Endometrial polyps are small growths within the uterine lining that can cause spotting between periods. They are sometimes associated with infertility and in rare cases, cancer. 

What are endometrial polyps?

Endometrial polyps, also called uterine polyps, are small round or oval growths that develop on the inner lining of the uterus, called the endometrium. They can contribute to abnormal menstrual bleeding and, in some cases, infertility. They are usually benign, but can be precancerous or cancerous, with a slightly higher risk of becoming cancerous in menopausal women. The polyps can range in size from a millimeter to several centimeters.

Symptoms of Endometrial Polyps

Many women who have endometrial polyps are symptom-free. Others may experience irregular menstrual bleeding including:

• Bleeding between periods
• Bleeding after menopause

If you experience any of these symptoms, it’s important to speak to your doctor. 

What causes endometrial polyps?

The cause of endometrial polyps is not always clear. Polyps can develop in women of any age but are rare in women under 20. Those at a higher risk for endometrial polyps include women that experience:

• Hormone-based treatments for menopause symptoms may further increase the risk of uterine polyps
• obesity
• Tamoxifen, a medication for breast cancer

These conditions all increase estrogen, which may be a factor in developing polyps. Estrogen is a hormone that causes thickening of the uterine lining during menstruation. When estrogen levels stay high or fluctuate too much, they may cause the lining of the uterus to thicken, which may lead to the formation of polyps.

Diagnosis

If your doctor suspects you might have endometrial polyps based on your symptoms, they could suggest one or more of the following diagnostic tests:

Pelvic exam: A speculum is used to examine the cervix and vaginal walls. A pelvic exam alone is not typically thorough enough to diagnose uterine polyps. 

• Hysterosonography: In this ultrasound procedure, a saline solution is injected into the uterus to enhance visibility, allowing for polyp detection.
• Hysteroscopy: A small, lighted telescope is inserted through the vagina to allow a direct view of the inside of the uterus.
• Transvaginal ultrasound: A small, wand-shaped device is inserted into the vagina, emitting soundwaves that create detailed images of the uterus.

These tests can help confirm your diagnosis and guide the next steps for treatment. Your doctor will determine which test is right for you.

What is the difference between endometrial polyps and endometrial fibroids?

Endometrial polyps and fibroids are both growths that develop in the uterus, but they differ in many ways.

• Polyps are made of endometrial (uterine) tissue, while fibroids are made of muscle tissue.
• Polyps are usually small and soft, while fibroids can vary greatly in size and are typically firmer.
• Both are influenced by hormonal levels, but fibroids may also be genetic.
• Polyps are typically removed through surgery, but fibroids can be managed through medication, uterine artery embolization, or surgery. Learn more about uterine fibroids.

Treatment for Endometrial Polyps

Treatment options for uterine polyps depend on factors like symptoms, size, whether you're planning to become pregnant, or whether you’ve entered menopause. Small polyps in premenopausal women without symptoms might not require treatment, and some polyps may go away on their own with time.

Common treatments include:

• Medications: Hormonal treatments can help to improve bleeding symptoms. However, they don’t make polyps go away.
• Surgery
• Hysterectomy: In very rare cases, if polyps are confirmed to be cancerous, or if they repeatedly return with bleeding problems, hysterectomy (removal of the uterus) may be recommended.

Living with Endometrial Polyps

Treatment for endometrial polyps varies because of menopausal status, symptoms, or precancerous risk. Treatment has a high success rate in relieving symptoms. However, it is possible that polyps could grow back or you could develop new ones. It’s important to get regular gynecological checkups so if new polyps do emerge, they can be treated in a timely manner.