Uterine Polyps: Symptoms, Causes, and When to See a Doctor

Why silent symptoms matter and what women often miss

You might never suspect a thing — but uterine polyps can quietly wreak havoc on your body. Often dismissed as “just hormones” or routine discomfort, these small growths in the uterus can trigger everything from heavy bleeding to unexpected fertility struggles. In this article, we explore the subtle signs, surprising causes, and what you can do if you suspect something isn’t quite right.

What are uterine polyps?

Uterine polyps, also known as endometrial polyps, are growths that form in the lining of the uterus. They can be as small as a sesame seed or as large as a golf ball. While most are benign, some may become precancerous — and their impact on reproductive health is often underestimated.

The scary part? Many women never notice them

Unlike fibroids, which often cause significant symptoms, polyps are often “silent.” But that doesn’t mean they’re harmless. Let’s explore the red flags you shouldn’t ignore.

Key warning signs you shouldn’t ignore

1. Spotting between periods

If you notice blood when you’re not expecting it — especially between cycles or after intercourse — it could be a sign of polyps irritating your uterine lining.

2. Unusually heavy periods

Heavier flow or longer-than-usual periods can indicate something is disrupting the normal shedding of the endometrium. Polyps can interfere with normal hormonal balance and vessel formation.

3. Bleeding after menopause

This is always a red flag. Postmenopausal bleeding should be evaluated immediately, and polyps are one of the more common (and treatable) culprits.

4. Difficulty conceiving

Uterine polyps can prevent fertilised eggs from implanting properly, leading to failed IVF cycles or unexplained infertility. Women undergoing fertility treatments are often advised to screen for and remove them.

5. Pelvic discomfort or cramping

While rare, large polyps can press against the uterine walls, creating a sense of fullness, pressure, or low-grade cramping that resembles menstrual pain.

6. Recurrent miscarriages

Some studies suggest a link between untreated uterine polyps and early pregnancy loss, due to interference with embryo implantation.

What causes uterine polyps?

Hormonal imbalances are often the root cause — particularly an excess of oestrogen. Risk factors include:

• Perimenopause and menopause
• Obesity
• Hormone replacement therapy (HRT)
• Polycystic ovary syndrome (PCOS)
• Certain medications like tamoxifen

How are they diagnosed?

Uterine polyps are typically identified via:

• Transvaginal ultrasound — an internal scan that can detect abnormal tissue growth.
• Sonohysterography — a saline solution is inserted into the uterus to improve visibility during ultrasound.
• Hysteroscopy — a thin, lighted tube is used to view the uterine cavity directly.

Do you always need surgery?

Not always. Small, asymptomatic polyps in non-menopausal women may simply be monitored. However, removal is often recommended if you’re:

• Experiencing abnormal bleeding
• Trying to conceive
• Postmenopausal
• At increased risk for uterine cancer

Treatment options

• Polypectomy — a minor surgical procedure, often done during hysteroscopy, to remove the growth.
• Hormonal therapy — may shrink polyps or manage bleeding, but results are temporary.
• Endometrial ablation — used in severe cases when no future pregnancy is planned.

Natural remedies and prevention

While there's no proven way to “cure” polyps naturally, lifestyle changes that help balance hormones may reduce risk:

• Maintain a healthy weight and avoid excess body fat (a source of oestrogen production).
• Eat anti-inflammatory foods like berries, leafy greens, turmeric, and omega-3s.
• Reduce xenoestrogen exposure (plastics, pesticides, synthetic fragrances).
• Limit processed sugar and alcohol.

What to do if you suspect polyps

Listen to your body. If you’re experiencing abnormal bleeding, pelvic discomfort, or unexplained fertility issues, don’t dismiss it. Book an appointment with a gynaecologist or request an ultrasound scan to rule out polyps or other uterine conditions.

Are uterine polyps cancerous?

Most are benign, but around 1–2% can be precancerous or malignant — especially in postmenopausal women. That’s why removal and biopsy are often advised if there’s any suspicion.

Can polyps come back?

Yes. Even after removal, there’s a recurrence rate — especially in women with hormonal imbalances. Ongoing management and regular check-ups are key.

Do expats in Spain need private insurance for gynaecological exams?

If you’re living in Spain and want quick access to gynaecologists, scans, or outpatient surgery without long public waiting lists, private medical insurance is essential. Many Sanitas health insurance plans offer full gynaecological care and diagnostic tests, including hysteroscopy, ultrasound, and fertility support. With coverage that includes specialist visits, it’s peace of mind you don’t have to wait for.

Final thoughts

Silent conditions like uterine polyps often go undetected until they interfere with your life. Don’t ignore the subtle signals your body sends — especially when it comes to reproductive health. A quick scan could save you years of pain, uncertainty, or infertility.