Uterine polyps are benign growths of the endometrium, which is the lining of the uterus. They are very common in women in their thirties, forties and fifties and are a frequent cause of abnormal bleeding.
Most polyps are not dangerous. Many are small and cause no symptoms. Others can lead to spotting, heavier periods or bleeding after intercourse or after menopause.
In Lisbon, Dra. Joana Faria evaluates and treats uterine polyps in Portuguese, English, French, and Spanish. The aim is to understand your symptoms, confirm the diagnosis and discuss whether it is better to remove the polyp or simply monitor it.
This page focuses on uterine polyps. For a broader overview you can also read the page on reproductive tract diseases and the specific pages on adenomyosis, myomas and endometriosis.
What it is
A uterine polyp is a small overgrowth of the endometrium that protrudes into the uterine cavity. It can be attached by a thin stalk or have a broad base.
Polyps vary in size. Some are only a few millimetres. Others can fill a large part of the cavity. It is also possible to have more than one polyp at the same time.
Most polyps are benign. In a small percentage of cases, particularly in women after menopause or with specific risk factors, polyps can contain abnormal or pre cancerous cells. This is why polyps that cause symptoms or appear atypical on ultrasound are usually removed and studied in the laboratory.
Main symptoms and when to worry
Many uterine polyps cause no symptoms and are found by chance during an ultrasound or a scan done for another reason.
When symptoms do appear, they often include:
- Spotting or brown discharge between periods.
- Heavier or longer periods.
- Bleeding after sexual intercourse.
- Bleeding after menopause, even if it is light.
- Difficulty getting pregnant or miscarriages in some cases, especially when the polyp is large and occupies part of the uterine cavity.
You should consider booking a consultation if you notice bleeding patterns that are different from your usual cycle, spotting that persists for several months or any bleeding after menopause.
You should seek urgent care if you have very heavy bleeding with clots and dizziness or fainting, or if bleeding is accompanied by severe pain and fever. These signs may indicate another problem that needs immediate evaluation.
Diagnosis: exams and what to expect
Diagnosing uterine polyps usually combines your symptoms with imaging exams. For most women, a detailed consultation and a good quality pelvic ultrasound are the first steps.
The evaluation may include:
- Clinical history
Discussion about your menstrual cycle, spotting, bleeding after intercourse or after menopause, pregnancies and any previous treatments. - Gynecologic examination
Assessment of the vulva, vagina and cervix. This also helps exclude local causes of bleeding. - Transvaginal pelvic ultrasound
Key exam to study the uterus and endometrium. Polyps often appear as focal lesions inside the cavity. The ultrasound can describe their size, number and location. - Saline infusion sonography
An ultrasound done while a small amount of fluid is placed in the uterus through a thin catheter. The fluid improves the contrast and helps to show the exact shape and base of the polyp. - Diagnostic hysteroscopy
A thin camera is introduced through the cervix to look directly inside the uterine cavity. This allows the doctor to see polyps in detail and, if necessary, to remove them during the same procedure.
Hysteroscopy is usually done as a short procedure. It can be performed under local or general anaesthesia depending on the situation and your preference. You will receive instructions about how to prepare and what to expect afterwards.
Treatment options and realistic expectations
Not all uterine polyps need to be removed. The decision depends on your age, symptoms, ultrasound appearance and reproductive plans.
Main options include:
- Watchful waiting
In young women with small polyps and no symptoms, simple follow up may be reasonable. Some polyps disappear on their own, especially in women who are still ovulating. The advantage is avoiding an invasive procedure. The limit is that the polyp may persist or cause symptoms later. - Hysteroscopic polypectomy
This is the most common treatment. Through a hysteroscope, the polyp is cut and removed from inside the cavity. The tissue is then sent to the laboratory for analysis. Recovery is usually quick, with mild cramping and light bleeding for a few days. - Medical treatment
Hormonal methods such as certain types of contraception or hormone releasing intrauterine devices can help control bleeding. They do not make all polyps disappear but can reduce symptoms, especially in women who are near menopause or are not candidates for surgery.
Realistic expectations are important. Removing a polyp that clearly matches your symptoms often brings a clear improvement. However, it is possible for new polyps to develop in the future, especially before menopause. In that case, symptoms can be evaluated again and a new plan can be discussed.
How Dra. Joana Faria approaches uterine polyps in practice
Dra. Joana Faria knows that abnormal bleeding generates understandable worry about cancer and fertility. Her approach is to explain in simple terms what is happening inside the uterus and what each option means for your future.
In daily practice she:
- Listens carefully to how bleeding affects your daily life, work and intimacy.
- Reviews ultrasound and hysteroscopy images with you whenever possible.
- Explains clearly when removal is recommended and when a conservative approach is safe.
- Works with experienced surgical teams for hysteroscopic polypectomy, aiming for effective treatment with a short recovery.
- Coordinates care with fertility and pregnancy specialists if you are trying to conceive.
The goal is that you feel informed, reassured and actively involved in decisions about your uterus, instead of feeling that a procedure is imposed without explanation.
