Uterine Polyps

What it is

Uterine polyps are benign growths of the tissue lining the uterus (endometrial polyps) or the cervix (cervical polyps). They are very common, especially between the ages of 40 and 50 and after menopause, and often cause no symptoms, being found during routine exams. When present, the most common signs are bleeding outside the menstrual period, heavy or irregular periods, bleeding after intercourse or after menopause and, in some cases, difficulty becoming pregnant. Diagnosis is made through a gynecological examination and transvaginal ultrasound, and confirmed by hysteroscopy, which allows the inside of the uterus to be seen. Most polyps are benign, but removal by surgical hysteroscopy is generally indicated when there are symptoms, a desire for pregnancy, larger polyps, or in postmenopausal women, and the tissue is sent for analysis.

Most common symptoms

• Bleeding outside the menstrual period
• Heavy, prolonged or irregular periods
• Bleeding after intercourse
• Bleeding after menopause
• Watery discharge or discharge streaked with blood
• Difficulty becoming pregnant
• No symptoms, found during a routine exam

Causes and risk factors

• Estrogen stimulation of the endometrium and cervix
• Age between 40 and 50 and postmenopause
• Obesity and high blood pressure
• Use of tamoxifen and hormone therapy
• Chronic inflammation of the cervix

How it is diagnosed

Cervical polyps are usually seen directly during the gynecological exam with a speculum. Endometrial polyps, on the other hand, are identified by transvaginal ultrasound, which shows thickening or an image inside the uterine cavity; saline infusion ultrasound can make the visualization sharper. Confirmation is made by diagnostic hysteroscopy, which allows the polyp to be seen, its size and location assessed and, often, removed in the same procedure. The tissue is always sent for pathological analysis.

How we treat it at Femi Saúde

Small polyps without symptoms in women before menopause can simply be monitored, since some regress on their own. Removal is indicated when there is bleeding, a desire for pregnancy, larger polyps, or in postmenopausal women. Endometrial polyps are removed by surgical hysteroscopy, a minimally invasive procedure in which the Femi Saúde gynecology team visualizes and removes the polyp through the natural passage, without incisions; cervical polyps can be removed in the office. All tissue is analyzed. When irregular bleeding persists after removal, hormonal methods such as the hormonal IUD may be considered. The plan is individualized, with periodic follow-up.

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