Maybe an ultrasound mentioned a possible uterine polyp, or unexpected bleeding led you to look for answers. The word polyp can sound alarming. Most uterine polyps are benign, and there is a clear path to learn what is present and whether it needs treatment. At Diana Health, we want you to understand each step so you can make decisions that fit your health and goals.
Uterine Polyps and Why They Develop
Uterine polyps, also called endometrial polyps, are overgrowths of the tissue lining the uterus. They may be tiny or several centimeters, single or multiple, and attached by a broad base or thin stalk. Mayo Clinic explains that hormones may play a role because this tissue responds to estrogen. Polyps are more common during perimenopause and after menopause; higher body weight and tamoxifen use are also associated with them. Often, no single cause can be identified. No specific food, exercise pattern, or stressful period has been shown to directly cause polyps, and no proven way exists to prevent them.
Polyps are different from fibroids. A polyp grows from the uterine lining; a fibroid grows from uterine muscle. Both may cause abnormal bleeding, but they are treated differently.
Symptoms of Uterine Polyps
Some polyps cause no symptoms and are found during imaging or another procedure. When symptoms occur, they may include:
- bleeding or spotting between periods
- irregular, heavy, or prolonged periods
- bleeding after sex
- vaginal bleeding or pink or brown discharge after menopause
- difficulty becoming pregnant, although a polyp is not always the cause
What to Expect at Your Visit
Your visit begins with your story. Your clinician will usually ask about:
- when bleeding started, how long it lasts, how heavy it is, clots, and bleeding between periods, after sex, or after menopause
- pain, fatigue, dizziness, and any chance of pregnancy
- medications and supplements, including hormone therapy, contraception, tamoxifen, and blood thinners
- previous imaging, biopsies, or procedures, along with pregnancy or fertility goals and relevant personal or family history
Depending on your symptoms, the visit may include vital signs, an abdominal or pelvic examination, a pregnancy test, or a blood count. A routine pelvic exam usually cannot see or feel a uterine polyp, but it can identify other causes of bleeding. A cervical polyp is different and may be visible during a speculum exam.
Diana Health’s guide to what to do about irregular bleeding can help you prepare for a visit.
Bleeding after menopause needs evaluation. Learn more in Diana Health’s guide to postmenopausal bleeding.
Tests Used to Find Uterine Polyps
Transvaginal Ultrasound
A transvaginal ultrasound is often the first imaging test. It may show a growth or focal thickening inside the uterus. It can suggest a polyp, but it cannot diagnose the tissue. If this type of ultrasound is not acceptable or feasible, other options exist, such as a transabdominal ultrasound.
Saline Infusion Sonography
For this test, also called a sonohysterogram, a thin tube passes through the cervix and a small amount of sterile saline is placed in the uterus during ultrasound. The fluid can show a polyp’s size and location more clearly. This imaging test does not remove tissue.
Hysteroscopy and Tissue Testing
During hysteroscopy, a thin camera passes through the vagina and cervix to see inside the uterus. It may be done in an office, procedure center, or operating room, depending on your needs and preferences. Small instruments can often remove a polyp during the same procedure. A pathologist then examines the tissue. Read more about what to expect during hysteroscopy.
An endometrial biopsy samples the uterine lining to evaluate for overgrowth or cancer. Because the sample is not directed at one spot, it can miss a focal polyp and does not remove it. Mayo Clinic’s diagnosis and treatment overview explains this distinction. A Pap test screens the cervix and does not diagnose a uterine polyp.
Treatment Pathology and Follow Up
Not every uterine polyp requires immediate removal. Observation may be reasonable for a small polyp without symptoms in a lower-risk premenopausal patient. Removal is more often recommended with abnormal or postmenopausal bleeding, a concerning finding or risk factor, or a fertility reason to evaluate the uterus. The decision also considers the polyp’s size and location, your fertility goals, and your preferences about pain control or anesthesia.
When removal is recommended, clinicians usually perform hysteroscopic polypectomy because they can see and remove the growth directly. Blind dilation and curettage alone may miss a focal polyp. Most pathology results confirm a benign polyp. Less often, the report may show hyperplasia, atypical hyperplasia, endometrial intraepithelial neoplasia, or cancer. Those findings require additional care, sometimes with a specialist.
After a benign result, follow-up depends on your symptoms, the pathology, and whether bleeding continues. Repeat imaging is not automatically needed. Contact your care team if bleeding persists or returns.
If you have abnormal bleeding, postmenopausal spotting, fertility concerns, or an imaging report that mentions a possible polyp, book a visit with Diana Health. We will listen, explain your options, and make a plan with you. As women’s health experts, we care for the whole you: your health, your questions, your concerns, and what matters most to you.
