Understanding Uterine Polyps and Their Impact on Fertility

What are Uterine Polyps?

Uterine polyps, also known as endometrial polyps, are benign (non-cancerous) growths that form on the inner wall of the uterus (the endometrium). These polyps are composed of endometrial tissue and can vary in size from a few millimetres to several centimetres. They can be single or multiple and are attached to the uterine wall by a thin stalk or a broad base. To understand more about Uterine Polyps, the Cleveland Clinic, a non-profit academic medical center, has written more on the topic here.

Types of Uterine Polyps

1.  Pedunculated Polyps: These are attached to the uterine wall by a slender stalk.
2. Sessile Polyps: These have a broad base and are more directly attached to the uterine wall.

Symptoms of Uterine Polyps

Many women with uterine polyps may not experience any symptoms. When symptoms do occur, they can include:

• Irregular menstrual bleeding
• Heavy menstrual periods (menorrhagia)
• Bleeding between periods (metrorrhagia)
• Postmenopausal bleeding
• Infertility

Causes and Risk Factors

The exact cause of uterine polyps is not fully understood, but several factors may contribute to their development:

• Hormonal Imbalance: Oestrogen, which stimulates the growth of the endometrium, is believed to play a role in the formation of polyps.
• Age: Polyps are more common in women in their 40s and 50s, especially around perimenopause.
• Obesity: Higher levels of oestrogen related to adipose tissue can increase the risk.
• Hypertension: High blood pressure is associated with an increased risk of developing polyps.
• Tamoxifen: Use of this drug for breast cancer treatment can increase the risk of uterine polyps.

Diagnosis of Uterine Polyps

Uterine polyps are usually diagnosed through:

• Transvaginal Ultrasound: An imaging test that provides a view of the uterus and can reveal polyps.
• Hysteroscopy: A procedure in which a thin, lighted telescope (hysteroscope) is inserted through the vagina and cervix into the uterus, allowing direct visualisation of the polyps.
• Endometrial Biopsy: A small sample of endometrial tissue is taken for examination to rule out other conditions.

If you have any of the listed symptoms or are concerned about the potential risk factors, the Mayo Clinic has further information on Polyps and when you should consult a healthcare practitioner, here.

How Uterine Polyps Can Affect Fertility

Uterine polyps can impact fertility in several ways:

• Interference with Embryo Implantation: Polyps can create a hostile environment for embryo implantation by disrupting the normal endometrial lining. This can prevent a fertilised egg from properly implanting and developing.
• Blocking the Cervix or Fallopian Tubes: Larger polyps or multiple polyps can block the opening of the cervix or fallopian tubes, hindering the movement of sperm or eggs.
• Inflammation and Irritation: Polyps can cause inflammation of the uterine lining, which can interfere with the implantation and growth of an embryo.
• Hormonal Imbalance: Polyps can contribute to or be a result of hormonal imbalances, which can affect ovulation and the overall menstrual cycle.

Treatment of Uterine Polyps Treatment options for uterine polyps include:

• Watchful Waiting: Small, asymptomatic polyps may be monitored over time to see if they resolve on their own.
• Medications: Hormonal medications, such as progestins or gonadotropin-releasing hormone agonists, may be used to shrink polyps, but this is usually a temporary solution.
• Surgical Removal (Polypectomy): This is the most common treatment for symptomatic polyps or those affecting fertility. It is typically done using hysteroscopy, which allows for the precise removal of polyps with minimal discomfort.

To understand more about the potential treatment of polyps, Brigham and Women’s Hospital are experts in the field and they have made a few notes, here.

Impact of Polyp Removal on Fertility

Polyp removal can significantly improve fertility outcomes for women experiencing infertility due to polyps. Studies have shown that women who undergo hysteroscopic polypectomy have higher pregnancy rates compared to those who do not have the polyps removed. The procedure can restore a healthy endometrial environment, facilitating better conditions for embryo implantation and pregnancy.

Diet & Lifestyle for Polyps

Nutrition can play a supportive role in managing polyps-related infertility, although it cannot directly remove polyps. Proper nutrition can help in several ways including:

• An Anti-Inflammatory Diet can help to reduce inflammation which can help manage chronic inflammation, which is often associated with the development of polyps.
• Hormonal Balance via the incorporation of Phytoestrogens. These are plant compounds that can help balance oestrogen levels, which may contribute to the development of polyps if elevated.
• Maintaining a Healthy Weight. Maintaining a healthy weight is crucial, as excess body fat can lead to higher oestrogen levels, potentially promoting the growth of uterine polyps. A balanced diet and regular physical activity can help achieve and maintain a healthy weight.
• Blood Sugar Control & Low-Glycemic Foods. By keeping blood sugar levels stable, by consuming low-glycemic foods, you can reduce insulin resistance, which has been linked to hormonal imbalances that may contribute to the growth of polyps.
• Supportive Nutrients, including Vitamin D, Antioxidants, Vitamins C and E, can support the condition.

While nutrition alone may not resolve polyp-related infertility, it plays a supportive role in managing the underlying conditions that contribute to the growth of polyps. By following a balanced, anti-inflammatory diet, maintaining a healthy weight, and focusing on hormonal balance, individuals may improve their overall reproductive health and potentially enhance their fertility outcomes.

Conclusion

Uterine polyps are common benign growths that can affect a woman’s menstrual cycle and fertility. While many polyps are asymptomatic, those causing symptoms or contributing to infertility may require treatment. Surgical removal of polyps can improve fertility outcomes, making it an important consideration for women experiencing infertility. Regular check-ups and early diagnosis can help manage and mitigate the impact of uterine polyps on reproductive health. To understand more, book in for your free 15 minute consultation to understand how we can help you.