Polyps

What are Polyps?

Polyps are small, benign (non-cancerous) growths that can form in different body parts, including the nose, colon, and uterus. In the uterus, they are typically found on the lining of the uterus, known as the endometrium. 


They may be single or multiple, can be of different sizes and shapes and can appear as a sessile or pedunculated (on a stem) type.


Polyps' Impact on Health

Uterine polyps are most commonly benign but, in some cases, can cause abnormal bleeding. Although they are infrequently cancerous, it is important to have them checked out by a healthcare professional to rule out other causes or conditions. 


They are often discovered incidentally during apelvic ultrasound or an evaluation for abnormal vaginal bleeding.


Symptoms of Uterine Polyps

Not all women with uterine polyps will have symptoms, but some common symptoms include the following:

  • Abnormal Vaginal Bleeding: This can be heavy, prolonged or irregular menstrual periods or bleeding between periods or after menopause.
  • Vaginal discharge: Some women with polyps may have an increased vaginal discharge or a change in the odour or colour of the discharge.
  • Pelvic pressure or pain: Uterine polyps will infrequently cause pelvic pressure or pain.
  • Infertility: Polyps may make it difficult to get pregnant due to a negative impact on implantation and are associated with miscarriage


Cause of Uterine Polyps

Uterine Polyps may occur spontaneously or because of high levels of oestrogen hormone, although it is unknown what causes them. Polyps grow faster during pregnancy and with use oral contraceptives or oestrogen replacement therapy.


Although most polyps are noncancerous, the polyps that develop in women during or after menopause have an increased risk of becoming cancerous.


Polyp Risk Factors

Uterine polyps can affect women of any age, but they are more common in women between the ages of 40 and 60. They occur more frequently in women who have been through menopause and are most likely due to the hormonal changes that occur during menopause. They are also commonly found in women with a higher estrogen level. Some other risk factors that can increase the likelihood of developing polyps include:

  • Obesity
  • Taking hormonal therapy (HRT) or oral contraceptive  pills for an extended period
  • Infertility
  • Endometriosis
  • Family history of polyps or uterine cancer
  • Chronic Inflammation or pelvic infections
  • Anovulatory cycles (cycles without ovulation) such as in women with Polycystic ovarian syndrome


Diagnosis of Uterine Polyps

Polyps are  typically diagnosed during a pelvic examination or ultrasound. The following diagnostic tools can be used to confirm the presence of polyps:

  • Pelvic Exam: During a pelvic examination, your doctor will use a speculum to visualise the cervix and may feel for any abnormalities in the uterus.
  • Ultrasound: Transvaginal ultrasound, which uses sound waves to create images of the uterus and ovaries, can be used to detect polyps and to evaluate their size, shape and location.
  • Hysteroscopy: During this procedure, a thin, lighted scope is inserted through the cervix into the uterus, allowing the healthcare professional to see inside the uterus and visualise any polyps. This is most commonly performed under an anaesthetic. 
  • Biopsy: A small sample of tissue may be taken from the polyp for examination under a microscope. This can confirm the diagnosis and rule out any abnormal cell growth or cancerous change.


Treatments for Uterine Polyps

The treatment of uterine polyps will depend on the size, location, and symptoms caused by the polyps. Some common treatment options include:

  • Watchful Waiting: Smaller polyps that do not cause any problems need not be removed. Polyps should be assessed intermittently to check their progression.
  • Medications: For some women, hormonal medications such as oral contraceptives may be used to shrink the polyp's size or control abnormal bleeding caused by the polyps.
  • Hysteroscopic Polypectomy: In this procedure, the polyps are removed by using a hysteroscope, a thin, lighted instrument inserted through the cervix into the uterus while the woman is under sedation. This procedure is performed most commonly under an anaesthetic as a day surgery procedure. .
  • Surgery: If polyps are large or are found to be precancerous or cancerous, surgery to remove the uterus (hysterectomy) might be recommended.


In some cases, a combination of treatments might be necessary.  After the polyps are removed, regular follow-up may be necessary to monitor for recurrence or other potential complications.


Recovery time will vary depending on the type of procedure. Following hysteroscopic polypectomy but most women can return to normal activities within a few days or up to 2 weeks. It's important to follow the post-operative instructions provided by your doctor to ensure a smooth and comfortable recovery.


It's also worth mentioning that some women may experience cramping or bleeding after the procedure, but this is usually mild and should be discussed with your doctor if it's causing significant discomfort.

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