Endometrial polyps, or uterine polyps, develop when cells of the inner lining of the uterus overgrow. These growths range in size and protrude into the uterus but typically cause no symptoms.

Endometrial polyps can affect anyone with a uterus. Typically, they are not cancerous but can sometimes cause problems that need a medical checkup.

Most people with endometrial polyps do not know they have them, as they often have no symptoms. Some may experience atypical bleeding, such as with longer than average periods of bleeding between periods.

This article explores endometrial polyps, including their causes, symptoms, diagnosis, and more.

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Endometrial polyps are an overgrowth of the tissue that lines the inside of the uterus. Endometrial tissue grows in response to certain hormones, mainly estrogen. Studies have found increased concentrations of estrogen receptors in the glandular cells of polyps.

Polyps can form in response to estrogen exposure that occurs naturally during the menstrual cycle or with certain medications that increase estrogen levels.

Some people may form polyps and some may not — this could be due to certain genetic causes that affect cell growth and cell death.

Endometrial polyps are typically asymptomatic, meaning they often do not cause noticeable symptoms.

However, in some cases, people can experience atypical uterine bleeding. This may present as longer menstrual periods or unexpected bleeding between periods.

A person with either of these symptoms may need further evaluation by their gynecologist.

Polyps may also cause problems with fertility or becoming pregnant depending on several factors, such as size, location, and number of polyps in the uterus.

If a gynecologist suspects a person may have endometrial polyps, they may order a transvaginal ultrasound. To perform this test, a doctor will insert a small wand into the vaginal cavity and apply ultrasounds to create images of the inside of the uterus.

Saline infusion sonography is the gold standard for diagnosing endometrial polyps. This method involves injecting sterile saline into the uterus to expand the organ and make imaging the inner lining clearer. The technician then uses ultrasound to note more details of the polyps, such as location and size.

To confirm a diagnosis, the doctor must take a tissue sample for a pathologist to study under a microscope. The doctor does this by hysteroscopy — a minimally invasive procedure that involves inserting a thin, lighted tube in the uterus to take a tissue sample.

Managing endometrial polyps depends on several factors, including:

  • the presence of symptoms
  • the risk of cancerous polyps
  • fertility concerns

For small polyps that are not causing symptoms, the doctor may suggest a watchful waiting approach. Sometimes, small polyps can resolve on their own without medical intervention.

If polyps do need treatment, doctors may perform a hysteroscopic polypectomy. This is a minimally invasive procedure that removes polyps through the cervix without the need for abdominal incisions.

Doctors may consider performing a dilatation and curettage, or D&C. This technique involves placing a suction device or instrument transvaginally into the uterus and removing the endometrial lining. A hysterectomy, or removal of the entire uterus, may be necessary in rare cases where a polyp is cancerous.

Most endometrial polyps are not harmful. However, there is around a 1% risk that a polyp can continue to grow and may turn into cancer.

Endometrial polyps can sometimes cause infertility. In people experiencing primary infertility, the incidence of having these growths ranges from 3.8% to 38.5%. In cases of secondary infertility, it varies from 1.8% to 17%.

If a person is experiencing irregular or heavy menstrual bleeding, bleeding between periods, or has concerns about fertility, they may wish to consult a gynecologist.

Having a timely evaluation can help diagnose and manage the condition effectively. Because of the small risk of cancer, it is best not to delay seeking consultation with a doctor.

Endometrial polyps are benign growths that can affect people with uteruses of all ages. While the exact cause remains unknown, it may have to do with estrogen exposure or genetic abnormalities.

Most uterine polyps do not cause symptoms but can sometimes cause irregular uterine bleeding, generating heavy periods or spotting between periods.

Diagnosis typically involves imaging techniques such as transvaginal ultrasound or saline infusion sonography. Depending on the severity, treatment options may include conservative management or surgical removal.