Uterine polyp removal and what to expect

Have you recently been diagnosed with uterine polyps? While you may be a little worried, you should know that uterine polyps are very common: Some studies estimate almost 25% of women develop them sometime during their life. They’re also a silent condition: Many of those who have it won’t even realize it.

While uterine polyps are common, treatment is unique to each person. Your doctor will weigh several factors – like your symptoms and age – as they create a specialized treatment plan. They will work with you to decide whether you can start with more conservative options like watchful waiting or hormone therapy, or if you should consider uterine polyp removal procedures.

Below, we’ll explain treatment options for uterine polyps, including what factors may affect your decision, and what you can expect if you decide to get them removed.

How uterine polyps are treated often depends on your symptoms, age and menopause stage

While the exact cause of uterine polyps is unknown, your age and your body’s estrogen levels appear to play a role. Doctors will also consider your age and if you have begun menopause.

If you’re premenopausal and have no symptoms, your age can affect uterine polyp treatment

Premenopause is the time during prime reproductive years when you have your menstrual cycle and no symptoms of menopause. People under 20 rarely develop uterine polyps, but the chances increase as you age and peak in your 40s, just before the start of menopause (the transition into menopause usually begins between 45 and 55 years old). In many cases, uterine polyps won’t cause any symptoms, so a doctor may take a watchful waiting approach.

Your age can also affect uterine polyp treatment if you’re postmenopausal and have symptoms

Postmenopause is the time after menopause when you haven’t had your menstrual period for over a year. Doctors may use the strength of the symptoms you’re experiencing (such as postmenopausal vaginal bleeding or pain) and the status of your menstrual cycle to recommend treatment. The risk of developing malignant (cancerous) polyps increases with age and postmenopausal bleeding.

Watchful waiting for uterine polyps

Uterine polyps can be very small – as small as a tomato seed – and small polyps without any symptoms may resolve on their own. After a uterine polyp diagnosis, doctors will likely recommend watchful waiting if you have no symptoms and are of reproductive age.

Watchful waiting means you’ll have regular checkups with your doctor so they can monitor the size of the polyps to see if they’re getting bigger, and they’ll also want to know if you begin to notice any symptoms.

Polyp size and your symptoms might mean uterine polyp removal is the best option

Polyps can vary widely in size, but large polyps are less likely to go away on their own and can often cause more severe bleeding symptoms. They may also make it hard to get pregnant or carry a pregnancy to term, so removing them may alleviate your symptoms and increase your chances of getting pregnant. And although cancer is rare, removing polyps also ensures that they aren’t cancerous.

Uterine polyp removal: Polypectomy

A polypectomy is a surgical procedure and the standard treatment for removing a uterine polyp. This technique is often recommended to help improve abnormal bleeding and fertility when polyps are larger in size.

What happens during a polypectomy

Doctors typically perform polypectomies during a hysteroscopy. The doctor will:

1. Use fluid to open your uterus.
2. Insert a hysteroscope, a thin tube with a camera attached, through the vagina and cervix to see inside your uterus.
3. Project its image onto a screen to guide removal.
4. Insert another small instrument, such as surgical tweezers or a wire snare, through the hysteroscope to remove the polyp.

The chances of your uterine polyps recurring after removal are low – between 0% and 15% – but they do have the potential to grow back.

When a hysterectomy for uterine polyp treatment might be recommended

Women choose to have hysterectomies for a range of health and lifestyle reasons, but in the case of uterine polyps, it’s not a common treatment. Depending on a range of factors, doctors may suggest a hysterectomy if you’re postmenopausal or if you don’t plan on becoming pregnant in the future.

This procedure is most likely going to be recommended if a uterine polyp that’s been removed turns out to be cancerous. However, that is rare and only about 0.3% of uterine polyps carry cancer cells.

What to expect after uterine polyp removal

By getting the uterine polyps removed, you can expect symptom relief, but there may be a few short-term symptoms as your body heals. Recovery time usually takes about two weeks, but it varies from person to person. Your care team will provide personalized instructions on caring for yourself following the procedure, but here’s some general information on what you can expect in the days and weeks following your procedure.

What to expect within the first 24 hours after uterine polyp removal

After a polypectomy, you can expect to go home the same day. Your doctor will likely prescribe pain medication for short-term use during your recovery, as needed. You may experience period-like symptoms such as vaginal bleeding and cramping, as well as pelvic discomfort and tenderness. You may also experience gas pains that can travel to your upper abdomen and shoulder.

What to expect in the first two weeks after uterine polyp removal

Most people can expect a quick recovery after uterine polyp removal. You’ll likely begin to feel better within a week, but inside, your body still needs a little more time to heal completely. Refer back to the specific care plan your doctor and care team gave you, but among the instructions, you’ll likely need to:

• Watch for signs of pain and odor. This could indicate an infection.
• Avoid using tampons for a few weeks. Consider using pads or period underwear as an alternative since you could experience some discharge – mostly water with some blood – for a few weeks.
• Abstain from sexual intercourse. It usually takes about two weeks for full recovery, so try to prioritize your healing until your doctor clears you.

Talk to your doctor about managing uterine polyps

Uterine polyps are often a silent condition. Many of those who have it don’t even know they do. When symptoms are present, they can be uncomfortable and inconvenient with irregular bleeding. They can also affect your chances of getting pregnant. Fortunately, there are several uterine polyp treatment options that can bring you peace of mind, relieve your symptoms and help you get pregnant.

Talk to your doctor. Whether your condition calls for watchful waiting or removal, they can work with you to make a plan for getting your health back on track.