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As a gynaecologist, one of the most common findings I pick up on a routine scan is an endometrial polyp — a small growth on the inner lining of the uterus. The word "growth" frightens people, so let me start with reassurance: the large majority are not cancer. But they are also not something to simply ignore, especially if you are bleeding when you shouldn't be. Here is what they actually are, and what to do about them.
The endometrium is the soft lining inside the uterus that builds up and sheds every month as your period. Sometimes a small area of this lining overgrows and forms a finger-like or rounded lump that projects into the cavity — that is a polyp. It may sit on a thin stalk or on a broad base, and you can have one or several. They range from a few millimetres to a few centimetres.
Many polyps cause no symptoms at all and are found by chance. When they do cause trouble, the commonest sign is abnormal bleeding:
Bleeding or spotting between periods
Heavier or longer periods than usual
Bleeding after sex
Any bleeding after menopause — this always needs checking
Difficulty getting pregnant, in some women
Polyps become more common with age, especially around and after menopause. Other factors that raise the chance include being overweight, high blood pressure, and taking the breast-cancer medicine tamoxifen or oestrogen without progesterone. That said, they can occur in younger women too — so age alone never rules them out.
The first step is usually a transvaginal ultrasound (TVS), where a polyp often shows up as a bright (echogenic) focus within the lining, sometimes with a single feeding blood vessel on Doppler. To see it more clearly we may do a saline infusion sonography (SIS), where a little sterile fluid is put into the cavity during the scan. The most accurate test is hysteroscopy — a thin camera passed into the uterus that lets us see the polyp directly and remove it in the same sitting. The removed tissue is always sent to the lab to confirm what it is.
Almost all endometrial polyps are benign — not cancer. A small proportion can contain precancerous or cancerous changes, and that risk is higher in women who are past menopause, who have bleeding, or who have larger polyps. This is exactly why we don't guess: a polyp that is causing symptoms or appears after menopause is removed and examined under a microscope, so that the rare serious one is never missed. The message is "worth checking," not "be afraid."
Small polyps in younger women that cause no symptoms can sometimes simply be watched, as a few resolve on their own. When a polyp causes bleeding, appears after menopause, is large, or is affecting fertility, the standard treatment is hysteroscopic polypectomy — removing it with a fine instrument through that same camera. It is usually a short day-care procedure, often without any cut, and you go home the same day.
Because a polyp sits inside the cavity where an embryo needs to implant, it can sometimes interfere with conception or with IVF. In women struggling to conceive, removing a polyp can improve the chances of pregnancy. If you are planning a baby or undergoing fertility treatment and a polyp is found, it is worth discussing removal with your doctor.
Please get checked if you notice bleeding between periods, bleeding after sex, periods that are suddenly heavier or longer, difficulty conceiving, or any bleeding at all after menopause. These are not always serious — but they are exactly the symptoms that deserve a scan rather than a wait.
Women's Health 6 min read
Endometrial Polyps: Symptoms, Ultrasound & Treatment
By Dr. Neha Singhania • 2026-06-16
As a gynaecologist, one of the most common findings I pick up on a routine scan is an endometrial polyp — a small growth on the inner lining of the uterus. The word "growth" frightens people, so let me start with reassurance: the large majority are not cancer. But they are also not something to simply ignore, especially if you are bleeding when you shouldn't be. Here is what they actually are, and what to do about them.
What is an endometrial polyp?
The endometrium is the soft lining inside the uterus that builds up and sheds every month as your period. Sometimes a small area of this lining overgrows and forms a finger-like or rounded lump that projects into the cavity — that is a polyp. It may sit on a thin stalk or on a broad base, and you can have one or several. They range from a few millimetres to a few centimetres.
What symptoms do they cause?
Many polyps cause no symptoms at all and are found by chance. When they do cause trouble, the commonest sign is abnormal bleeding:
Who is more likely to get them?
Polyps become more common with age, especially around and after menopause. Other factors that raise the chance include being overweight, high blood pressure, and taking the breast-cancer medicine tamoxifen or oestrogen without progesterone. That said, they can occur in younger women too — so age alone never rules them out.
How are they diagnosed?
The first step is usually a transvaginal ultrasound (TVS), where a polyp often shows up as a bright (echogenic) focus within the lining, sometimes with a single feeding blood vessel on Doppler. To see it more clearly we may do a saline infusion sonography (SIS), where a little sterile fluid is put into the cavity during the scan. The most accurate test is hysteroscopy — a thin camera passed into the uterus that lets us see the polyp directly and remove it in the same sitting. The removed tissue is always sent to the lab to confirm what it is.
Are they cancerous?
Almost all endometrial polyps are benign — not cancer. A small proportion can contain precancerous or cancerous changes, and that risk is higher in women who are past menopause, who have bleeding, or who have larger polyps. This is exactly why we don't guess: a polyp that is causing symptoms or appears after menopause is removed and examined under a microscope, so that the rare serious one is never missed. The message is "worth checking," not "be afraid."
How are they treated?
Small polyps in younger women that cause no symptoms can sometimes simply be watched, as a few resolve on their own. When a polyp causes bleeding, appears after menopause, is large, or is affecting fertility, the standard treatment is hysteroscopic polypectomy — removing it with a fine instrument through that same camera. It is usually a short day-care procedure, often without any cut, and you go home the same day.
Polyps and getting pregnant
Because a polyp sits inside the cavity where an embryo needs to implant, it can sometimes interfere with conception or with IVF. In women struggling to conceive, removing a polyp can improve the chances of pregnancy. If you are planning a baby or undergoing fertility treatment and a polyp is found, it is worth discussing removal with your doctor.
When should you see a gynaecologist?
Please get checked if you notice bleeding between periods, bleeding after sex, periods that are suddenly heavier or longer, difficulty conceiving, or any bleeding at all after menopause. These are not always serious — but they are exactly the symptoms that deserve a scan rather than a wait.