What Are Endometrial Polyps?
The uterus is mostly composed of muscle. The inside lining of the uterus is made of endometrial tissue that grows and shrinks during the menstrual cycle. If a woman does not become pregnant, this lining sheds during her period. After a period, the lining grows rapidly under the influence of hormones like estrogen. Polyps are areas that grow a little too much. As they grow, they usually fan out but remain attached to a small stalk.
These polyps can be as small as a sesame seed or as large as a golf ball. Rarely, polyps can grow to the size of an orange! In addition to uterine polyps, women can get a polyp on the edges of their cervix, in the area of their vagina, or even the ovaries.
What Are the Most Common Symptoms of Endometrial Polyps?
Some polyps do produce very unpleasant and painful symptoms like:
- An irregular menstrual bleeding— frequent, unpredictable period that can be long or short, light or extremely heavy
- Bleeding between menstrual periods
- Vaginal bleeding after menopause
The important thing to remember about polyps is that they are composed of endometrial (or lining) cells. Unlike fibroids, which have almost a zero potential for malignancy, polyps have a small likelihood of being malignant—around 3%.
How Are Uterine Polyps Evaluated?
If you were diagnosed with having endometrial polyps, your Viva Eve gynecologist may want to do an endometrial biopsy. This is to ensure that the polyp is not cancerous or to check for other abnormalities or hormonal imbalances.
When performing the endometrial biopsy, your gynecologist removes a small piece of tissue from the uterine lining for examination. Laboratory tests are required to determine if the polyp is normal (benign) or abnormal (precancerous or cancerous). The lab can also discover other potential abnormalities in your uterine lining. Your doctor always checks to see if your hormone levels are balanced, as endometrial polyps seem to be estrogen-sensitive.
There are several ways for your doctor to perform an endometrial biopsy or endometrial polyp removal:
- Your Viva Eve gynecologist inserts a straw-shaped device called a pipelle into your uterus to suction a small amount of tissue from the lining. This is a quick procedure but may cause some cramping. This technique is used when only a tiny amount of tissue is needed or a very small polyp needs to be removed.
- A suctioning device called a Vabra aspirator is necessary for larger endometrial polyp removal. This procedure can be slightly more uncomfortable.
- Sonohysterography is used to investigate uterine abnormalities in women who experience infertility or multiple miscarriages. Doppler ultrasound images can help the physician to see and evaluate blood flow blockages, blood flow in polyps, tumors, and congenital malformation.
- Hysteroscopy, which consists of placing a small camera into your vagina, past your cervix, and up into your uterus so your gynecologist can monitor the condition of your pelvic organs via a video screen. Depending on their size, endometrial polyp removal may be done simultaneously.
The procedure takes anywhere from 5 to 15 minutes. Most women experience some cramping afterward, but the discomfort can be controlled with over-the-counter pain medications. Some women feel dizzy or nauseated during the endometrial polyp biopsy, but it subsides once the biopsy is complete. Soreness and slight bleeding for a day or two are common endometrial polyp removal side effects.
Patients are advised to avoid strenuous exercise, heavy lifting, sex, douching, and tampons until the spotting disappears.
Endometrial Polyps Treatment Options
- Small polyps can resolve on their own, so your Ob/Gyn may recommend a “wait and see” approach
- Some medications, such as progestins or gonadotropin-releasing hormone agonists, can alleviate symptoms, but these are usually temporary options.
- Surgery may be required if the polyps are larger in size, reoccurring, or indicative of precancerous or cancerous conditions. Postmenopausal women are most at risk for polyps being or turning cancerous. Fortunately, cancerous conditions represent less than one percent of all endometrial biopsy polyps.
Viva Eve board-certified gynecologists are renowned for their extensive skills in diagnosing and treating endometrial, uterine and ovarian polyps, and also polyps on the cervix surface area or in vaginal walls. We will listen to all your concerns and together we will come up with the treatment plan that works for you and your unique circumstances.