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Polyps, Endometrial / Uterine Polyps

Uterine (endometrial) polyps consist of areas in your uterus where the lining of the uterus (endometrium) becomes overgrown and forms a mass (polyp). Uterine polyps may attach to the interior of your uterus by a large base or a thin stalk and range in size from a few millimeters — the size of a sesame seed — to several centimeters — the size of a golf ball or larger.

As the polyps grow, they protrude into your uterus. You can have one or many uterine polyps. The polyps may stay contained within your uterus, or occasionally, they may slip down through the opening of the uterus (cervix) into the vagina. A uterine polyp that develops near the fallopian tubes may obstruct the opening of the tubes, possibly leading to difficulty in becoming pregnant.

Although they can happen at any time, uterine polyps most commonly occur in women in their 40s and 50s.

Although there's no definitive cause of uterine polyps, hormonal factors appear to play a role. Uterine polyps are estrogen-sensitive, meaning that they respond to estrogen in the same way that the lining of your uterus (endometrium) does — growing in response to circulating estrogen.

Risk Factor :
You're at greater risk of developing uterine polyps if :

  • You're obese
  • You take tamoxifen (Nolvadex), a drug therapy for breast cancer
  • You have high blood pressure (hypertension)
  • You have cervical polyps

When to seek medical advice :
If you experience any signs or symptoms of uterine polyps, such as irregular bleeding or bleeding between periods, seek prompt medical attention.

Many women with uterine polyps are asymptomatic — having no signs or symptoms. However, other women with uterine polyps experience one or more of the following :

  • Irregular menstrual bleeding, such as bleeding varying amounts at frequent but unpredictable intervals
  • Bleeding between menstrual periods
  • Excessively heavy menstrual periods
  • Vaginal bleeding after menopause
Uterine polyps can develop in pre- or postmenopausal women. Postmenopausal women may experience only light bleeding or spotting.

If your doctor suspects that you have uterine polyps, he or she might perform one of the following tests or procedures :
  • Transvaginal ultrasound. Your doctor places in your vagina a slender, wand-like device that sends out sound waves and creates an image of your uterus. This imaging test allows your doctor to identify abnormalities in your uterus. In a closely related procedure, known as hysterosonography, your doctor injects salt water (saline) into your uterus through a small tube (catheter) threaded into your uterus by way of your vagina. The saline fills and expands your uterine cavity, which allows the doctor to better visualize the inside of your uterus during the ultrasound.
  • Hysteroscopy. Many doctors perform a procedure called hysteroscopy to diagnose and treat uterine polyps. In a hysteroscopy, your doctor inserts a thin, flexible, lighted telescope (hysteroscope) through your vagina into your uterus. Hysteroscopy not only allows your doctor to view the inside of your uterus to examine it for the presence of polyps, but also makes it possible to remove the polyps at the same time. This eliminates the need for a follow-up procedure.
  • Curettage. Your doctor uses a long metal instrument with a loop on the end (curet) to scrape the walls of your uterus. This may be done to collect a specimen for laboratory testing (biopsy) or to remove the polyps. Curettage may be performed on it own (blind curettage) or with the guidance of a hysteroscope. Blind curettage makes finding uterine polyps more difficult than if your doctor is able to visualize the inside of your uterus.

Most uterine polyps are noncancerous (benign). However, some precancerous changes of the uterus (endometrial hyperplasia) or uterine cancers (endometrial carcinoma) appear as uterine polyps. Your doctor may send a tissue sample for laboratory analysis to be certain you don't have uterine cancer.

Complications :
Uterine polyps may present an increased risk of miscarriage in women undergoing in vitro fertilization (IVF) treatment for infertility. If you're undergoing IVF treatment and you have uterine polyps, your doctor may recommend polyp removal before embryo transfer.

Possible treatments for uterine polyps include :

  • Surgical removal (excision). If you undergo hysteroscopy, special instruments inserted through the hysteroscope — the device your doctor uses to see inside your uterus — make it possible to cut away and remove any polyps once they're identified. The removed polyp may be sent to a laboratory for microscopic examination.
  • Hysterectomy. If closer examination reveals that your uterine polyps contain cancerous cells, surgery to remove your uterus (hysterectomy) becomes necessary.

Uterine polyps, once removed, can recur. It's possible that you might need to undergo treatment more than once if you experience recurring uterine polyps.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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