What is a uterine polyp?

What are the risk factors and causes? What symptoms to look for? How is this disease diagnosed? What complications are to be feared? How is treatment organized? What should you do if you want to get pregnant? Let's take a look at uterine polyps and their possible consequences for fertility.

What is a uterine polyp?

A uterine polyp is a growth in the lining of the uterus. Depending on its location, it is referred to as :

• Intracavitary polyp (located in the uterine cavity);
• Uterine (endometrial) polyp;
• Endocervical polyp (located in the cervix);
• Polyp of cervical origin (inserted into the endometrium or cervical canal and exiting through the external orifice of the cervix).

This benign tumor may occur singly or in groups. It can be :

• Pedunculated (with a foot insertion) or sessile (with a broad base of implantation);
• Fibrous or mucinous; variable in size, ranging from a few millimeters (called "micropolyps") to several centimeters.

Uterine polyps, which are hormone-dependent (stimulated by hormones such as estrogens), do not usually affect women before the age of 30. However, their incidence is much higher in peri-menopause (between 45 and 60 years of age).

Uterine polyps are mostly asymptomatic and are often discovered by chance during a gynecological consultation, a fertility check or an ultrasound to look for the causes of metrorrhagia or menorrhagia (terms referring to bleeding outside the period or excessive menstruation, respectively).

A uterine polyp is harmless in most cases and should not be confused with a uterine fibroid (a muscular tissue in the myometrium between the endometrium and the uterine serosa) or with endometrial cancer.

What are the symptoms and causes of uterine polyps?

Even if they are silent for long periods of time, certain symptoms may warrant a consultation with your gynecologist. These are the following signs:

• Metrorrhagia (bleeding outside the period);
• Menorrhagia (abnormally heavy periods);
• Infertility (rarely the only cause);
• Leucorrhea (heavy genital discharge).

Although the exact causes of uterine polyps are not yet well understood, it is clear that an imbalance between female sex hormones (progesterone and estrogen) is involved in explaining this condition.

Several risk factors have been identified. Among them are the following characteristics:

• Being overweight;
• All situations that lead to excess estrogen (e.g., being overweight) and/or progesterone deficiency;
• Certain oncological treatments.

How can a uterine polyp be detected?

To make a diagnosis, specialists have at their disposal several tests such as:

• Speculum gynecological examination (evaluation of the cervix and vaginal walls);
• Endovaginal pelvic ultrasound (medical imaging technique to explore the uterus and ovaries);
• Diagnostic hysteroscopy (technique for direct visualization of the interior of the uterine cavity);
• Directed biopsy (histological examination after taking a piece of tissue).

Uterine polyp: what are the treatments to cure it?

Depending on the size, appearance and risk of complication, several types of treatment can be considered:

• Hormonal treatment (progestins) for small polyps;
• Polypectomy or surgical removal of uterine polyps (treatment by natural way by; Hysteroscopy with local or general anesthesia);
• Endometrectomy (removal of the uterine lining by hysteroscopy to avoid any risk of recurrence. This operation is proposed to patients who no longer wish to procreate or who are already menopausal).

Source: IVI-Fertilite.fr

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