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Advanced Gynaecology guide

Endometrial Polyps

How uterine polyps are detected, when biopsy or hysteroscopic removal is advised and how age and bleeding pattern influence risk.

Specialist-depth overview
10–12 min readUpdated 21 July 2026Evidence-informed patient education

Endometrial polyps are localised overgrowths of the uterine lining. They can cause bleeding between periods, heavy periods, bleeding after menopause or fertility difficulties, although some are found incidentally on ultrasound.

The significance of a polyp depends on symptoms, age, menopausal status, size and risk factors.
Saline ultrasound or hysteroscopy may define the uterine cavity more clearly than a routine scan.
Removal allows symptom treatment and laboratory examination of the tissue.
Original educational diagram for Endometrial Polyps
Original educational diagram created for this topic. It explains the care pathway visually and is not a diagnostic image.

Assessment

The bleeding history, pregnancy possibility, medicines and anaemia symptoms are reviewed. Transvaginal ultrasound is often the first test. Findings can vary through the menstrual cycle, and a suspected polyp may require further cavity assessment.

When removal is considered

Hysteroscopic removal is commonly advised for symptomatic polyps, postmenopausal bleeding, infertility treatment planning or concerning features. Observation may be reasonable for selected small asymptomatic polyps after individual assessment.

Procedure and pathology

A hysteroscope allows direct visualisation and targeted removal. The tissue is sent to pathology. Most polyps are benign, but laboratory examination is important, particularly after menopause or when bleeding is persistent.

Follow-up

Bleeding response and pathology results determine next steps. Persistent symptoms may indicate another cause such as adenomyosis, fibroids, ovulatory dysfunction or endometrial disease.

Questions worth discussing at your consultation

  • How certain is the scan that this is a polyp?
  • Is observation safe in my situation?
  • Will removal be outpatient or under anaesthesia?
  • When will the pathology result be available?
When to seek urgent careUrgent review is needed for very heavy bleeding, fainting, severe pain, fever after a procedure or postmenopausal bleeding accompanied by significant weakness.
Medical note: This page is educational and is structured to support a specialist consultation. Diagnosis, investigations and treatment must be individualised. It has not been presented as a substitute for an examination or emergency assessment.