examination of a biopsy of endometrial tissue, but can also be diagnosed on ultrasound or hysteroscopy.
Treatment of uterine polyps
For treatment of uterine polyps, physicians may recommend:
Curettage. Most cases of uterine polyps are treated through curettage, in which physicians use a long metal instrument with a loop on the end to scrape the inside walls of the uterus. A hysteroscope may be used to help the physician see inside the uterus before and after the procedure.
Medication. Some hormonal medications such as progestins and gonadotropin-releasing hormone agonists can help to shrink a uterine polyp and lessen symptoms. Medication is typically a short-term solution – symptoms often recur after patients stop taking the drugs.
Watching and waiting. When uterine polyps are small and have no symptoms, physicians may recommend waiting to see if they resolve on their own.
Surgical removal. Uterine polyps may also be removed in a surgical procedure, where instruments are inserted into the uterus through a hysteroscope.
Care of uterine polyps at BWH
Patients requiring evaluation and treatment of uterine polyps receive world-class care at the Division of Minimally Invasive Gynecologic Surgery (MIGS) at Brigham and Women's Hospital (BWH) in Boston. BWH physicians in MIGS provide comprehensive care for women with conditions including uterine polyps and other causes of abnormal uterine bleeding, uterine fibroids, pelvic pain, endometriosis, pelvic organ prolapsed, cervical incompetence and ovarian cysts – offering the latest minimally invasive options for these conditions.
BWH is also a leading provider of services in women's health, including women's neurology, sports medicine, and mental health services, such as evaluation and treatment of women and depression. Learn more now about our women's health services.