7 Common Uterine Polyps Symptoms You Should Know

Uterine polyps, also known as endometrial polyps, are growths that develop in the inner lining of the uterus (endometrium). These soft, usually benign growths can vary in size from a few millimeters to several centimeters and may appear as single or multiple formations. While many women with polyps in uterus may not experience any symptoms at all, others can face significant discomfort and health concerns that affect their quality of life and fertility.

Understanding the symptoms of uterine polyps is crucial for early detection and appropriate medical care. These growths are most common in women in their 40s and 50s, though they can occur at any age. The condition affects approximately 10-24% of women, with higher rates among those experiencing abnormal uterine bleeding. This comprehensive guide will help you recognize the key warning signs and understand when to seek medical attention.

1. Irregular Menstrual Bleeding

One of the most common and noticeable symptoms of uterine polyps is irregular menstrual bleeding. Women with endometrial polyps often experience unpredictable menstrual cycles that differ significantly from their normal pattern. This irregularity can manifest in various ways, making it difficult to predict when periods will occur.

The bleeding may occur at unexpected times throughout the month, with periods starting earlier or later than anticipated. Some women notice that their cycle length becomes inconsistent, varying from month to month without any clear pattern. This irregularity happens because the polyps disrupt the normal hormonal signals that regulate the menstrual cycle and can cause the uterine lining to shed unevenly.

The unpredictability of irregular bleeding can significantly impact daily life, making it challenging to plan activities or maintain a normal routine. Women may need to constantly be prepared for unexpected bleeding episodes, which can cause anxiety and stress. If you notice that your previously regular menstrual cycle has become unpredictable or erratic, it’s important to consult with a healthcare provider for proper evaluation.

2. Heavy Menstrual Periods (Menorrhagia)

Heavy menstrual bleeding, medically termed menorrhagia, is another hallmark symptom of uterine polyps. Women experiencing this symptom often find that their periods are significantly heavier than what they consider normal, requiring more frequent changes of sanitary products throughout the day.

Specific indicators of heavy menstrual bleeding include:

• Soaking through one or more pads or tampons every hour for several consecutive hours
• Needing to use double sanitary protection to control menstrual flow
• Waking up during the night to change sanitary products
• Passing blood clots larger than a quarter
• Menstrual periods lasting longer than seven days

The increased blood flow occurs because polyps add extra tissue to the uterine lining, creating more surface area that sheds during menstruation. Additionally, polyps can interfere with the uterus’s ability to contract properly, which normally helps control bleeding. Heavy periods can lead to iron deficiency anemia over time, causing fatigue, weakness, and shortness of breath. If you experience heavy menstrual bleeding that interferes with your daily activities or causes you concern, medical evaluation is recommended.

3. Bleeding Between Periods (Intermenstrual Bleeding)

Bleeding or spotting between menstrual periods is a significant indicator of uterine polyps. This symptom, known as intermenstrual bleeding or metrorrhagia, occurs when bleeding happens during the time between expected menstrual cycles. The bleeding can range from light spotting to more substantial flow.

This between-period bleeding can occur at any point in the menstrual cycle, though it’s sometimes more common around ovulation or in the luteal phase. The bleeding may be bright red, pink, or brown in color and may be accompanied by mild cramping or discomfort. Some women notice this bleeding after physical exertion, exercise, or bowel movements due to the mechanical irritation of the polyps.

The presence of polyps creates fragile tissue that bleeds easily, even from minor irritation or hormonal fluctuations. The polyps have their own blood supply and can bleed spontaneously, independent of the normal menstrual cycle. Because intermenstrual bleeding can also indicate other conditions, including more serious ones, any bleeding between periods should be evaluated by a healthcare professional to determine the underlying cause.

4. Postmenopausal Bleeding

For women who have gone through menopause, any vaginal bleeding is considered abnormal and requires immediate medical attention. Postmenopausal bleeding is one of the most significant symptoms associated with uterine polyps in older women and should never be ignored or dismissed as normal.

