What are Uterine Polyps?

Uterine polyps are growths that occur in the endometrium, the inner lining of the uterus (the organ in which a fetus grows). For that reason, they are sometimes called endometrial polyps.

Uterine polyps are formed by the overgrowth of endometrial tissue. They are attached to the endometrium by a thin stalk or a broad base and extend inward into the uterus. The polyps may be round or oval, and range in size from a few millimeters (the size of a sesame seed) to a few centimeters (the size of a golf ball), or larger. There may be one or several polyps present. Uterine polyps are usually benign (noncancerous), but they may cause problems with menstruation (periods) or fertility (the ability to have children).

What causes uterine polyps?

The exact reason that polyps form is unknown, but swings in hormone levels may be a factor. Estrogen, which plays a role in causing the endometrium to thicken each month, appears to be linked to the growth of uterine polyps.

Who is affected by uterine polyps?

Uterine polyps are more likely to develop in women who are between 40 and 50 years old than in younger women. Uterine polyps can occur after menopause and rarely occur in women under 20 years old. Your chances of developing uterine polyps may increase if you are overweight or obese, have high blood pressure (hypertension), or are taking tamoxifen, a drug that is used to treat breast cancer.

The symptoms of uterine polyps include the following:

• Irregular menstrual periods
• Unusually heavy flow during menstrual periods
• Bleeding or spotting between periods
• Vaginal spotting or bleeding after menopause
• Infertility (inability to become pregnant or carry a pregnancy to term may be signs that uterine polyps are present)

The most common symptom of uterine polyps is irregular or unpredictable menstrual periods. Most women have periods that last 4-7 days. A woman’s period usually occurs every 28 days, but normal menstrual cycles can range from 21 to 35 days. Approximately half of women with uterine polyps have irregular periods.

Other symptoms include prolonged or excessive menstrual bleeding (menorrhagia), bleeding between periods, and bleeding after menopause or after sexual intercourse. Uterine polyps are the cause of abnormal bleeding in about 25% of these cases.

Uterine Fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas. Uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. The growth patterns of uterine fibroids vary: they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

As many as three out of four women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

In women who have symptoms, the most common symptoms of uterine fibroids include:

·  Heavy menstrual bleeding
·  Prolonged menstrual periods: seven days or more of menstrual bleeding
·  Pelvic pressure or pain
·  Frequent urination
·  Difficulty emptying your bladder
·  Constipation
·  Backache or leg pains

Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and, rarely fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.

Fibroid location, size, and number influence signs and symptoms:

Submucosal fibroids

Submucosal fibroids grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.

Subserosal fibroids

Subserosal fibroids project to the outside of the uterus (subserosal fibroids) and can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing a pressure sensation, or on your spinal nerves, causing backache.

Intramural fibroids

Intramural fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.

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