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    Causes of Uterine Polyps, a Common Reason for Bleeding During Menopause

    Updated 17 February 2022 |
    Published 09 November 2018
    Fact Checked
    Anna Klepchukova
    Reviewed by Anna Klepchukova, Flo chief medical officer, UK
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    Mention "uterine polyps" to most women and you’ll draw a blank stare. It’s not a condition with which many women are familiar, but polyps aren’t rare. According to some estimates, as many as 10% of women without visible symptoms are diagnosed with uterine polyps (also known as endometrial polyps). The polyps are also a very common cause of abnormal vaginal bleeding.

    Being diagnosed with uterine polyps can be a worrying time for a woman and it’s natural to have concerns about cancer. Although the majority of cases are completely benign and non-cancerous, some endometrial polyps do develop into cancer at a later stage. For this reason, it’s important for women to be aware of the condition and its treatment.

    What are uterine polyps?

    Many women are unaware of uterine polyps until being diagnosed by a healthcare provider. This can be an anxious time and it’s natural to have some worries about the condition. If you’re in this position, or even if you’re not, one of the best things you can do is to make yourself aware of the condition and its symptoms.

    Uterine polyps are small tissue growths on the inside of the womb (also called the uterus). Since these growths come from the endometrium — the lining of the womb — they are also called endometrial polyps.

    Uterine polyps can vary enormously in size: some are as small as a sesame seed, while others are as large as a golf ball. It’s also possible to have a single polyp or many and most polyps stay within the womb. In some cases however the polyp may pass through the cervix (neck of the womb) and into the vagina.

    It’s common for the condition to be symptom-free, and so many women will be completely unaware that they have polyps.

    It will be stressful to find out that you have endometrial polyps, but remember that most cases are entirely benign (non-cancerous). Having polyps does not mean that you have cancer, but you should be aware that some polyps later become cancerous.

    After diagnosis, your healthcare provider will be able to offer you advice on the range of treatment options that are available to you. They will also be able to talk to you about the risk of developing cancer later.

    Some factors can increase the risk of developing endometrial polyps:

    • obesity
    • high blood pressure
    • menopause
    • taking tamoxifen, a breast cancer drug
    Uterine polyps treatment appointment

    Can uterine polyps cause bleeding during menopause?

    Although many women with endometrial polyps experience no symptoms, the most common sign is bleeding. For a postmenopausal woman, vaginal bleeding may mean that one or more polyps have developed. If you are concerned that this is the case, seek advice from a trusted healthcare provider — they will be able to offer expert counsel on the most appropriate investigations.

    Causes of recurrent uterine polyps

    In some cases, women experience a recurrence of endometrial polyps and a return of symptoms. If this happens you will need to resume treatment, either by medication or surgery.

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    Diagnosis of endometrial polyps

    We still don’t know exactly what causes endometrial polyps, but hormone levels may play a part in how they develop. During your menstrual cycle, the level of estrogen in your body rises and falls and this is what causes the lining of your womb to develop in preparation for a fertilized egg.

    Overactivity in the development of the lining results in a uterine polyp. Most commonly they affect women right before and during menopause. This means that you are more likely to be diagnosed with polyps in your 40s and 50s when estrogen levels in your body are fluctuating. In some cases, younger women can also develop polyps. 

    Uterine polyps may cause no symptoms, particularly if there is a single polyp or if they are small. The most common sign is bleeding but you may notice any combination of these other symptoms:

    • irregular periods that vary in their timing and heaviness
    • heavy periods
    • bleeding or spotting  between periods
    • bleeding after menopause
    • difficulty getting pregnant

    The symptoms of uterine polyps can be identical to those of uterine cancer — even though most cases are benign, it’s important to take the condition seriously. Polyps are more likely to be a precursor to cancer in women who are postmenopausal.

    Your doctor will also be careful to check if you have uterine fibroids rather than polyps. There are many similarities between polyps and fibroids, but a number of important differences. Unlike polyps that grow from the lining of the uterus, fibroids develop from the muscle of the wall of the uterus.

    Fibroids can cause heavy bleeding but are also associated with symptoms like pain, constipation, and difficulty urinating. Fibroids can be investigated using the same methods as those that are used for endometrial polyps.

    There are a number of different methods available to further investigate endometrial polyps. Your doctor will be able to explain which of these is available and most suitable for you:

    • Ultrasound. A thin wand-like device will be inserted int