After menopause, the uterine lining should remain thin and stable without regular shedding. However, uterine polyps can continue to grow or persist after menopause, particularly in women taking hormone replacement therapy. These polyps can cause spontaneous bleeding episodes that may range from light spotting to heavier bleeding resembling a period.

While uterine polyps are often benign, postmenopausal bleeding requires thorough investigation because it can also be a sign of more serious conditions, including endometrial cancer. Studies show that approximately 5-10% of postmenopausal women with bleeding have endometrial cancer, making proper evaluation essential. Any woman experiencing bleeding after menopause should contact her healthcare provider promptly for examination and appropriate diagnostic testing, such as transvaginal ultrasound or endometrial biopsy.

5. Infertility or Difficulty Conceiving

Uterine polyps can significantly impact fertility and make it difficult for women to become pregnant or maintain a pregnancy. For some women, infertility may be the only symptom that leads to the discovery of endometrial polyps, as they may not experience any bleeding or pain.

Polyps interfere with fertility through several mechanisms:

• They can block the fallopian tube openings, preventing sperm from reaching the egg
• Polyps may prevent a fertilized egg from properly implanting in the uterine wall
• They can disrupt the normal hormonal environment needed for embryo development
• Large polyps can physically distort the uterine cavity, creating an unsuitable environment for pregnancy
• They may cause inflammation that is hostile to sperm survival and embryo development

Research indicates that removing uterine polyps can improve fertility rates, particularly in women undergoing fertility treatments such as in vitro fertilization (IVF). Studies have shown that polyp removal may increase pregnancy rates by up to 50% in some cases. Women experiencing difficulty conceiving, especially those with other risk factors for polyps, should discuss the possibility of uterine polyps with their fertility specialist.

6. Pelvic Pain or Cramping

While not as common as bleeding symptoms, some women with uterine polyps experience pelvic pain or cramping. The discomfort can vary in intensity from mild to severe and may occur at different times throughout the menstrual cycle.

The pain associated with uterine polyps typically presents as:

• Cramping sensations in the lower abdomen or pelvic region
• Dull, aching pain that comes and goes
• Increased menstrual cramps compared to previous periods
• Discomfort during intercourse (dyspareunia)
• Sharp, sudden pain if a polyp becomes twisted or begins to pass through the cervix

Large polyps are more likely to cause pain symptoms, particularly if they hang down through the cervical canal. When a polyp extends through the cervix, the uterus may contract in an attempt to expel it, causing cramping similar to labor pains. This process of passing a uterine polyp can be quite uncomfortable but typically resolves once the polyp is expelled or removed. If you experience persistent or severe pelvic pain, it’s important to seek medical evaluation to determine the cause and receive appropriate care.

7. Abnormal White or Yellowish Vaginal Discharge

Some women with uterine polyps notice changes in their vaginal discharge, including increased volume or abnormal coloring. While vaginal discharge is normal and varies throughout the menstrual cycle, certain changes can indicate the presence of uterine polyps.

Discharge associated with endometrial polyps may have these characteristics:

• White or yellowish color that differs from typical discharge
• Increased volume requiring more frequent use of panty liners
• Watery or mucus-like consistency
• Discharge that occurs throughout the month, not just at certain cycle phases
• Sometimes streaked with blood, appearing pink or brown

The abnormal discharge occurs because polyps can produce mucus and may cause irritation or minor bleeding that mixes with normal vaginal secretions. While this symptom is less specific than bleeding patterns, persistent abnormal discharge warrants medical evaluation. It’s important to note that other conditions, including infections, can also cause discharge changes, so proper diagnosis is essential to identify the underlying cause and receive appropriate treatment.

Main Causes and Risk Factors of Uterine Polyps

While the exact cause of uterine polyps remains unclear, researchers have identified several factors that contribute to their development. Understanding these causes and risk factors can help women assess their likelihood of developing polyps and take appropriate preventive measures.

