Uterine Polyps: Small Growths, Big Drama
Uterine polyps—also called endometrial polyps—may be small, but they sure know how to make a scene. From unexpected spotting to bleeding after sex, heavier periods, or irregular cycles that have you raising an eyebrow at your uterus, polyps can stir up a lot of questions (and frustration).
These soft, often benign growths develop from the endometrial lining—the innermost layer of the uterus. They can range from teeny-tiny bumps to larger, stalk-like structures that resemble skin tags. Some women have a single polyp; others end up with an entire little family of them. Because they contain glandular tissue and blood vessels, polyps are prone to bleeding—especially when bumped or irritated.
Why Do Polyps Happen?
Truthfully, we don’t have a definitive answer as to why polyps grow. However, estrogen appears to play a major role, as polyps are considered estrogen-sensitive tissue. This is one reason they’re more commonly found during times of hormonal fluctuation, like perimenopause.
If you’re taking tamoxifen—a common breast cancer medication—you’re at higher risk for developing polyps. While tamoxifen acts as an anti-estrogen in breast tissue, it can behave like estrogen in the uterus, which can stimulate unwanted growths like polyps.
Who Gets Polyps?
The short answer? Many women do.
Endometrial polyps can be diagnosed at almost any age after puberty, but they’re most commonly found in women between the ages of 40–49. Thankfully, the majority of polyps are non-cancerous. That said, there is a small percentage that may be cancerous or precancerous, which is why many healthcare providers recommend removal and biopsy—just to be safe.
In women who are considered low-risk and aren’t experiencing symptoms, your provider may recommend a “watch and wait” approach, with routine imaging to monitor for changes in size or shape.
How Are Polyps Diagnosed?
Polyps are most often detected via pelvic ultrasound, especially when evaluating abnormal bleeding. Sometimes, they’re discovered incidentally during other procedures like:
An endometrial biopsy
A hysterosalpingogram (HSG) during fertility evaluation
A saline sonohysterogram, which offers a clearer view of the uterine lining
What’s the Treatment for Polyps?
In most cases, polyps are removed with a hysteroscopic polypectomy—a procedure where a thin, lighted tube (a hysteroscope) is inserted into the uterus to locate and remove the polyp. While the word “hysteroscopy” might sound intimidating, these are common, outpatient procedures that are typically quick and well-tolerated.
As someone who’s been present during several polypectomies (I’m not a surgeon, but I’ve been invited into the OR by patients), I can tell you the prep time is often longer than the procedure itself. Most women recover quickly and feel relief soon after.
What About Polyps After Menopause?
Here’s where we take things a little more seriously.
Postmenopausal women should not be experiencing bleeding or spotting. While light bleeding can occur around the time of starting or adjusting hormone therapy, any unexpected bleeding should be discussed with your healthcare provider.
This is because polyps in postmenopausal women can sometimes be associated with endometrial hyperplasia—a thickening of the uterine lining that may, in some cases, progress into endometrial cancer. Again, most polyps are benign, but postmenopausal bleeding should never be ignored.
The Bottom Line
Endometrial polyps are incredibly common and usually benign—but that doesn’t mean they’re harmless. They can disrupt your cycle and cause stress and bleeding that no one needs. If you’re dealing with spotting, irregular bleeding, or any changes to your cycle—especially after age 40—talk to your provider.
Getting evaluated (and if needed, removing the polyp) is usually simple, quick, and well worth it for your peace of mind and hormonal health.
Citations:
Al-Rayes S, Mohamed M, Suarthana E, Kigloo HN, Raina J, Tulandi T. Risks of Malignancy among 11,204 Patients with Endometrial Polyp: A Systematic Review and Meta-analysis. Gynecology and Minimally Invasive Therapy. 2025;14(1):40-50. doi:https://doi.org/10.4103/gmit.gmit-d-24-00056
Mansour T, Chowdhury YS. Endometrial Polyp. PubMed. Published April 25, 2023. https://www.ncbi.nlm.nih.gov/books/NBK557824/