Polyps in Uterus: Symptoms, Infertility, Causes & Treatment

Polyps in the uterine are characterized by abnormal growth of endometrial cells that lead to the formation of a nodule. They can cause symptoms such as vaginal bleeding outside of a period, heavy menstrual flow, abdominal pain and difficulty getting pregnant in some cases.

Although the exact cause of uterine polyps, also referred to as endometrial polyps, is not fully known, they seem to be common in menopausal women with hypertension and/or who use tamoxifen.

If you suspect you may have polyps in the uterus, you are advised to consult a gynecologist. Although treatment is not always necessary, the doctor may advise surgical removal of the polyp.

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Common symptoms

The main symptoms of polyps in the uterus include:

  • Heavy menstrual flow
  • Vaginal bleeding outside of a period, after sex or during menopause
  • Intense period cramps
  • Abdominal pain
  • Difficulty getting pregnant

However, many women with uterine polyps do not experience any symptoms, and they are only identified when during routine tests.

Can uterine polyps cause infertility?

Uterine polyps can make it difficult for some women to implant a fertilized egg in the uterus, and can therefore reduce the chances of pregnancy.

Furthermore, depending on the size and number of polyps in the uterus, they are also associated with a greater risk for miscarriage. However, more studies are needed to prove this risk.

Confirming a diagnosis

Polyps in the uterus are diagnosed by a family doctor or gynecologist through an assessment of the person's symptoms, health history and test results. The doctor may order a transvaginal ultrasound or hysteroscopy, which can help to visually identify the polyp in the uterus.

In addition, the doctor may also recommend an endometrial biopsy, curettage or removal of the polyp so that a sample of the uterine tissue can be analyzed in the laboratory and assessed for the possibility of uterine cancer.

Possible causes

Uterine polyps are caused by the abnormal multiplication of endometrial cells. This overgrowth causes the endometrial layer to form lumps. However, the process that triggers this is not fully known. 

Polyps in the uterus are more common in perimenopausal or menopausal women with hypertension, obesity and/or polycystic ovarian syndrome, and in women who use tamoxifen or take hormone replacement therapy with high doses of estrogen.

Trearment options

In most cases, uterine polyps do not require treatment and the gynecologist can only recommend routine ultrasound monitoring to assess whether the polyp has increased or decreased in size.

However, polyps that cause symptoms such as vaginal bleeding or infertility, or are associated with a higher risk for uterine cancer, may be surgically removed. More serious cases may even require a hysterectomy, or removal of the uterus.

Sometimes, after removing the polyp in the uterus, the use of an IUD with levonorgestrel may be indicated to reduce the risk of the polyp returning.

Can a uterine polyp turn into cancer?

Most uterine polyps are benign lesions that rarely turn into cancer. However, this can happen in some cases, especially in menopausal women and over 60 years old who have large polyps that present with symptoms.

Therefore, regular monitoring and optimal treatment of polyps as guided a gynecologist is essential to reduce the risk for cancer.