Hormonal Factors

Estrogen plays a central role in the development of endometrial polyps. The endometrium is highly responsive to estrogen, and excessive estrogen stimulation without adequate progesterone balance can lead to overgrowth of the uterine lining. This hormonal imbalance causes certain areas of the endometrium to proliferate excessively, forming polyps. Women with conditions that increase estrogen exposure, such as obesity, polycystic ovary syndrome (PCOS), or those taking unopposed estrogen therapy, face higher risk.

Age

The risk of developing uterine polyps increases with age, particularly as women approach and go through perimenopause and menopause. Most polyps are diagnosed in women between ages 40 and 50, though they can occur at any age. The hormonal fluctuations that occur during perimenopause may contribute to polyp formation, as estrogen levels become erratic before eventually declining.

Obesity

Being overweight or obese significantly increases the risk of developing uterine polyps. Excess fat tissue produces estrogen, leading to higher overall estrogen levels in the body. This additional estrogen exposure can stimulate excessive growth of the endometrial lining and promote polyp formation. Research shows that women with a body mass index (BMI) over 30 have substantially higher rates of endometrial polyps.

High Blood Pressure

Hypertension has been linked to an increased risk of uterine polyps, though the exact mechanism isn’t fully understood. Some researchers believe that high blood pressure may affect blood flow to the uterus or interact with hormonal factors to promote polyp development. Women with high blood pressure should be aware of this connection and discuss screening for polyps if they experience symptoms.

Tamoxifen Use

Women taking tamoxifen, a medication used to treat and prevent breast cancer, have a significantly increased risk of developing uterine polyps. Tamoxifen acts as an estrogen antagonist in breast tissue but has estrogen-like effects on the uterus, stimulating endometrial growth. Women on tamoxifen therapy should have regular gynecological monitoring and promptly report any abnormal bleeding.

Chronic Inflammation

Chronic inflammation of the uterine lining may contribute to polyp formation. Repeated inflammatory processes can trigger abnormal cell growth and proliferation. Conditions that cause chronic pelvic inflammation or repeated uterine infections may increase polyp risk over time.

Prevention Strategies for Uterine Polyps

While it’s not always possible to prevent uterine polyps entirely, certain lifestyle modifications and health management strategies may reduce your risk or help detect polyps early when they’re easier to manage.

Maintain a Healthy Weight

Since obesity is a significant risk factor for uterine polyps, maintaining a healthy body weight through balanced nutrition and regular exercise can help reduce risk. Weight loss in overweight or obese women can lower estrogen levels and decrease the likelihood of polyp development. Aim for at least 150 minutes of moderate-intensity exercise per week and follow a diet rich in fruits, vegetables, whole grains, and lean proteins.

Manage Blood Pressure

Keeping blood pressure within healthy ranges may help reduce the risk of developing uterine polyps. Regular monitoring, a low-sodium diet, stress management, regular physical activity, and medication when prescribed by a doctor can all contribute to healthy blood pressure levels. Women with hypertension should work closely with their healthcare provider to maintain optimal blood pressure control.

Regular Gynecological Check-ups

Routine gynecological examinations and being attentive to changes in menstrual patterns can lead to early detection of uterine polyps. Women should schedule annual well-woman visits and promptly report any abnormal bleeding, changes in menstrual patterns, or other concerning symptoms to their healthcare provider. Early detection allows for timely intervention and better outcomes.

Hormone Balance

If you’re using hormone therapy, work with your healthcare provider to ensure appropriate balance between estrogen and progesterone. Unopposed estrogen therapy (estrogen without progesterone) increases the risk of endometrial proliferation and polyp formation. Women with an intact uterus who use hormone replacement therapy should typically receive combined estrogen-progesterone therapy to protect the endometrium.

