Fibroids and Polyps

Uterine fibroids and endometrial polyps are some of the most common causes of abnormal bleeding and pelvic pressure symptoms, particularly in people of reproductive age. These non-cancerous growths vary in size and location, and while some may never cause issues, others can have a real impact on daily life, fertility, and wellbeing.

What Are Fibroids?

Fibroids (also known as leiomyomas or myomas) are benign muscle growths of the uterus. They can vary from tiny nodules to large, heavy growths that distort the shape of the uterus.

Fibroids are classified based on where they are located:

Submucosal: growing into the cavity of the uterus
Intramural: within the muscle wall
Subserosal: projecting to the outer surface
Pedunculated: attached by a stalk

What Are Polyps?

Polyps are small overgrowths of the uterine lining (endometrium) that protrude into the cavity. They can cause irregular or heavy bleeding and may also affect fertility.

Polyps are usually benign, but in some cases—especially post-menopause or in people with risk factors—they can contain pre-cancerous or cancerous cells.

Common Symptoms

Some people have fibroids or polyps and never know it. Others experience:

Heavy or prolonged periods (menorrhagia)
Bleeding between periods
Pelvic pressure or bloating
Painful periods
Urinary frequency or bowel changes
Infertility or miscarriage

How Are They Diagnosed?

Initial evaluation often includes:

Pelvic ultrasound: Usually transvaginal, to visualise the uterus and endometrium
Hysteroscopy: A small camera passed through the cervix to see inside the uterus

Treatment Options

Treatment depends on symptoms, size/location of the growths, fertility plans, and personal preferences.

For Fibroids:

Watchful waiting for small, asymptomatic fibroids
Hormonal treatments (e.g. progestins, GnRH analogues)
Laparoscopic myomectomy: Minimally invasive surgical removal
Hysterectomy: Removal of the uterus if childbearing is complete or other treatments are not suitable

For Polyps:

Hysteroscopic polypectomy: Day procedure with a small camera and instruments

My Approach

I perform minimally invasive (keyhole) surgery whenever possible, which means shorter recovery times and less pain. If you need surgery, I’ll talk through all your options, what to expect, and make sure your treatment plan fits your values and goals.

Will It Affect My Fertility?

Both fibroids and polyps can contribute to infertility or miscarriage, depending on their location. Removing them may improve your chances of conceiving, especially if they distort the uterine cavity. We can explore this together if pregnancy is a goal of yours.

Is It Cancer?

In most cases, no. Both fibroids and polyps are benign. However, any abnormal bleeding — especially after menopause — should be evaluated, as a small proportion of polyps may be pre-cancerous or cancerous.

Dr Sam Holford

What’s Next?

If you’re dealing with heavy periods, pressure symptoms, or trying to conceive, it’s worth getting things checked. You don’t have to put up with it.

Book an appointment

FAQs

What's the difference between a fibroid and a polyp?

A fibroid is a benign growth of the muscular wall of the uterus, while a polyp is an overgrowth of the uterine lining (endometrium). Both can cause similar symptoms, but their composition and treatment can differ.

Do all fibroids and polyps need to be removed?

Not necessarily. If they are small and not causing any symptoms, we may recommend simply monitoring them. Treatment is usually recommended if they are causing heavy bleeding, pain, pressure, or if they might be affecting fertility.

Can fibroids turn into cancer?

It is extremely rare for a fibroid to be cancerous. A cancerous fibroid is called a leiomyosarcoma, and it occurs in less than 1 in 1,000 cases. Polyps, especially after menopause, have a slightly higher (but still small) risk of containing pre-cancerous or cancerous cells.

How are fibroids and polyps removed?

Polyps and some fibroids (submucosal) are usually removed with a minimally invasive procedure called a hysteroscopy. Larger fibroids may require a laparoscopic myomectomy (keyhole surgery to remove the fibroids) or, in some cases, a hysterectomy.

Useful Resources

Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.