- An endometrial polyp is usually benign, but it can cause abnormal vaginal bleeding, abdominal pain, or difficulty getting pregnant.
- Diagnosis may involve transvaginal ultrasound, hysteroscopy, and sometimes a biopsy to check whether the polyp is benign or malignant.
- Treatment may include surgery to remove the polyp, especially when it causes symptoms, affects fertility, or needs to be tested for cancer.
An endometrial polyp is a benign growth on the wall of the uterus. It can cause symptoms such as vaginal bleeding, abdominal pain, and, in some cases, difficulty getting pregnant.
An endometrial polyp is not always considered a serious problem. However, there is a risk that it can become malignant, especially after menopause or in people with conditions such as diabetes or obesity.
If an endometrial polyp is suspected, it is important to see a gynecologist to confirm the diagnosis. Treatment may include surgery to remove the polyp.
Endometrial polyp symptoms
The main symptoms of an endometrial polyp are:
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Excessive, prolonged, or abnormal vaginal bleeding outside of the menstrual period
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Difficulty getting pregnant
However, endometrial polyps may cause few or no symptoms. In some cases, they are found during routine exams, such as a pelvic ultrasound.
Symptom severity is also not necessarily linked to the size, location, or number of polyps in the uterine lining.
Is an endometrial polyp serious?
An endometrial polyp is usually not serious. It is considered a benign change and may shrink over time without the need for specific treatment. However, there is a small risk that the polyp can become malignant (cancerous), which is why a biopsy is usually recommended.
The risk of a polyp being malignant is higher when it causes symptoms, occurs after menopause or in women over 60, or is associated with conditions such as diabetes or obesity. This risk may also be higher with tamoxifen use.
Symptoms of a malignant polyp
The symptoms of a malignant endometrial polyp are usually the same as those of a benign polyp. For this reason, any polyp that is found should be evaluated with a biopsy.
Confirming a diagnosis
An endometrial polyp is diagnosed by a gynecologist or other women’s health provider based on the person’s symptoms and the results of tests such as transvaginal ultrasound or hysteroscopy.
According to the American College of Obstetricians and Gynecologists, hysteroscopy is commonly used to find the cause of abnormal uterine bleeding and can help identify benign growths in the uterus, such as polyps.
After the polyp is identified, the doctor may also recommend a biopsy to determine whether the polyp is malignant or benign. The biopsy can be done during a hysteroscopy, which is used to confirm the diagnosis.
Possible causes
An endometrial polyp does not have one specific cause, but it appears to happen due to hormonal or genetic changes. These changes can lead to abnormal multiplication of endometrial cells, which are found in the most superficial layer of the uterine wall.
In addition, an endometrial polyp is more common in older women and in people with conditions such as polyendocrine metabolic ovarian syndrome (PMOS) or liver failure. It is also more common with the use of some medications, such as hormonal contraceptives or tamoxifen, and with hormone replacement therapy (HRT).
Treatment options
Treatment for an endometrial polyp may include surgery to remove the polyp, especially when it causes symptoms, affects fertility, or needs to be tested for cancer.
However, in women without symptoms and with polyps smaller than 1 cm, the chance of the polyp shrinking without specific treatment is higher. In these cases, the doctor may only recommend regular follow-up.
After endometrial polyps are removed, a doctor may sometimes recommend a levonorgestrel IUD, such as Mirena, to help control abnormal bleeding or lower the chance of the polyp coming back. However, this depends on each person’s situation.
Surgical removal
Polypectomy is surgery to remove the polyp and can be performed during hysteroscopy. This procedure can help relieve symptoms such as pain and bleeding, and the risk of the polyp coming back after surgery is low.
Although it is rarer, hysterectomy, which is the complete removal of the uterus, may also be recommended.
Can an endometrial polyp affect pregnancy?
n endometrial polyp can make it harder for some women to get pregnant, and removing it may increase the chance of pregnancy in some cases.
Endometrial polyps may also be associated with miscarriage in some cases, although this link is not fully clear. The risk is not necessarily related only to the size or number of polyps.