Monitor Tamoxifen Effects

Women taking tamoxifen for breast cancer treatment or prevention should have regular gynecological monitoring, including prompt evaluation of any abnormal bleeding. Your healthcare team should be aware of your tamoxifen use and may recommend periodic ultrasound examinations to monitor the uterine lining for polyps or other abnormalities.

Frequently Asked Questions About Uterine Polyps

Can uterine polyps be cancerous?

Most uterine polyps are benign (non-cancerous), with less than 5% being precancerous or cancerous. However, the risk increases with age, particularly in postmenopausal women, and in those with symptoms like abnormal bleeding. This is why any polyps discovered should be evaluated and often removed for pathological examination to rule out malignancy. Risk factors for cancerous polyps include postmenopausal status, tamoxifen use, and obesity.

Can you feel uterine polyps?

Generally, you cannot feel uterine polyps yourself, as they’re located inside the uterus. However, in rare cases where a large polyp protrudes through the cervix into the vagina, you might feel it as a smooth, soft mass. Most polyps are discovered through symptoms like abnormal bleeding or during routine gynecological examinations and imaging studies rather than by physical sensation.

Do all women with uterine polyps have symptoms?

No, many women with uterine polyps experience no symptoms at all. Asymptomatic polyps are often discovered incidentally during pelvic examinations, ultrasounds performed for other reasons, or fertility evaluations. Small polyps are particularly likely to be asymptomatic. However, larger polyps or multiple polyps are more likely to cause noticeable symptoms such as abnormal bleeding or infertility.

What happens if uterine polyps are left untreated?

Untreated uterine polyps may persist without causing problems, grow larger and cause more symptoms, or occasionally resolve on their own, particularly small polyps in premenopausal women. However, leaving polyps untreated carries certain risks, including continued abnormal bleeding leading to anemia, ongoing fertility problems, and a small risk of cancerous transformation, especially in postmenopausal women. The decision to treat or monitor polyps depends on factors like size, symptoms, age, and fertility concerns.

How are uterine polyps diagnosed?

Uterine polyps are diagnosed through several methods. Transvaginal ultrasound is often the first imaging test and can reveal polyps as thickened areas in the uterine lining. Sonohysterography (saline infusion sonography) provides clearer images by filling the uterus with saline during ultrasound. Hysteroscopy, which involves inserting a thin camera through the cervix into the uterus, allows direct visualization of polyps and enables simultaneous removal and biopsy. Endometrial biopsy can also detect polyps while sampling tissue to check for abnormal cells.

Can uterine polyps come back after removal?

Yes, uterine polyps can recur after removal, with recurrence rates varying from 3.5% to 40% depending on various factors. Women who are younger, obese, have high blood pressure, or take tamoxifen have higher recurrence rates. Having multiple polyps initially also increases the likelihood of recurrence. Regular follow-up with your healthcare provider after polyp removal is important to monitor for recurrence, especially if you experienced symptoms or have risk factors.

Can young women get uterine polyps?

While uterine polyps are most common in women in their 40s and 50s, younger women can develop them as well. Polyps in younger women are less common but may be associated with obesity, PCOS, or other hormonal imbalances. Young women experiencing irregular bleeding, especially if trying to conceive, should discuss the possibility of polyps with their healthcare provider.

Is it possible to pass a uterine polyp naturally?

Yes, it is possible to spontaneously pass a uterine polyp, though this is relatively uncommon. When it occurs, women may notice tissue passing with blood during menstruation or at other times, often accompanied by cramping. Passed uterine polyps typically appear as soft, grayish or reddish tissue fragments. If you believe you’ve passed a polyp, try to save the tissue for your doctor to examine, and schedule an appointment to ensure complete passage and rule out other conditions.

References:

• Mayo Clinic – Uterine Polyps
• American College of Obstetricians and Gynecologists – Abnormal Uterine Bleeding
• Johns Hopkins Medicine – Endometrial Polyps
• National Institutes of Health – Endometrial Polyps and Their Implication in the Pregnancy Rates
• Cleveland Clinic – Uterine Polyps