Endometrial (Uterine) Polyps: Causes, Symptoms, and Treatments

During your menstruation, you may have experienced heavy cramps alongside blood clots, which you initially thought was just a bad period. However, your menstrual bleeding doesn't stop at the expected time (around five days later), and your cycle becomes irregular; suddenly, you have the gut feeling that something is wrong.

One possible cause of these conditions is endometrial polyps, also known as uterine polyps. These benign growths can negatively affect your reproductive health and disrupt your daily activities.

What is an endometrial polyp?

Endometrial polyps are abnormal growths that attach to the inner lining of the uterus (the endometrium). They form when cells in the endometrial tissue overgrow and may show up as single or multiple growths. While typically non-cancerous (benign), in some cases they can develop pre-cancerous changes or, rarely, become cancerous.

Uterine polyps range in size from a few millimetres – no larger than a sesame seed – to several centimetres. They attach to the uterine wall with a large base or a thin stalk. They usually remain in the womb but can sometimes slip through the cervix into the vagina.

What causes endometrial polyps?

Although the exact cause of these polyps is currently unknown, it is thought that oestrogen plays a role in their development. This is because the oestrogen hormone stimulates the growth of the endometrium during the menstrual cycle to prepare for the implantation of a fertilised egg.

However, when there is an excess of oestrogen hormone, particularly when there is insufficient progesterone to balance it, the endometrial tissue can overgrow and form uterine polyps.

What are the risk factors for endometrial polyps?

There are several factors that can increase your risk of developing endometrial polyps. Some of these factors include:

• Age:

  • If you are in your 40s or 50s and approaching menopause (perimenopause), oestrogen levels can spike higher than normal or drop sharply from cycle to cycle, which can increase the risk of polyp growth.

  • Additionally, if you are postmenopausal (aged 50 or over), despite lower overall oestrogen levels, the absence of regular progesterone increases polyp risk.

• Body weight:

  • Being overweight (BMI 25 to 29.9) or obese (BMI >30) can increase the risk of this abnormal growth.

• Cancer medication:

  • Certain medications used to treat breast cancer, such as tamoxifen, can increase the risk of developing uterine polyps.

• Hormonal therapy:

  • Taking a high dose of hormone replacement therapy (HRT) oestrogen for menopause without adequate progesterone can also increase the risk of these polyps.

• Genetic condition:

  • You have a family history of Lynch and Cowden syndromes.

• High blood pressure:

  • Having high blood pressure (hypertension) may also contribute to the development of these polyps.

If you are at risk of developing uterine polyps, timely detection can prevent these growths from worsening and protect your reproductive health. Schedule an appointment with Thomson Women's Clinic and Cancer Surgery, where our obstetrician and gynaecologist (O&G) specialists can perform further assessments and take steps to manage these growths early.

What are the symptoms of endometrial polyps?

If the polyp is small, you may not experience any symptoms. However, when symptoms do occur, they often manifest as:

• Prolonged periods

• Bleeding after an intercourse

• Irregular menstrual periods

• Abnormal vaginal discharge

• Heavy menstrual bleeding during periods

• In some women, endometrial polyps may cause infertility issue

Although these symptoms may be mistaken for particularly intense menstrual periods, it is recommended that you consult an O&G if you experience postmenopausal bleeding or vaginal bleeding or spotting when you are not on your period.

This is because abnormal vaginal bleeding can be a sign of endometrial polyps, particularly if you are postmenopausal.

How are endometrial polyps diagnosed?

To diagnose uterine polyps, your healthcare provider will review your medical history, ask about any medications you are currently taking and check for any symptoms you are experiencing.

If you still have periods, they may ask about the specifics of your menstrual cycle and fertility, including how long your periods last, how often you have them and whether you have had difficulty conceiving. If you are postmenopausal, your doctor may ask if you have noticed any bleeding or spotting.

Following this, they will perform a pelvic examination and a Pap smear to check for polyps. They may also perform additional tests to confirm the diagnosis. 

These investigations may include:

• Transvaginal ultrasonography:

  • During transvaginal ultrasound, your doctor inserts a handheld device called an ultrasound transducer into your vagina. The device emits sound waves that provide an image of the inside of your uterus, including any irregularities that may be present.

• Sonohysterography:

  • After the initial transvaginal ultrasound, your doctor will inject some sterile fluid into the hollow part of the womb (uterine cavity) through a thin, flexible tube (catheter) before doing the endometrial polyp ultrasound again. The fluid causes the uterine cavity to expand to provide a clearer image of any growth in the womb.

• Hysteroscopy:

  • Your doctor inserts a long, thin tube with a lighted telescope (hysteroscope) through the vagina and cervix to examine the inside of the womb.

• Endometrial biopsy:

  • Your doctor inserts a thin, soft plastic instrument to collect some tissues from the inner wall of your uterus. The tissues will then be sent to the laboratory to detect any abnormal cells.

