Fibroids, polyps, and uterine disease
Uterine polyps are soft finger-shaped growths in the endometrium (lining of the uterus). They may occur alone or in clusters and may also be called endometrial polyps. They are most commonly found around menopause or in women with heavy or irregular cycles.
When polyps are small they do not cause trouble. As they grow bigger they can push through the opening of the uterus and cause bleeding and cramping. They may also become infected if they are injured by tampons or during sexual intercourse. Rarely do polyps cause infertility because they usually do not block the passage where sperm enter the uterus. Polyps can rarely be cancerous and are less common after menopause.
Protruding polyps can be seen during a pelvic examination. Otherwise, diagnosis is made by a hysteroscopy, ultrasound, hysterosalpingogram, or sonohysterogram. In order to evaluate polyps, typically a hysteroscopy and sometimes a D&C (scraping out the contents from inside of the uterus) is performed. A hysteroscopy is a procedure where a thin tube is inserted through the cervix to look inside the uterus. This is used to find and remove the polyps for a closer exam under the microscope. A procedure called a D&C may also be done if the hysteroscopy alone cannot remove the polyp or source of bleeding.
Uterine fibroids are noncancerous growths of the uterus that often appear during your childbearing years. Also called leiomyomas or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer. As many as three out of four women have uterine fibroids, but most are unaware of them because they often cause no symptoms.
Your doctor may discover them incidentally during a pelvic exam, infertility ultrasound or prenatal ultrasound. In general, uterine fibroids cause no problems and seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if you have discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain. Fibroids that are within the uterine cavity (submucousal fibroids) seem to cause the most problems for fertility patients and may decrease fertility and possibly increase the chance of miscarriage.