Also referred to as uterine polyps, endometrial polyps are abnormal growths in your endometrium, the lining of your uterus. The excessive growth leads to the formation of polyps. Uterine polyps are more commonly found in women who’ve undergone menopause, although younger women can get them too. You can have just one polyp or many.
Endometrial polyps are attached to the inner wall of your uterus by a thin base or a stalk that connects them to the endometrial lining. Polyps can range in size and shape, from the size of a seed all the way up to the size of a ping-pong ball.
Endometrial polyps irritate the surrounding tissues in your uterus, although it’s not unusual for them to infect your cervix and vagina as well. Most endometrial polyps are benign or noncancerous. A small number can be cancerous or precancerous, however, which is why it’s vital that you have them removed and sent to a lab to be analyzed. Endometrial polyps should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.
Checking for Polyps
It’s not unusual to be unaware of uterine polyps; not everyone has symptoms. The most common symptom is unusual or spotty bleeding. With bleeding polyps, you might see:
- Irregular bleeding during your period that lasts longer than normal
- Breakthrough bleeding between periods that may be spotty or sustained
- A heavier than normal or excessively heavy flow during your period
- Post-menopausal bleeding
- An inability to get pregnant
Any of these symptoms, especially if you notice them on a regular basis, signal that something can be wrong. Bring them to your doctor’s attention because the sooner you’re checked for uterine polyps, the quicker your OBGYN in NYC can rule out more serious complications. Your doctor can remove the polyps to reduce the abnormal bleeding you’re experiencing.
Causes and Risk Factors
The exact cause of uterine polyps isn’t known, although studies show that hormones impact the formation of polyps, which grow in estrogen-rich areas. Additionally, polyps are often found where the endometrial lining has become overgrown. While causes are not concrete, doctors have identified several possible risk factors, such as if you’re:
- On the cancer drug tamoxifen
- Perimenopausal or postmenopausal
- Experiencing hypertension
- Familiar with cervical polyps because you’ve had them before
Testing for Polyps
Since polyps show so few symptoms, the best way to get a positive diagnosis and be able to proceed with treatment is for your doctor to order some tests. Many of these tests require mild sedation and/or localized anesthesia. All are minimally invasive procedures that leave no scars and require only about 24 hours for recovery.
- Sonohysterography, also known as hysterosonography, uses a tube to push sterile saline into your uterus to aid in the clarity of the images made by a sonogram machine. This test is used to see if there are any polyps or masses in your uterus. There should be very little discomfort with this test, although some women do experience period-like cramping afterward.
The best time to schedule this test is seven to 10 days after your period ends. You shouldn’t be on your period or pregnant during this test. For a day or two after the test, the fluids used will seep out of your vagina throughout the day. Some of it may look a little bloody, but that’s normal.
- Endometrial biopsy is the removal of a very small tissue sample from your endometrium. The endometrial biopsy polyp is scraped out and then sent out for analysis. This is the test that your doctor uses to rule out cancer. It may be required if you are over the age of 45 years old and have abnormal uterine bleeding or if you are at a higher risk of cancer due to a family history of uterine cancer.
This procedure may cause some cramping during the test, as well as discharge with small amounts of bleeding after the test. Post-procedure bleeding and cramping is not unusual. Mild pain relievers such as acetaminophen (Tylenol) that don’t promote bleeding help you get through the discomfort.
- Hysteroscopy is a procedure that allows the doctor to see inside your uterus by using a small, wand-like lighted scope.
- A basic pelvic exam may allow your doctor to find polyps, especially if you find a polyp on cervix.
- Pap smear, which is a regular and routine test, may reveal abnormal cells if you have polyps.
- Ultrasound is another test that can detect masses in your uterus. It uses images made through sound waves taken from the outside by rubbing a wand over your abdominal area. This test allows your local OBGYN to check for ovarian abnormalities in addition to uterine polyps.
- Transvaginal Ultrasound does the same thing as an ultrasound, except from inside your vagina, using a vagina probe, rather than a wand on the outside of your abdomen.
- Dilation and curettage (D&C) is where your doctor gently scrapes your uterine walls to obtain endometrium samples. At this time, it’s possible to detect a polyp on cervix or polyps in vagina.
- Hysterosalpingogram (HSG) is a procedure that uses dye injected into your uterus. X-rays reveal if there are any polyps.
Sometimes, you may not have to do anything if your polyps are very small and causing no symptoms but this is to be decided by your physician. It’s not unusual for polyps to resolve on their own, where your body re-absorbs them without incident. If, however, they aren’t shrinking on their own or they become pre-cancerous or cancerous, your doctor will have to take measures. Further steps may include:
- Some medications containing hormones, such as progesterone and gonadotropin-releasing hormone agonists, might help you with any symptoms you’re experiencing with the polyps. Typically, once you stop taking these drugs, the polyps return. This may be the best treatment if you have endometrial hyperplasia, which is an overgrowth of the cells in the endometrium.
- Often, surgery is the last resort. If your doctor has ordered a hysteroscopy as a test, removing the polyps found may be performed as part of this minimally invasive procedure. Anything removed during this test is sent to a lab, just as with a biopsy. If the polyps turn out to be precancerous or cancerous, then your OBGYN in NYC will most certainly order them all removed and carefully followed with your physician.
Important Reminder: This information is only intended to provide gynecology guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist or certified gynecology specialist can determine an accurate diagnosis and proper treatment.
Do you have questions about Endometrial Polyps? Would like to schedule an appointment with the top Midtown NYC Gynecologist, Dr. Anat Zelmanovich, please contact our office.
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
New York, NY 10010
☎ (212) 533-4575
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
New York, NY 10028
☎ (212) 533-4575