Uterine Polyps on an anatomical model
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Uterine Polyps: Symptoms, Causes & Treatment

Uterine polyps are small growths that develop from the lining inside the uterus, called the endometrium.

Most are benign, or non-cancerous, and some cause no symptoms at all.

When they do cause symptoms, the most common sign is unusual bleeding. That might mean heavier periods, spotting between periods, bleeding after sex or bleeding after menopause.

Because the symptoms can overlap with fibroids, adenomyosis, hormonal changes and other conditions, you usually can’t tell from your bleeding alone whether a polyp is responsible.

Key takeaways

  • Uterine polyps, also called endometrial polyps, arise from the lining inside the uterus.
  • Most are non-cancerous.
  • The most common symptom is abnormal vaginal bleeding.
  • Polyps may cause heavy periods, spotting between periods, bleeding after sex or bleeding after menopause.
  • Some uterine polyps are found while investigating fertility problems.
  • Transvaginal ultrasound and hysteroscopy are commonly used to investigate polyps.
  • Some asymptomatic polyps can be monitored, while others are removed by hysteroscopy.
  • Any bleeding after menopause needs medical assessment.

On this page

What are uterine polyps?

Uterine polyps are growths that arise from an overgrowth of cells in the endometrium, the tissue lining the inside of the uterus.

They are also called endometrial polyps.

A polyp can be small and flat or grow on a stalk into the uterine cavity.

You may have one polyp or several.

Most uterine polyps are benign and some are discovered incidentally when an ultrasound or hysteroscopy is being performed for another reason.

Are uterine polyps the same as cervical polyps?

No.

Uterine or endometrial polyps grow from the lining inside the uterus.

Cervical polyps grow on the cervix, which is the lower part of the uterus opening into the vagina.

Both can cause irregular bleeding, including bleeding between periods or after sex, but they’re found and managed differently.

What are the symptoms of uterine polyps?

Some people with uterine polyps have no symptoms.

When symptoms occur, abnormal bleeding is the most common.

This can include:

  • heavy periods
  • irregular periods
  • spotting or bleeding between periods
  • bleeding after sex
  • bleeding after menopause

Some people may also experience abdominal or pelvic discomfort, unusual vaginal discharge or difficulty becoming pregnant.

Bleeding patterns alone can’t tell you whether a polyp is present.

Read our guide to spotting and bleeding between periods for other possible causes.

Can uterine polyps cause period blood clots?

They can contribute to heavy menstrual bleeding in some people, and heavy flow can make larger blood clots more likely.

But blood clots aren’t a specific sign of polyps.

Fibroids, adenomyosis, ovulatory changes and other causes of heavy menstrual bleeding can produce a similar pattern.

If you’re regularly passing large clots or your flow has become much heavier than normal for you, it’s worth having the bleeding assessed rather than trying to identify the cause from the clot itself.

See our guide to period blood clots.

What causes uterine polyps?

Uterine polyps develop when cells in the endometrium grow excessively in a localised area.

The exact reason this happens isn’t always known.

Hormones, including oestrogen, appear to play a role. Inflammation and genetic factors may also contribute.

Uterine polyps can occur at different ages but are particularly common in the years approaching menopause.

There is currently no proven way to prevent them.

Uterine polyps vs fibroids: what’s the difference?

Polyps and fibroids are both growths involving the uterus, but they arise from different tissues.

Uterine polyps Fibroids
Grow from the endometrial lining Grow from uterine muscle and fibrous tissue
Project into the uterine cavity Can grow within the wall, into the cavity or towards the outside of the uterus
Often associated with irregular bleeding or spotting May cause heavy periods, pelvic pressure or pain depending on location
Often removed by hysteroscopy when treatment is needed Treatment varies according to size and location

 

Both conditions can cause heavy menstrual bleeding.

Read our guide to uterine fibroids for more.

How are uterine polyps diagnosed?

Your doctor will usually ask about your bleeding pattern, age, medical history and whether you have reached menopause.

Transvaginal ultrasound

A transvaginal ultrasound can show the uterine lining and may reveal a polyp inside the uterine cavity.

If the ultrasound doesn’t provide enough information, other investigations may be recommended.

Saline sonography

A specialised ultrasound called saline infusion sonography or sonohysterography may sometimes be used.

Saline is placed inside the uterine cavity to make its outline easier to see on ultrasound.

Hysteroscopy

A hysteroscopy allows the doctor to look directly inside the uterus using a very thin telescope passed through the cervix.

