

Cervical, Endocervical, and Endometrial Polyps

The endometrium is the inside lining of the uterus. The cervix is the lower part of the uterus that extends down into the top of the vagina. A polyp is a mass of tissue projecting from a mucous membrane, such as the cervix or endometrium. A pedunculated polyp is attached to the mucous membrane by a stalk, which is its blood supply.

Endometrial polyps are overgrowths of endometrial glands and stroma in the endometrium.

Cervical and endocervical polyps are the most common benign, neoplastic (new) growths of the cervix. Cervical polyps (also referred to as ectocervical) grow on the outside of the cervix. Endocervical polyps grow inside the cervical canal.

Endocervical polyps are more common than cervical polyps. They have a narrow stalk and occur more often in women who are pre-menopausal. Cervical polyps have a shorter, broader base and occur more often in women who are menopausal.

There are six different types of known cervical and endocervical polyps: adenomatous, cystic, fibrous, vascular, inflammatory, and fibromyomatous. More than 80% of polyps are adenomatous.

Polyps are rare, occurring in about one in every 10,000 women. They are more common in women who have been pregnant more than once.

More than 99% of polyps are benign. The incidence of malignant polyps of the cervix is rare. Less than 1 in every 200 polyps is malignant.

Most polyps are smooth, soft, reddish-purple to cherry red, and fragile. They are considered fragile because it is common for polyps to bleed when touched.

Single or multiple polyps can occur. They range in size from only a few millimeters to 2-3 centimeters in length and width.

Polyps often do not cause symptoms. They are usually found during a routine pelvic exam. If you have polyps, bleeding or spotting may result from a pelvic exam, sexual intercourse, or with any manual stimulation of the cervix.

The most effective and least invasive way to remove polyps is with a polypectomy. With a polypectomy a wire loop is used to remove the polyp at its base. If a polyp is removed at the base the bleeding is generally minimal. After the polyp is removed, the base is cauterized to stop the bleeding.

Very heavy bleeding can result if the base of the polyp pulls away from the cervix or if the polyp is removed at the stalk rather than at the base. Although it is possible to develop new polyps following polypectomy, if the polyp is removed at the base you are less likely to develop new polyps.

Gynecologists often recommend dilation and curettage (D&C) for heavy or irregular bleeding, often without knowing the cause of the bleeding. Polypectomy is a more effective and less invasive treatment than D&C. Frequent D&Cs is Asherman's Syndrome, a painful condition caused by the formation of scar tissue and adhesions in the uterus, which can result in chronic pelvic pain and infertility. For more information, click on the D&C link on HERS Foundation's website Home page

Doctors sometimes appear alarmed by the presence of polyps, but they are usually benign and do not cause significant symptoms. At the most, polyps may cause bleeding between menstruation, and they are easily removed.

The uterus and cervix have many important lifelong functions. Although the cervix is frequently described separately from the uterus, the uterus is continuous with the cervix, which is continuous with the vagina, much in the way that your head is continuous with your neck, which is continuous with your shoulders.


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