At some point in their lives, most women will likely experience irregular bleeding during their periods or menstrual cycles. Stress, medications, major changes in exercise or nutrition, and several other health and lifestyle factors can cause cycle fluctuations.
But if you regularly experience heavy bleeding during your period, your periods consistently last longer than seven days, or you have regular bleeding between periods, it could be a sign of an underlying condition like uterine polyps.
Some studies estimate that up to 25% of women may experience uterine polyps at some point in their lives. A uterine polyp does not always cause symptoms, but if it does, it can affect your daily routine and quality of life.
Below, we’ll discuss what you need to know about uterine polyps: what they are, their symptoms, and when you should see your doctor.
What are uterine polyps?
Uterine polyps are growths that attach to the inner wall of the uterus. They are often called endometrial polyps because the endometrium is the tissue that lines the inside of the uterus. During the menstrual cycle, that uterine lining thickens and then sheds during your period.
These growths are usually not cancerous, although larger polyps have a higher chance of becoming cancerous, but this is rare and only about 0.3% of uterine polyps contain cancer cells. The average size of a uterine polyp is less than two centimeters across, but they can be as small as a few millimeters (think tomato seed) or as large as several centimeters (a ping pong ball or larger).
The most common symptoms of uterine polyps that you should know
Uterine polyps don’t always have symptoms – some people may have uterine polyps and not even know it. However, uterine polyps can bleed at any time, and their size and location can make it difficult for fertilized eggs to implant in the uterine wall. Because of this, uterine polyps can cause a variety of bothersome menstrual symptoms and fertility problems.
If you experience any of these symptoms, uterine polyps may be the cause:
Abnormal bleeding or spotting during your period or throughout your menstrual cycle
Abnormal bleeding or spotting is the most common symptom of uterine polyps. An irregular period may present with symptoms including bleeding between menstrual cycles, periods that consistently last longer than seven days, or an extremely heavy period.
Postmenopausal bleeding
Postmenopausal bleeding is when you have vaginal bleeding more than a year after your last period. It can range from light bleeding (spotting) to a heavy flow like a normal menstrual cycle.
Some people experience pain
Although rare, uterine polyps, especially large ones, can cause discomfort and a dull ache in the abdomen, pelvis, or lower back.
Sterility
Because of their location in the uterus, uterine polyps can cause infertility (the inability to become pregnant or carry a pregnancy to term).
Conditions that share symptoms similar to uterine polyps and how to differentiate them
While abnormal bleeding is usually the most common symptom of uterine polyps, this condition shares this symptom with several other conditions. How can you tell them apart? A doctor can provide an official diagnosis, but if you’re evaluating your symptoms, here’s how they might compare to other conditions.
Uterine polyps vs. uterine fibroids
Uterine fibroids are muscular tumors that grow inside the uterus, but they can also grow outside it. Like uterine polyps, they are usually not cancerous, and both conditions share common menstrual symptoms, such as bleeding between periods, as well as long, heavy periods and pelvic pain. But unlike uterine polyps, symptoms of uterine fibroids can also include pain during sex, constipation, and frequent urination.
Uterine polyps vs. endometriosis
Endometriosis is a chronic condition in which endometrial tissue (the tissue that lines the inside of the uterus) grows outside the uterus. Like uterine polyps, endometriosis can cause abnormal menstrual bleeding and infertility.
However, the most common symptom of endometriosis is severe pelvic pain or lower back pain. This is because the outer tissue that grows doesn’t shed during your period, which can cause pain and inflammation. And while pelvic or lower back pain can also be a symptom of larger uterine polyps in some women, it’s not as common.
Uterine polyps vs. polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a condition in which the body does not ovulate properly due to a hormonal imbalance in which not enough female hormones are produced and too many male sex hormones are produced.
Both uterine polyps and PCOS can cause infertility and an irregular menstrual cycle, but the biggest difference lies in how they affect your cycle. Uterine polyps are linked to abnormal bleeding and can cause you to bleed more than usual. PCOS, on the other hand, can prevent you from bleeding as much as you should. While people with PCOS may have regular periods, some may have periods every five weeks or no periods at all.
We do not know the causes of uterine polyps, but we do know the risk factors.
While the exact cause of uterine polyps is unknown, experts believe that hormones play a role. Research indicates that uterine polyps tend to grow when the body produces too much estrogen.
Uterine polyps are also closely related to age: they are rare in women under 20 and most common between the ages of 20 and 40. The risk of developing uterine polyps peaks at age 40, when menopause approaches. While the risk decreases significantly once menopause is reached, some women experience uterine polyps later.
Conditions that may increase the risk of uterine polyps
Your chances of developing uterine polyps may increase if:
- They are overweight. When you gain weight, the extra fat your body develops will cause your estrogen levels to increase.
- Receiving hormone replacement therapy with a high dose of estrogen. This therapy is sometimes recommended to control menopausal symptoms. It may be associated with the development of polyps and their related symptoms of irregular bleeding.
- Take tamoxifen. This drug is used to treat breast cancer and works against cancer cells in breast tissue, but has cancer-like effects on endometrial tissue. Long-term use of tamoxifen has been associated with uterine polyps, which may develop in 20-35% of women who take it for a long period.
- You have a family history of Lynch or Cowden syndrome. Lynch syndrome and Cowden syndrome are genetic disorders that run in families. Both are characterized by a genetic predisposition or increased risk of developing certain types of cancer.
Can uterine polyps be prevented?
While you can’t completely prevent uterine polyps from developing, there are some things you can do to reduce your risk of developing them. The best option is to maintain a healthy weight with a balanced diet and exercise. An annual gynecological visit can also help detect uterine polyps early so that treatment can begin as soon as possible.
How are uterine polyps diagnosed?
It can be common for people to have uterine polyps and not know it. But if you think you’re experiencing symptoms of uterine polyps, diagnosis begins with a visit to your primary care physician, OB-GYN, or women’s health specialist.
When testing for uterine polyps, doctors typically begin with a review of your medical history and a physical exam before moving on to further diagnostic testing with several minimally invasive procedures:
- Medical examination:Your medical exam will include a review of your medical history (symptoms, medications, and menstrual cycle) as well as a gynecological exam that may include a pelvic exam and Pap test. Your doctor will use this information to decide if additional testing or imaging is needed.
- Transvaginal ultrasoundA transvaginal ultrasound is a test that examines the reproductive organs. Your doctor or an ultrasound specialist will insert a probe into your vagina to capture an image of your pelvic region and measure the thickness of the uterine lining. If the lining is thickened or irregular, further evaluation may be required.
- SonohysterographyA sonohysterogram (also called saline infusion sonography or SIS) is an ultrasound exam in which a salty fluid (saline solution) is inserted into the uterus to better evaluate the uterine lining.
Schedule an appointment with your doctor if you think you have symptoms of uterine polyps.
Most women experience irregular periods at some point in their lives. But if you regularly experience symptoms of uterine polyps, such as irregular menstrual bleeding or bleeding between periods, don’t ignore them. Schedule an appointment with a primary care doctor or a women’s health specialist. They can help you with the diagnosis and treatment of uterine polyps.
