Endometrial Polyps are small growths, usually a result of thickening of the lining of the womb, although sometimes they may be a fibroid polyp (benign growths of muscle). They can occur at any age, although more common in the perimenopause and menopause. They are very common occurring in 1 in 10 women but are found more often in women with abnormal bleeding. They are usually benign but sometimes they may be cancerous. That is why all polyps that are removed are analysed to check they are not sinister.
They may cause no symptoms and may be discovered incidentally. They may be more than one in the uterine cavity and depending on their size (ranging from a few mm to the size of a golf ball) polyps may be responsible for heavy periods, intermenstrual bleeding, irregular bleeding, post menopausal bleeding, and some early miscarriages. In some women, polyps may make it more difficult in getting pregnant as a polyp can act like a foreign body in the womb in this situation. If the polyp protrudes out of the neck of the womb, it can cause bleeding after sex. Polyps usually do not cause pain. Hormones including excess of estrogen, HRT, being overweight are implicated in some polyps developing although in most cases, no obvious cause is found.
Polyps are removed by a simple minimally invasive procedure called hysteroscopy (see separate leaflet on Hysteroscopy) through the vagina, using a surgical instrument with a telescope and camera at the end, either under local or a short general anaesthetic. There are no other options other than surgery once a polyp is diagnosed. Watchful waiting is usually not recommended. There are no alternative methods of treating polyps. However, a progesterone containing coil (Mirena IUS) may help in preventing recurrent polyps by thinning the lining. Polyps may return especially if they are as a result of excess estrogen stimulating the lining and women then sometimes need repeat surgery.
Nitu Bajekal Nov 2013