This can be particularly useful for finding polyps and small fibroids.

In some clinics, a polyp can be removed during the same hysteroscopy.

Hysteroscopy may be performed while you’re awake in an outpatient clinic or under anaesthesia depending on your circumstances, the procedure required and the service providing it.

How are uterine polyps treated?

Not every polyp needs immediate removal.

Treatment depends on:

  • whether you have symptoms
  • your age and menopausal status
  • the size and appearance of the polyp
  • whether fertility is a concern
  • your individual risk factors

Monitoring

If a polyp is small, appears low risk and isn’t causing symptoms, your doctor may recommend monitoring rather than immediate surgery.

Some small polyps may shrink or disappear without treatment.

Managing bleeding

Medicines or hormonal treatments may sometimes be used to manage abnormal or heavy bleeding.

They may help symptoms but don’t necessarily remove the polyp itself.

Hysteroscopic polypectomy

When removal is recommended, uterine polyps are commonly removed through a hysteroscope.

This is called a polypectomy.

A thin camera is passed through the cervix into the uterus so the polyp can be seen and removed without an abdominal incision.

Some Australian services perform suitable polypectomies in an outpatient clinic without general anaesthesia, while others are performed as a day procedure under anaesthesia.

The removed tissue is normally sent to a pathology laboratory for examination.

Can uterine polyps affect fertility?

They can in some circumstances.

A polyp projecting into the uterine cavity may interfere with implantation or be discovered while investigating difficulty becoming pregnant.

Polyp removal may be recommended when a polyp is thought to be contributing to fertility problems.

If you’re planning pregnancy, treatment decisions should take fertility goals into account.

Can uterine polyps be cancerous?

Most uterine polyps are benign.

However, abnormal or cancerous cells can occasionally be found within a polyp.

This is one reason removed uterine polyps are generally sent to pathology for testing.

The possibility of an abnormal polyp becomes more important when there are risk factors such as postmenopausal bleeding or concerning imaging findings.

Importantly, most people with abnormal bleeding do not have uterine cancer, but bleeding after menopause should always be assessed.

When should you see a doctor?

Arrange an assessment if you have:

  • bleeding between periods
  • bleeding after sex
  • unusually heavy periods
  • a significant change in your usual bleeding pattern
  • difficulty becoming pregnant
  • persistent pelvic symptoms

Any vaginal bleeding after menopause should be assessed by a doctor, even if it happens only once or is very light.

Frequently asked questions

Are uterine polyps cancerous?

Most uterine polyps are benign, but abnormal or cancerous cells can occasionally occur. If a polyp is removed, it is usually sent for laboratory testing.

Can a uterine polyp disappear on its own?

Some small polyps may shrink or disappear without treatment, which is why monitoring can be appropriate for some people without symptoms or significant risk factors.

Can uterine polyps cause heavy periods?

Yes. Heavy periods are one possible symptom, although bleeding between periods and irregular bleeding are also commonly associated with uterine polyps.

Can uterine polyps cause blood clots?

They can contribute to heavy menstrual bleeding, which may make visible clots more likely. Clots aren’t specific to polyps and can occur for many other reasons.

Can a polyp cause bleeding after sex?

Yes. Both uterine and cervical polyps can sometimes be associated with bleeding after sex, although there are several other possible causes. Repeated bleeding after sex is worth having assessed.

Is a uterine polyp the same as a fibroid?

No. Polyps arise from the lining of the uterus, while fibroids are growths made from uterine muscle and fibrous tissue.

How are uterine polyps removed?

They are commonly removed by hysteroscopic polypectomy. A thin camera is passed through the cervix into the uterus so the polyp can be seen and removed without an abdominal incision.

Do uterine polyps grow back?

A removed polyp itself doesn’t grow back, but new polyps can develop later in some people.

Should bleeding after menopause be blamed on a polyp?

No. A polyp is one possible cause of postmenopausal bleeding, but any vaginal bleeding after menopause needs assessment so that other causes, including endometrial abnormalities, can be ruled out.

Irregular bleeding is worth understanding

Uterine polyps are usually benign and often straightforward to treat.

But because they can cause the same bleeding patterns as several other uterine conditions, symptoms alone usually can’t tell you whether you have one.

If your periods suddenly become much heavier, you start bleeding between periods or after sex or you have any bleeding after menopause, having the cause investigated is more useful than trying to diagnose it from the appearance of the blood.

Related reading

Sources and further reading

This article provides general educational information and isn’t a substitute for individual medical advice.