Uterine and Endometrial Polyps: Symptoms, Causes, and Treatment in the UK

Uterine polyps, also known as endometrial polyps, are growths attached to the inner wall of the uterus that extend into the uterine cavity. They are formed by the overgrowth of cells in the lining of the uterus (the endometrium). These polyps are typically small—ranging from a few millimetres to several centimetres—and are usually held in place by a thin stalk or a broad base.

In the UK, it is estimated that a significant number of women will develop polyps at some point, particularly during their 40s and 50s. While the majority of these growths are benign (non-cancerous), they can cause significant disruption to a woman's quality of life by causing unpredictable bleeding and discomfort. According to NHS and NICE guidance, any postmenopausal bleeding or persistent irregular bleeding requires clinical investigation to rule out rarer, more serious underlying causes.

Many women with uterine polyps do not experience any symptoms at all; the polyps may only be discovered during a routine investigation for other issues. However, when symptoms do occur, they typically involve the menstrual cycle. Common signs include:

• Irregular menstrual bleeding: Having periods at unpredictable times or intervals.
• Intermenstrual spotting: Bleeding or spotting between your regular periods.
• Heavy periods (Menorrhagia): Losing a significant amount of blood during your cycle, often requiring frequent changes of sanitary products.
• Postmenopausal bleeding: Any vaginal bleeding that occurs after you have gone through the menopause.
• Infertility: Difficulty conceiving, as polyps can sometimes interfere with the implantation of a fertilised egg.

If you are experiencing any of these symptoms, it is important not to ignore them. While polyps are often the cause, these symptoms can overlap with other conditions such as fibroids or hormonal imbalances.

The exact cause of uterine polyps is not fully understood, but hormonal factors appear to play a major role. They are sensitive to oestrogen, meaning they grow in response to the hormone circulating in the body. Because of this, certain groups are at a higher risk:

• Women who are perimenopausal or postmenopausal.
• Those with high blood pressure (hypertension).
• Women who are living with obesity.
• Patients taking tamoxifen, a drug used for breast cancer treatment.
• Those with a family history of Lynch syndrome or Cowden syndrome.

Understanding these risk factors helps UK clinicians determine the likelihood of polyps when a patient presents with abnormal uterine bleeding (AUB).

If you consult a healthcare professional regarding abnormal bleeding, the diagnostic pathway usually involves several steps aligned with British gynaecological standards. Initially, a GP will perform a physical examination and may request a transvaginal ultrasound. During this procedure, a small probe is inserted into the vagina to create an image of the uterus.

If a polyp is suspected, you may be referred for a hysteroscopy. This involves a thin, flexible telescope (a hysteroscope) being passed through the cervix to look directly at the lining of the womb. This is often done as an outpatient procedure in UK hospitals. If polyps are found, they can frequently be removed during the same appointment using small instruments. This procedure, known as a polypectomy, is generally very successful and prevents the symptoms from recurring.

Management and Follow-up

Once removed, the tissue is typically sent to a laboratory for biopsy. This is standard practice in the UK to ensure there are no abnormal or cancerous cells present. Most women find that their menstrual cycle returns to normal shortly after the procedure.

Navigating women's health concerns can be daunting, and waiting for a traditional GP appointment in the UK can sometimes be difficult. Speaking to an online doctor is an efficient way to discuss your symptoms from the comfort of your home. A private GP can provide a calm, evidence-based review of your menstrual history and bleeding patterns.

By choosing to speak to a GP online, you can:

• Receive a professional assessment of your symptoms.
• Discuss whether your bleeding patterns are 'normal' or require further investigation.
• Obtain a private referral letter to a gynaecologist for an ultrasound or hysteroscopy, potentially speeding up your access to specialist care.
• Get advice on managing heavy periods while waiting for treatment.

Our editorial team ensures all advice follows NICE (National Institute for Health and Care Excellence) pathways, ensuring you receive high-quality, British-standard medical guidance.