Uterine Polyps

What are Uterine Polyps?

One or dozens of uterine polyps (endometrium polyps) can develop on the uterine lining when endometrial cells overgrow. They are usually benign, but they can be malignant or become malignant. They can range in size from very small and barely visible to the naked eye to as big as an apple.

They most often occur in perimenopausal and postmenopausal women, but those of childbearing age may have them as well. They are caused at least in part by hormones. Uterine polyps are not preventable, but risk increases with hypertension, obesity and tamoxifen (breast cancer medication) use. They may cause infertility.

What are the Symptoms of Uterine Polyps?

Some women do not have signs or symptoms of uterine polyps.

Those who do may experience:

  • Unpredictable and irregular menstrual periods
  • Breakthrough bleeding or spotting
  • Heavy menstrual bleeding
  • Postmenopausal bleeding
  • Difficulty becoming pregnant
  • Full-term pregnancy failure

Uterine Polyps Causes

It is not completely understood why uterine polyps occur, but it is thought that they are affected by hormone levels and are particularly sensitive to increased levels of estrogen.

It is known that there are certain risk factors associated with uterine polyps. Women who are undergoing hormone replacement therapy (HRT), for example for the menopause, are more likely to develop them, as are those taking tamoxifen, a selective estrogen-receptor modulator which is prescribed to treat and prevent breast cancer.

Obesity and high blood pressure are also both associated with an increased risk of uterine polyps. Fat cells in the body produce estrogen, so individuals who are obese are more likely to have high estrogen levels which could lead to polyps. In regards to high blood pressure, it is not fully understood why it could increase the risk of uterine polyps and researchers are still debating exactly how prevalent polyps are among women with high blood pressure.

How are Uterine Polyps Treated?

The most common treatments for uterine polyps are:

  • Monitoring when small since they may go away without treatment
  • Hormones
  • Polyp removal

In most cases, uterine polyps do not come back after surgical removal.

Uterine Polyps Prevention

Women who are at an increased risk of uterine polyps due to taking certain medications may want to consider weighing up the risk against the benefits of the medication. When it comes to HRT, some may prefer to put up with the symptoms of menopause in order to reduce the risk of polyps, while others may find their symptoms are too extreme to cope without HRT.

With tamoxifen, doctors will usually always recommend that patients continue to take the medication despite the increased risk of polyps, since it can help to treat and prevent life-threatening breast cancer. Polyps, while uncomfortable, are usually benign and therefore preferable to the risk of breast cancer. Instead, it is often recommended that the patient is fitted with an IUD (inauterine device) which contains levonorgestrel. These IUDs, which are most commonly used as a contraceptive method, have been proven to reduce the risk of polyps in women taking tamoxifen.

Finally, women who are obese should consider losing weight to reduce their risk of uterine polyps. Since obesity is often associated with high blood pressure, which may be another risk factor of polyps, doing so could help to prevent the condition and improve overall health.