If your healthcare provider suspects you may have endometrial polyps, they will likely begin with a pelvic exam and ask about your symptoms. If abnormal bleeding or fertility challenges are present, further testing may be needed to confirm the diagnosis.

Common diagnostic methods include:

  • Transvaginal Ultrasound: This is a common first step. A small ultrasound probe is inserted into the vagina to capture images of the uterus. Polyps may appear as irregular growths inside the uterine lining.
  • Saline Infusion Sonohysterography (SIS): In this procedure, sterile fluid is introduced into the uterus through a thin catheter before an ultrasound is performed. The fluid helps outline the shape of the uterine cavity, making polyps easier to detect.
  • Hysteroscopy: This procedure involves inserting a thin, lighted scope through the cervix into the uterus. It allows your provider to see inside the uterus and identify polyps directly. It may also be used to remove the polyp at the same time.
  • Endometrial Biopsy: A small tissue sample from the uterine lining may be taken to examine under a microscope. This helps rule out abnormal or cancerous cells, especially in postmenopausal patients.

Treatment Options for Endometrial Polyps

Whether or not treatment is necessary depends on several factors, such as the size of the polyp, your symptoms, age, and whether you are trying to conceive.

Watchful Waiting

If polyps are small and not causing symptoms, your healthcare provider may suggest monitoring them over time. Some polyps go away on their own, particularly in people who are premenopausal.

Medications

Hormonal medications may help shrink or control polyps. These include:

  • Progestins (oral or IUD-based)
  • Hormonal birth control pills
     While these treatments may help manage symptoms like irregular bleeding, they are not considered permanent solutions, as polyps often return when medication is stopped.

Surgical Removal (Polypectomy)

If a polyp is large, causes symptoms, or affects fertility, your provider may recommend removing it. This is often done via a hysteroscopic polypectomy, a minimally invasive procedure that can be done in a doctor’s office or outpatient setting. Most people recover quickly with minimal discomfort.

Can Endometrial Polyps Come Back?

While many people never develop another polyp after removal, recurrence is possible. Studies suggest recurrence rates range between 2.5% and 3.7%. Regular monitoring and follow-up with your healthcare provider can help catch returning polyps early.

Complications and Risks

In rare cases, endometrial polyps may be linked to abnormal cell growth. The risk of cancer is slightly higher in postmenopausal individuals, which is why bleeding after menopause always warrants further investigation.

Possible complications include:

  • Persistent abnormal bleeding
  • Difficulty conceiving or carrying a pregnancy
  • Rarely, progression to precancerous or cancerous changes

Takeaway

Endometrial polyps are common, mostly benign growths that form inside the uterus. While many people never notice them, others may experience irregular bleeding, pain, or fertility issues.

Diagnosis is typically made through imaging or hysteroscopy, and treatment options range from observation to medication to minor surgery. If you're experiencing symptoms or are struggling with conception, don’t hesitate to talk to your provider.