Uterine polyps: A common reason for irregular bleeding around menopause

If you’re approaching menopause and experience vaginal bleeding outside of your normal pattern, it could be due to a condition called uterine polyps. The good news is if your polyps become problematic, they are treatable. Here’s what you need to know.

Top things to know:

• Uterine polyps are abnormal growths on the inside lining the uterus
• They occur most commonly leading up to and after menopause
• Symptoms include irregular bleeding between periods and periods that vary in length and heaviness

Smaller polyps are often not noticeable, or can go away on their own, but problematic polyps can be treated with medications, non-invasive surgery, and/or lifestyle changes.

What are uterine polyps?

Uterine polyps are abnormal growths on the inside lining of the uterus (the endometrium). They are sometimes called endometrial polyps and can cause symptoms such as irregular vaginal bleeding (1, 2).

Uterine polyps are very common. Up to 3 in 10 people may have them at some point in their lives (3, 4), but fewer than 1 in 100 people develop polyps before age 30 (3, 5). They occur most commonly leading up to and after menopause (6). Small polyps may cause no symptoms at all and can go away on their own (2, 7). In other cases, untreated polyps may cause symptoms that affect quality of life and can carry a small chance of becoming cancerous (3, 8). They may also affect fertility, but research on this topic is still lacking (9, 10).

Nearly all symptoms of uterine polyps are easy to track. Tracking your bleeding patterns, pain, and other symptoms with Clue can provide your healthcare provider with information that may help with diagnosis and in forming a treatment plan. Early treatment can reduce the risk of complications.

What you might notice

Signs and symptoms of uterine polyps include:

• Irregular bleeding between periods or after menopause
• Periods that vary in length and heaviness
• Very heavy periods
• Difficulty getting pregnant (1, 2, 8–12)

Why they happen

Uterine polyps occur when cells of the uterine lining (the endometrium) multiply too many times. As this happens, lumps are formed. These lumps often resemble hanging sacs or mushrooms made of tissue (14). Most are very small, but can range in size from a few millimeters, to several centimeters in diameter (15). Polyps can be numerous or few, and some people might only have one. Some research shows that estrogen plays an important role in the formation of polyps, but it’s not yet clear how (4).

Some people are more likely than others to develop uterine polyps. They are most common in people who are perimenopausal and postmenopausal. Obesity also makes people significantly more likely to develop polyps (4, 16, 17). Another contributing factor may be taking the breast cancer drug tamoxifen (18, 19).

Uterine polyps are similar to one type of uterine fibroids. Fibroids form from muscle tissue in the uterus, but can cause many of the same symptoms, as well as other ones. The biggest difference is that fibroids are more likely to be problematic in the reproductive years and shrink after menopause, while polyps are more likely to be problematic after menopause.

Why get them checked out?

Small uterine polyps are often asymptomatic, and can come and go on their own (2, 7). Some untreated polyps, however, may cause symptoms that affect quality of life and can lead to complications such as anemia (20). Anemia is a condition when the body doesn’t have enough healthy red blood cells to function properly. This can happen when uterine polyps cause a high amount of blood loss (21).

In rare cases, some uterine polyps carry a small chance of becoming cancerous (3, 8). They may also affect the ability to get or stay pregnant, but research on this topic is still lacking (9, 10).

How they’re diagnosed

A healthcare provider will probably ask questions about symptoms and medical and menstrual history and perform a simple physical exam. If they suspect you have uterine polyps, they may also perform:

• A transvaginal ultrasound
• A hysteroscopy: a small camera inserted into the uterus
• A biopsy: a small tool is inserted into the uterus to take a tissue sample

What you can do about them

Small uterine polyps can go away on their own without treatment (2, 7). If they do become problematic, there are a few different options treating existing polyps, and for preventing their future formation.

• Medications: Hormonal medications are sometimes prescribed to treat the symptoms of uterine polyps. These include Gonadotropin Releasing Hormone (GnRH) agonists, which block the body’s production of certain hormones progesterone, and progesterone, often prescribed in the form of a cream. These has been little research on the effectiveness of these hormonal treatments for uterine polyps (22).
• Non-invasive surgery: Small polyps can be removed with a process called hysteroscopic excision. About 7 in 10 people with small polyps (<1cm) found their symptoms significantly improved after this procedure (1, 2, 11).
• Lifestyle Changes: Research on this is still unclear, but weight loss may improve the prognosis of people who are diagnosed with both uterine polyps and obesity (16, 23).

What to track

Essential to track:

• bleeding patterns
• pain

Helpful to to track:

• heaviness of bleeding
• sex (if trying to get pregnant)

Use Clue to track bleeding, pain, and other symptoms.