Have you recently been diagnosed with uterine polyps? Although you may be a little worried, you should know that uterine polyps are very common: some studies estimate that nearly 25% of women develop them at some point in their lives. They are also a silent condition: many who suffer from them don’t even realize they have them.
While uterine polyps are common, treatment is unique to each person. Your doctor will evaluate several factors, such as your symptoms and age, as he or she creates a specialized treatment plan. He or she will work with you to decide if you can start with more conservative options, such as watchful waiting or hormone therapy, or if you should consider uterine polyp removal procedures.
Below, we’ll explain the treatment options for uterine polyps, including the factors that may affect your decision and what you can expect if you decide to have them removed.
Treatment for uterine polyps usually depends on your symptoms, age, and stage of menopause.
While the exact cause of uterine polyps is unknown, your age and your body’s estrogen levels seem to play a role. Doctors will also take into account your age and whether you have started menopause.
If you are premenopausal and have no symptoms, your age may affect the treatment of uterine polyps.
Premenopause is the period of your prime reproductive years when you have a menstrual cycle and no symptoms of menopause. Women under age 20 rarely develop uterine polyps, but the chances increase with age and peak at age 40, just before the onset of menopause (the transition to menopause usually begins between ages 45 and 55). In many cases, uterine polyps don’t cause any symptoms, so your doctor may take a watchful approach.
Your age may also affect treatment for uterine polyps if you are postmenopausal and have symptoms.
Postmenopause is the period after menopause when you have not had your menstrual period for more than a year. Doctors can use the intensity of the symptoms you are experiencing (such as postmenopausal vaginal bleeding or pain) and the status of your menstrual cycle to recommend treatment. The risk of developing malignant (cancerous) polyps increases with age and postmenopausal bleeding.
Watchful waiting for uterine polyps
Uterine polyps can be very small (as small as a tomato seed), and small polyps without symptoms may go away on their own. After a diagnosis of a uterine polyp, doctors will likely recommend watchful waiting if you have no symptoms and are of reproductive age.
Watchful waiting means that you will have regular checkups with your doctor so that he or she can monitor the size of the polyps and see if they are growing, and he or she will also want to know if you begin to notice any symptoms.
The size of the polyp and its symptoms could mean that removal of the uterine polyp is the best option.
Polyps can vary widely in size, but large ones are less likely to go away on their own and can often cause more severe bleeding symptoms. They can also make it difficult to get pregnant or carry a pregnancy to term, so removing them can relieve symptoms and increase your chances of getting pregnant. And while cancer is rare, removing polyps also ensures that they are not cancerous.
Removal of uterine polyps: polypectomy
Polypectomy is a surgical procedure and the standard treatment for removing a uterine polyp. This technique is often recommended to help improve abnormal bleeding and fertility when polyps are larger in size.
What happens during a polypectomy?
Doctors often perform polypectomies during a hysteroscopy. The doctor will:
- Use liquid to open the uterus.
- Insert a hysteroscope, a thin tube with a camera attached, through the vagina and cervix to view the inside of the uterus.
- Project your image onto a screen to guide removal.
- Insert another small instrument, such as surgical forceps or a wire loop, through the hysteroscope to remove the polyp.
The chances of uterine polyps coming back after removal are low (0% to 15%), but they do have the potential to grow back.
When a hysterectomy might be recommended for the treatment of uterine polyps
Women choose to undergo a hysterectomy for a variety of health and lifestyle reasons, but in the case of uterine polyps, it is not a common treatment. Depending on a number of factors, doctors may suggest a hysterectomy if you are postmenopausal or if you do not plan to become pregnant in the future.
This procedure is most likely recommended if a removed uterine polyp turns out to be cancerous. However, this is rare and only about 0.3% of uterine polyps contain cancer cells.
What to expect after uterine polyp removal
When you have uterine polyps removed, you can expect some symptom relief, but there may be some short-term symptoms while your body heals. Recovery time is usually about two weeks, but varies from person to person. Your care team will give you personalized instructions on how to care for yourself after the procedure, but here is some general information about what you can expect in the days and weeks following the procedure.
What to expect within the first 24 hours after uterine polyp removal
After a polypectomy, you can expect to go home the same day. Your doctor will likely prescribe pain medication for short-term use during your recovery, as needed. You may experience menstrual-like symptoms, such as vaginal bleeding and cramping, as well as pelvic discomfort and tenderness. You may also experience gas pains that may extend to your upper abdomen and shoulder.
What to expect in the first two weeks after uterine polyp removal
Most people can expect a quick recovery after uterine polyp removal. You’ll probably start to feel better within a week, but inside, your body still needs a little more time to fully heal. Refer back to the specific care plan your doctor and care team gave you, but among the instructions, you’ll probably need to:
- Watch for signs of pain and odor. This could indicate an infection.
- Avoid using tampons for a few weeks. Consider using sanitary pads or menstrual underwear as an alternative, as you may experience some discharge (mostly watery with some blood) for a few weeks.
- Abstain from having sexual relations. Full recovery usually takes about two weeks, so try to prioritize your healing until your doctor gives you the all-clear.
Talk to your doctor about managing uterine polyps.
Uterine polyps are often a silent condition. Many people who have them don’t even know they have them. When symptoms do occur, they can be uncomfortable and bothersome, with irregular bleeding. They can also affect your chances of getting pregnant. Fortunately, there are several treatment options for uterine polyps that can give you peace of mind, relieve symptoms, and help you get pregnant.
Talk to your doctor. Whether your condition requires close observation or removal, he or she can work with you to come up with a plan to get your health back to normal.