• Curettage:

  • Your doctor inserts a long metal instrument called a curette to scrape the tissues or polyps from the inner wall of your uterus. The tissues or polyps will then be sent to the laboratory to detect any abnormal or cancerous cells.

Endometrial polyp treatment costs

If you have any concerns about endometrial polyps, or if you are experiencing symptoms such as irregular bleeding or a prolonged period, it is important to seek a proper evaluation. Early detection and monitoring can help prevent growth progression and ensure appropriate treatment.

At Thomson Women's Clinic and Cancer Surgery, our O&G team provides support across the full care pathway – from initial assessment and diagnosis through to treatment and follow-up, where needed. If you would like to discuss your concerns, you are welcome to schedule a consultation with our team. 

Depending on your diagnosis and clinical needs, your doctor may recommend one or more of the following procedures:

• Uterine polypectomy:

  • During a polypectomy, hysteroscopy is used to visualise and safely remove polyps from the uterus.

  • Estimated costs for inpatient polypectomy procedures range from SGD 767 to SGD 4,300, depending on hospital type and ward class.

• Hysteroscopy:

  • A hysteroscopy allows your doctor to examine the inside of the uterus directly and, where necessary, carry out treatment at the same time.

  • Estimated costs range from SGD 696 to SGD 10,905, depending on whether the procedure is performed on an outpatient or inpatient basis.

Please note that additional costs may apply for pre-procedure consultations, imaging, medications, and follow-up appointments. The figures above are estimates only and will vary based on your individual clinical needs, hospital type, ward class, and insurance arrangements.

Several funding options may help offset costs, including MediSave, MediShield Life, and Integrated Shield Plans, subject to eligibility and your plan's terms.

This price was last updated in June 2025. Therefore, prices may have changed since then. For more information, contact our medical concierge, who can provide detailed guidance based on your specific situation.

When should you see a doctor?

Many women with endometrial polyps experience mild or no symptoms at all. However, certain signs warrant timely medical evaluation – and some should not be left unaddressed.

Seek prompt medical attention if you experience:

• Any vaginal bleeding after menopause. Postmenopausal bleeding is never considered normal and should always be assessed by a doctor, even if the bleeding is light or occurs only once.

• Bleeding or spotting between periods. Intermenstrual bleeding that is not related to your expected cycle may indicate an underlying gynaecological condition requiring evaluation.

• Unusually heavy or prolonged menstrual bleeding. If your periods are significantly heavier than usual, last longer than seven days, or require you to change sanitary products every hour or more frequently, consult a doctor.

• Bleeding after sexual intercourse. Post-coital bleeding that occurs more than once should be assessed, as it can be a sign of changes in the cervix or uterine lining.

Consider scheduling a routine consultation if you notice:

• Irregular menstrual cycles that are new or worsening

• Persistent pelvic discomfort or pressure

• Unexplained changes in vaginal discharge

• Difficulty conceiving, particularly if you are actively trying to get pregnant

Postmenopausal bleeding and sudden, heavy vaginal bleeding require prompt medical evaluation. These symptoms should not be attributed to normal ageing or dismissed without assessment by a healthcare professional.

FAQ

Could my endometrial polyp turn into cancer?

In most cases, endometrial polyps remain benign. Recent research shows that about 2.5–3% of endometrial polyps may develop into cancerous polyps, with the risk higher in postmenopausal women (potentially around 5%).

Can I prevent myself from getting an endometrial polyp?

Currently, there is no proven way to completely prevent endometrial polyps. However, you can reduce your risk by keeping a healthy weight, managing conditions such as high blood pressure and maintaining healthy hormone levels through your lifestyle choices.

Should I worry about endometrial polyps?

While most endometrial polyps are benign and manageable, it's important not to ignore any symptoms, particularly if you are in a higher-risk group. This includes being postmenopausal, being overweight, or taking certain medications such as tamoxifen.

What is the best treatment for endometrial polyps?

Can endometrial polyps be removed without surgery?

Yes, there are several non-surgical options available, particularly for smaller polyps. Hormonal treatments, such as progesterone therapy and the levonorgestrel intrauterine system, can help to shrink polyps and prevent them from coming back.

What is the difference between a polyp and a fibroid?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations for your specific conditions, schedule a consultation with our O&G specialist at Thomson Women's Clinic and Cancer Surgery.

References:

Uglietti, A., Buggio, L., Farella, M., Chiaffarino, F., Dridi, D., Vercellini, P., & Parazzini, F. (2019). The risk of malignancy in uterine polyps: A systematic review and meta-analysis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 237, 48–56. https://doi.org/10.1016/j.ejogrb.2019.04.009

Al-Rayes, S., Mohamed, M., Suarthana, E., Nassiri Kigloo, H., Raina, J., & Tulandi, T. (2025). Risks of malignancy among 11,204 patients with endometrial polyp: A systematic review and meta-analysis. Gynecology and Minimally Invasive Therapy, 14(1), 40–50. https://doi.org/10.4103/gmit.GMIT-D-24-00056