There are many causes of bleeding during menopause, most of which are benign. Uterine polyps are one of them, and they tend to affect women more in the stages of perimenopause (menopause transition, two to nine years before post-menopause) and menopause. During the stages before post-menopause (having missed a cycle for at least 12 months), you will still produce an adequate enough amount of oestrogen to trigger menstrual periods. However the oestrogen in the early stages of menopause are lower than usual. As long as oestrogen levels remain irregular, you run a risk of developing these polyps. For the most part, uterine polyps are benign and can easily be treated. These polyps once treated can reoccur in some women.
What are Uterine Polyps?
Uterine polyps are bulb-shaped growths that attach to the inner walls of the uterus and protrude into the uterine cavity. These are caused by the overgrowth of cells in the endometrium (uterine lining). Polyps can be as small as a few millimetres or as large as several centimetres. They are attached to the lining by a base, or thin stalk. Commonly, uterine polyps stay in the uterus, but may sometimes slip into the vagina. Uterine polyps are very common in women in their 40s to 50s.
Signs and Symptoms
Uterine polyps can form before menopause, or post-menopause, although post-menopausal women tend to just have light bleeding or spotting associated with them. Some women have no symptoms, and some pre-menopausal and perimenopausal women experience irregular menstrual cycles, heavy bleeding, bleeding between periods, and infertility. Since perimenopausal women experience infrequent and irregular periods, seeing your physician is the only way to find out if these symptoms are relevant to fluctuating oestrogen levels or uterine polyps.
Researchers aren't really sure what causes uterine polyps, although they have concluded that hormonal imbalances plays into them a great deal, which is why the occur more in perimenopausal women. Uterine polyps are sensitive to oestrogen, just as the lining is, that the polyp is attached to. This means that when oestrogen signals for the lining to thicken and grow, the polyp grows as well. Other than this occurrence, other causes of uterine polyps, remain unknown.
If your physician thinks you may have this condition, they will have to perform one or more medical exams for confirmation. One of the first medical examinations you will have is a transvaginal ultrasound. Transvaginal ultrasounds are performed with a wand-shaped device that's inserted into the vagina in order to view the uterus. In addition to this examination, your physician may inject salt water into your uterus, to expand it, making the view clearer; this procedure is called hysterosonography.
There are several treatments available for the removal of uterine polyps. The first well-known treatment is called hysteroscopy. In this procedure your doctor will insert a lighted, thin, flexi hysteroscope into your uterus, through the cervix. This hysteroscope will enable him to see any polyps and remove them, straight away. Curettage is another procedure used to remove the polyp. Your doctor will insert a thin metal instrument with a loop at the end, into the uterus to scrape the polyp from the wall of the uterus. This procedure can be performed on its own (blind curettage), or with the aid of a hysteroscope. Small polyps may resolve without treatment. Although polyps are typically non-cancerous, if in rare circumstances, cancerous cells are discovered, your uterus may have to be removed (hysterectomy).