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Uterine polyps

I am married for 2 years, trying actively to conceive for the past 6 months without success. I went for a check-up recently and was told that I had uterine polyps. What are they and what are the causes? Must I have them removed?

Uterine polyps also known as endometrial polyps are overgrowth of the cells in the inner lining of the womb (endometrium). They are attached to the wall of the womb by a stalk, the base of which can be thin or broad. They can be single or in a cluster and vary in size from a few millimetres to several centimetres. They usually extend into the cavity of the womb, but may slip down occasionally through the neck of the womb (cervix). They are usually noncancerous (benign), but may be pre-cancerous occasionally. They rarely turn cancerous.

Hormonal imbalance resulting in an over-dominance of circulating female hormone, oestrogen appears to play a role in the formation of uterine polyps, the cells of which grow in response to oestrogen. Obesity and infertility are also associated with uterine polyps.

Uterine polyps can occur in any age group but more commonly in older women around or completed menopause. They do not give rise to symptom usually but may cause the following occasionally

  • Bleeding in between menstrual periods

  • Excessively heavy menstrual flow

  • Irregular vaginal bleeding

  • Vaginal bleeding after menopause

  • Infertility

Uterine polyps may be detected by ultrasound examination, hysterosalpingogram (an X-ray examination for the uterine cavity) or by hysteroscopy using a thin telescope inserting into the cavity of the womb. Small polyps without symptoms might resolve on their own. No treatment is required unless other risk factors for uterine cancer are present.

Since you have fertility issues, surgical removal using hysteroscope may be necessary. After the polyps have been examined under microscope, you may require medications such as progestogens to balance the oestrogen or GnRH agonist injection.

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