What’s the Difference Between Polyps and Uterine Fibroids?

Both fibroids and polyps can cause irregular menstrual bleeding and heavy periods, but there are a few differences in symptoms between the two conditions.

For some people, uterine fibroids may not cause any symptoms. Polyps can also sometimes be asymptomatic.

The causes of fibroids and polyps aren’t fully understood. Researchers think both are related to changes in hormone levels, particularly the hormones estrogen and progesterone.

Obesity is one risk factor for both conditions since people with obesity have higher levels of estrogen in the blood. A breast cancer medication known as tamoxifen (an estrogen receptor modulator) also increases your likelihood of developing both polyps and fibroids.

Additional causes for fibroids

Uterine fibroids are most commonly seen in people in their 30s and 40s, but can occur at any age. Polyps tend to occur in your 40s, just before or just after menopause. Fibroids and polyps may shrink once a person assigned female at birth reaches menopause as estrogen levels naturally decline.

Fibroids, which are also called leiomyomas or myomas, tend to run in families, so genetics may play a role in this condition.

Black women may also be at a higher risk of having fibroids. According to the American College of Obstetricians and Gynecologists (ACOG), fibroids may also develop at a younger age and cause more severe symptoms in Black women compared with white women.

Relationship between endometriosis and polyps

Endometriosis occurs when tissue similar to the lining of the uterus (known as the endometrium) grows outside the uterus. The displaced tissue thickens and bleeds during menstruation, but since it’s located outside the uterus, it has no way to exit the body. This can lead to scarring that may fuse organs together, causing painful inflammation.

Both endometriosis and polyps involve abnormal overgrowth of the endometrium, and both are likely related to estrogen. However, polyps don’t grow outside the uterus. Polyps attach to the inner wall of the uterus by a base or a thin stalk.

Studies have shown a higher incidence of polyps in people with endometriosis compared with people without endometriosis. This is likely because the two conditions share a common or related cause.

Many people with fibroids never receive a diagnosis because the condition often occurs without any symptoms. Occasionally, a doctor may be able to feel a fibroid during a regular pelvic exam.

If you’re experiencing symptoms like bleeding, pain, or irregular menstruation, discuss this with a healthcare professional. They may decide to do further testing depending on your symptoms and health history.

Since the symptoms of fibroids and polyps are similar, a doctor will likely need to perform a few different tests to find out if you have fibroids, polyps, or another condition with similar symptoms, like endometriosis or ovarian cysts.

These tests may include:

• transvaginal ultrasound, an imaging test used to visualize the uterine cavity
• hysteroscopy, where a doctor inserts a thin tube with a camera into the uterus
• endometrial tissue biopsy, when a small sample of the polyp is taken and sent to a laboratory for evaluation under a microscope.
• other imaging tests, such as an MRI or CT scan

Small polyps and fibroids may go away on their own, but when they cause heavy or painful menstrual periods, you may need treatment to stop the bleeding.

Both polyps and fibroids can be treated with surgery, medications that manage hormones, or both. But there are differences in the types of techniques used.

Treatments for fibroids

Medications may help manage symptoms or they may be used as an option prior to surgery to help control bleeding. Medications may include:

• birth control pills
• antiestrogens, such as raloxifene
• gonadotropin-releasing hormone agonists (GnRH agonists)
• intrauterine devices (IUDs)

In some cases, your doctor may recommend surgery. The surgical procedure to remove fibroids is known as a myomectomy. A myomectomy can be done in a variety of ways:

• abdominal myomectomy
• laproscopic myomectomy
• hysteroscopic myomectomy

Other procedures may incldure:

• hysterectomy, or the removal of your uterus
• uterine fibroid embolization (UFE)
• MRI-focused ultrasound therapy

You cannot have children following hysterectomy or UFE.

Treatments for polyps

A doctor may recommend medications temporarily if polyps are small and not causing symptoms. Medication may also be recommended following surgery to prevent recurrence. Examples include:

• tibolone, a steroid to block estrogen
• GnRH agonists
• IUDs

Surgical treatment options for polyps may include:

• polypectomy to remove the polyp
• endometrial ablation to prevent recurrence if you don’t plan to have any (more) children
• hysterectomy to remove the entire uterus (if cancer is detected)

Fibroids and polyps aren’t life threatening, but if left untreated, symptoms can worsen and cause discomfort that can negatively impact your quality of life.

Both fibroids and polyps can make it more difficult to become pregnant. If you’re already pregnant, fibroids and polyps can increase your chances of having complications like placental abruption or preterm delivery.

Heavy bleeding associated with fibroids or polyps can also lead to anemia. Symptoms of anemia include:

• fatigue
• weakness
• dizziness or fainting
• headache
• shortness of breath
• cold hands and feet
• pale skin

Here are some answers to common questions about polyps and fibroids.

Are fibroids worse than polyps?

The severity of fibroids and polyps depends on the size of the growths and where they’re located. While both conditions can be painful, polyps may cause more serious symptoms compared with fibroids. Many people with fibroids don’t experience any symptoms at all.

In some cases, polyps can lead to cancer. Fibroids are always noncancerous.

Do polyps and fibroids need to be removed?

Small polyps and fibroids may go away on their own. Depending on your symptoms, your doctor might recommend monitoring the polyps or fibroids and delaying treatment, including surgery, to see if they shrink over time.

What type of doctor treats fibroids and polyps?

Both gynecologists and OB/GYNs can treat fibroids and polyps.

Can you prevent fibroids or polyps?

You can’t prevent polyps and fibroids unless you have a hysterectomy (surgery to remove the uterus).

Can endometriosis cause fibroids?

Endometriosis doesn’t cause fibroids, but the two conditions can occur together as they’re both linked to the same likely cause. Studies suggest that endometriosis and fibroids often appear together. In one retrospective review of 208 patients with symptomatic fibroids, for example, 87% of patients were also found to have endometriosis.

Polyps and uterine fibroids can cause similar symptoms and can sometimes be mistaken for each other. Both conditions are caused by growths of tissue in the uterus. The main difference between the two is the type of tissue involved.

Since the symptoms are so similar between fibroids and polyps, the only way to get a proper diagnosis of either condition is to schedule an appointment with a gynecologist for more testing.

Treatment options for fibroids and polyps are different and depend on the severity of your symptoms and how they affect your quality of life. Once you have a diagnosis, your doctor will come up with a treatment plan that works best for your individual case.