Uterine Polyps
Uterine polyps are growths that occur in the endometrium, the inner lining of the uterus (the organ in which a fetus grows). That’s why, sometimes they are called endometrial polyps.
Such polyps are formed by the overgrowth of endometrial tissue. They are attached to the endometrium by a thin stalk or a broad base and extend inward into the uterus. The polyps may be round or oval, and range in size from a few millimeters (the size of a sesame seed) to a few centimeters (the size of a golf ball), or larger. There may be one or several polyps present.
These polyps are usually benign (noncancerous), but they may cause problems with periods (menstruation) or the ability to have children (fertility).
Symptoms –
Uterine polyps are known to cause irregular vaginal bleeding. This may lead to the following symptoms:
• spotting or bleeding between periods
• unusual vaginal discharge
• heavier menstruation
• bleeding after menopause
• menstrual-like cramps or pain
While these symptoms may be related to uterine polyps, it’s important to rule out uterine cancer. Cancerous tumors may also cause pelvic pressure or pain.
Some people with such polyps may not have any symptoms. Instead, the growths may be incidental findings when ruling out other conditions.
Causes –
The exact reason that polyps form is unknown, but swings in hormone levels may be a factor. Estrogen, which plays a role in causing the endometrium to thicken each month, also appears to be linked to the growth of uterine polyps.
Risk Factors –
Uterine polyps are more likely to develop in women who are between 40 and 50 years old than in younger women. These polyps can occur after menopause but rarely occur in women under 20 years old.
Other factors that may increase the risk for uterine polyps are:
• Obesity
• Tamoxifen, a treatment for breast cancer
• Postmenopausal hormone replacement therapy
• Family history of Lynch syndrome or Cowden syndrome
Complications –
Most uterine polyps aren’t cancer. But some might turn into cancer later on. The chances of that happening are higher if you’ve gone through menopause.
These polyps might be associated with infertility. If you have uterine polyps and you’re unable to have children, removal of the polyps might allow you to become pregnant, but the data are inconclusive.
Diagnosis –
If your doctor suspects you have polyps, he or she might perform one of the following –
• Transvaginal ultrasound
• Hysterscopy
• Endometrial Biopsy
Treatment –
For treatment, your doctor might recommend –
• Watchful waiting.
Small polyps without symptoms might resolve on their own. Treatment of small polyps is unnecessary unless you’re at risk of uterine cancer.
• Medication.
Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may lessen symptoms of the polyp. But taking such medications is usually a short-term solution at best — symptoms typically recur once you stop taking the medicine.
• Surgical removal.
▪︎ Curettage – This may be performed along with hysteroscopy. While using the hysteroscope to look at the interior of the uterus, the doctor uses a curette to scrape the lining and remove any polyps. The polyps may be sent to a laboratory to determine whether they are benign or cancerous.
▪︎ Additional surgery may be necessary if a polyp cannot be removed using other methods, or if the polyps are cancerous. A hysterectomy, a surgical procedure in which the entire uterus is removed, may be necessary in cases where cancer cells are found in the uterine polyps.
Rarely, uterine polyps can recur. If they do, you might need more treatment.
Prevention –
There is no way to prevent uterine polyps. It’s important to have regular gynecological checkups. Risk factors such as obesity, high blood pressure, or taking tamoxifen to treat breast cancer may increase the chance of developing polyps. Uterine polyps sometimes return after treatment, and additional treatment may be necessary.
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