If an ultrasound has picked up a polyp in your uterus, or if you have been having unusual bleeding, this guide explains what polyps are, when they need to be removed, and what the removal procedure actually involves. A polyp is quite different from a fibroid. Our fibroids guide covers the difference in detail.

What is a uterine polyp?

A uterine polyp (also called an endometrial polyp) is a small growth of tissue that comes from the lining of the uterus. Imagine a tiny skin tag, except that it sits inside the uterus. Polyps are attached to the uterine wall by a thin stalk or a wider base.

They range in size from a few millimetres (the size of a sesame seed) to several centimetres (the size of a grape or larger). A woman can have one polyp or several at the same time.

How common are uterine polyps?

Polyps are common, especially in women in their 40s and 50s, and in women around menopause. The exact numbers are hard to know because many polyps cause no symptoms and are never diagnosed. 

Symptoms of uterine polyps

Many polyps cause no symptoms and are found by chance on an ultrasound done for another reason. When symptoms do occur, the most common are:

1. Bleeding between periods.

2. Heavier or longer periods than usual.

3. Bleeding after sex.

4. Bleeding after menopause. This is always a red flag. See our full guide on postmenopausal bleeding for what to do.

5. Difficulty getting pregnant or recurrent miscarriage.

How are polyps diagnosed?

The usual first test is a pelvic ultrasound. A transvaginal ultrasound (a small probe placed in the vagina) gives a clear view of the inside of the uterus. Polyps often show as a bright, well-defined area inside the uterine cavity.

If the ultrasound is not clear, a saline infusion sonogram (gentle fluid is placed into the uterus during the ultrasound) can give a better picture. The most accurate way to see a polyp is with hysteroscopy, which looks directly inside the uterus using a thin camera.

Do all polyps need to be removed?

In most cases, yes. Here is the thinking behind that:

1. Polyps that cause bleeding usually need to be removed to stop the bleeding.

2. Polyps found after menopause are almost always removed because the risk of cancer, although small, is higher in this group.

3. Polyps that may be affecting fertility are removed if the woman is trying to conceive.

4. Small polyps with no symptoms in a younger woman may sometimes be watched, especially if they are tiny.

Your specialist will tailor the recommendation to your age, symptoms, and plans.

How are polyps removed?

Polyps are removed with a procedure called hysteroscopic polypectomy. It is a short day procedure. Here is what to expect at our hysteroscopy appointments.

1. You arrive at the day hospital in the morning after fasting from midnight.

2. A light general anaesthetic puts you to sleep for the procedure.

3. A thin camera (hysteroscope) is passed through the cervix into the uterus. No cuts are made on your tummy.

4. Small specialised instruments are used to remove the polyp cleanly. The entire polyp is sent to the laboratory.

5. You wake up in recovery with mild cramping, similar to period pain, and some light bleeding.

6. You go home the same day. Most women return to work in 1 to 2 days.

What happens after polyp removal?

You may have some light bleeding or spotting for up to 2 weeks. Cramping usually settles in a few days. Simple pain relief is enough for most women.

The laboratory result comes back in 1 to 2 weeks. In the vast majority of cases, the polyp is benign (non-cancerous) and no further treatment is needed. If any pre-cancerous or cancerous changes are found, your specialist will discuss the next steps with you.

Polyps and fertility

Polyps inside the uterine cavity can sometimes make it harder to conceive or increase the risk of miscarriage. The reason is that they may interfere with where the embryo tries to implant. Studies have shown that removing polyps before trying to conceive can improve pregnancy rates for some women. If you are planning pregnancy and have been told you have a polyp, a specialist consultation is a good idea.

Polyps and cancer risk

The vast majority of uterine polyps are benign. The chance of a polyp containing pre-cancerous or cancerous changes is small, but it is higher in women past menopause and in women on certain medications like tamoxifen. This is why postmenopausal polyps are almost always removed and sent to the laboratory for examination, even when symptoms are mild.

About Northside Gynaecology and polyp care

Northside Gynaecology is a specialist gynaecology practice in Brisbane. Our team, led by Dr Archna Saraswat, FRANZCOG, performs hysteroscopic polyp removal regularly. We consult from Kedron, North Lakes, and Caboolture Private Hospital.

Frequently asked questions

What is a uterine polyp?

A uterine polyp is a small growth of tissue from the lining of the uterus. Most are benign (non-cancerous). They vary in size from a few millimetres to several centimetres. A woman can have one polyp or many.

Are uterine polyps cancerous?

The vast majority of uterine polyps are not cancerous. A small percentage can show pre-cancerous changes, especially in women past menopause. This is why polyps are usually removed and sent to the laboratory, even when symptoms are mild.

Do polyps cause infertility?

Polyps inside the uterine cavity can sometimes make it harder to conceive or stay pregnant. Removing them can improve fertility outcomes for some women. If you are planning pregnancy and have been told you have a polyp, this is worth discussing with a specialist.

How are polyps removed?

Polyps are removed with a procedure called hysteroscopic polypectomy. A thin camera is passed through the cervix into the uterus and the polyp is removed with small instruments. It is a day procedure, usually done under light anaesthetic.

Can polyps come back after removal?

New polyps can grow after removal, although this is not common. Follow-up depends on your symptoms and the laboratory result. Your specialist will advise what to watch for.

What is the difference between a polyp and a fibroid?

A polyp is made of lining tissue and is usually small and soft. A fibroid is made of muscle tissue and can be much larger and firmer. They can both cause bleeding and are treated differently. See our fibroids blog for more.

How long is recovery after polyp removal?

Most women return to normal activity within 1 to 2 days. Light bleeding and mild cramping are common for up to 2 weeks. Avoid tampons, swimming, and sex for 1 week to let the uterus heal.

Book a polyp consultation in Brisbane

If you have been told you have a polyp, or if you have unusual bleeding, a specialist consultation is the fastest route to answers.

You can book at Kedron, North Lakes, or Caboolture Private Hospital. Call 07 3054 4687 or use our contact page. Bring your ultrasound report and any GP referral so you can claim your Medicare rebate.