Pulverizing Uterine Polyps

You have experienced a heavy menstrual cycle. Your periods are irregular. You sometimes have spotting or bleeding in between periods. You could have uterine polyps.

Polyps are small growths on the surface of the uterine wall, an overgrowth of the lining. Uterine polyps usually occur in women in their 40s and 50s. Polyps or those that grow in the lining of the uterus occur in 10 percent to 25 percent of women and are present in 25 percent of women with abnormal uterine bleeding or heavy periods.

While the uterus is mostly muscle, its inner lining is made of hormonally influenced endometrial tissue that grows and sheds with each menstrual cycle. Polyps are uterine tissue that grow a bit too much in response to hormones like estrogen and fail to slough off with menstruation.

Polyps generally cause no symptoms and conventional teaching has been that they are almost always benign and non-cancerous. As such, they cannot spread to other parts of the body. Nor does it raise the risk of developing uterine cancer.

The most common symptom of polyps is abnormal bleeding. Many people with uterine polyps have irregular periods. Some other possible symptoms include pelvic bloating, belly or pelvic pain, constipation and pain during intercourse. While none of these symptoms is life-threatening, they can detract from a woman’s quality of life.

According to the Cleveland Clinic, polyps may be round or oval and they range in size to a few millimeters (the size of a sesame seed) to a few centimeters (the size of a golf ball) or larger. It’s possible that you could have one or several of them present.

Though polyps are benign, they may cause problems with fertility.

Your chance of developing uterine polyps increases if you are:

§  Overweight (BMI 25 < 30) or obese (BMI > 30).

§  Prone to high blood pressure (hypertension).

§  On tamoxifen, a drug that is used to treat breast cancer.

§  On hormone replacement therapy that involves a high dosage of estrogen.

You’re at greater risk of getting uterine polyps if you have Lynch syndrome or Cowden syndrome.

Often at times, uterine polyps are asymptomatic, where they don’t cause symptoms. So there are some people with uterine polyps who don’t receive diagnoses.

Large polyps can sometimes cause dull aching in your abdomen or lower back, similar to menstrual cramps. But pain isn’t a usual symptom of polyps.

Experts aren’t sure what causes uterine polyps, but hormone levels may be an influence. Estrogen causes the endometrium to thicken each month during your menstrual cycle. The thickening contributes to uterine polyp growth. Many risk factors for polyps involve your body being exposed to high estrogen levels.

The diagnosis of uterine polyps is usually made by ultrasound (allows for a clearer view of the uterus, fallopian tube and ovaries) or hysteroscopy (endoscopic inspection of the uterine lining and walls).

Removal of uterine polyps is typically done under general anesthesia by visualizing the polyps with hysteroscopy and then scraping or cutting them away. The tissue is sent off to the lab to be sure it’s benign.

There are different types of treatments for uterine polyps. Your doctor may engage in “watchful waiting” where active treatment is unnecessary unless the polyp changes or if you are at risk for the development of cancer. Some other methods of treatment include medications like progestins or gonadotropin-releasing hormone agonists may be used to relieve symptoms and uterine polypectomy where your polyp is removed by hysteroscopy. Polyps rarely grow back after removal.

Only about 5 percent of uterine polyps are cancerous. Your risk is greater of a polyp being cancerous if you are postmenopausal or if you are experiencing abnormal bleeding. There are some instances where a benign polyp may resemble uterine cancer (endometrial sarcomas) or precancer (endometrial hyperplasia). If there’s a doubt, your doctor can perform a biopsy on the tissue to rule out cancer. If your provider is concerned that a polyp can cause cancer or if a polyp is causing unpleasant symptoms, they can safely remove it.