Definition

Cervical polyps are protrusions, tissue growths, or masses that develop on the cervical canal (the narrow passage at the lower part of the uterus that connects to the vagina).

The cervix, or the neck of the uterus, connects the uterine cavity with the upper part of the vagina. The cervix functions as a passageway for sperm to fertilize an egg. During childbirth, the cervix thins and widens to allow the baby to pass through the birth canal.

There are two types of cervical polyps:

• Ectocervical polyps: These polyps arise from the outer surface layer of cells on the cervix. They are more commonly found in women who have not yet reached menopause.
• Endocervical polyps: The most common type of cervical polyp, originating from the cervical glands. Postmenopausal women are more frequently found to have endocervical polyps.

Causes

The exact cause of cervical polyps is not yet known. However, it is suspected that polyps may occur due to:

• Abnormal Body Response

Estrogen is a hormone associated with female reproductive organs and affects other tissues, such as breast growth, the uterus, and bones, and increases "good" cholesterol (HDL) in the blood.
Estrogen levels typically fluctuate throughout a woman's life stages. The highest levels of estrogen are found during reproductive age, pregnancy, and the months leading up to menopause. Chemical compounds that mimic estrogen can also be found in the environment around us. If the body has an abnormal response to increased estrogen levels, it may lead to excessive growth of cervical tissue, resulting in polyps.

• Chronic Inflammation

There is a theory that long-term inflammation or infection of the cervix can gradually cause abnormal changes in the cells. An inflamed cervix may appear red or irritated.

• Blood Vessel Obstruction

It is suspected that an obstruction of blood vessels in the cervix can disrupt blood flow to the tissue, contributing to the development of polyps.

Risk Factor

Cervical polyps are a common reproductive organ condition. Most cervical polyps are benign and not cancerous. Women of reproductive age over 20 years who have a history of giving birth two or more times are at higher risk of developing cervical polyps. This condition is rarely found in girls who have not yet had their first menstruation.

In addition, polyps are also quite common in pregnant women, likely due to the increase in estrogen levels during pregnancy.

Symptoms

Polyps do not always cause symptoms. About 2 out of 3 women found to have cervical polyps do not experience any complaints. Doctors usually discover polyps during a Pap smear (a cervical cell sample for a cervical cancer screening test) or other procedures involving the cervix. However, if symptoms do occur, they may include:

• Heavier menstrual bleeding than usual
• Bleeding or spotting from the vagina after sexual intercourse
• Abnormal vaginal bleeding that occurs after menopause or outside the menstrual cycle
• White or yellowish vaginal discharge, which may have an odor if infected

We also have articles regarding excessive menstrual bleeding that you can read here: Hypermenorrhea - Definition, Cause And Risk Factor.

Diagnosis

The doctor will perform a pelvic examination. Once polyps are present, typically only one to a maximum of three polyps are identified. Polyps can appear reddish, purplish, or gray. Their shape also varies, ranging from finger-like, round, or thin-stemmed. The size is typically a few millimeters to centimeters, usually around 1-2 cm.

A sample of the polyp tissue may be taken for laboratory examination to confirm whether the tissue found on the cervix is cancerous or not. Most biopsy results show cells consistent with benign polyps. However, abnormal cells or cells suspected of being precancerous (cells that can develop into cancer) may also be found.

Management

Treatment will depend on the symptoms you are experiencing and the appearance of the polyps. Generally, polyps do not need to be removed if you are not experiencing any symptoms. Polyps will be removed if they are large, causing symptoms, or if abnormal cells are found.

During the procedure, you may be given either local anesthesia at the site of the polyp or general anesthesia. It is possible to remove polyps and destroy the roots by: 

• Polyp excision
• Cryotherapy with liquid nitrogen
• Electrosurgical excision
• Laser surgery

You may experience mild and brief pain during polyp removal, as well as some bleeding and cramping for a few days afterward. Vaginal spotting may occur for 1-2 days after polyp removal. Over-the-counter pain relievers such as paracetamol or ibuprofen can relieve the pain.

Complications

Most polyps are benign, not cancerous, and easily removed. Cervical cancer rarely originates from cervical polyps. Most cervical cancers are caused by human papillomavirus (HPV) infection, which also causes genital warts.

Polyps usually do not regrow after being removed. However, if you have had multiple polyps, you are at a higher risk of developing them again.

Some cervical cancers may initially appear as polyps. Some uterine polyps can be associated with uterine cancer.

If you are interested in reading further about cervical cancer, you can read it here: Cervical Cancer - Definition, Cause And Risk Factor.

Prevention

You cannot prevent the development of cervical polyps. However, regular pelvic exams and pap smears can help detect and manage cervical polyps before they cause symptoms.

You should consult a doctor before undergoing a reproductive organ examination. Ask your doctor how often you should have a pap smear. The frequency of exams will generally depend on your health history and age. Pap smears are usually performed every 3–5 years for women who have never had abnormal test results.

Since some infections are linked to cervical polyps, there are a few simple ways to help reduce your risk of genital infections. Wear cotton underwear that allows air circulation. It will prevent excessive heat and moisture, which creates an ideal environment for infection. You can also use condoms during intercourse to reduce the risk of sexually transmitted infections.

When to See a Doctor?

You should consult a doctor if you experience:

• Abnormal vaginal bleeding, including bleeding after intercourse or out of the menstrual cycle
• Abnormal vaginal discharge
• Very heavy menstrual bleeding
• Bleeding or spotting after menopause

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