Endometrial polyp

Last updated: 25 May 2026
Reviewed by: Specialist doctors from the Elfcare quality team

Have you been experiencing irregular bleeding between periods, heavier periods than usual, or spotting after the menopause that you have put down to hormonal changes? Perhaps you have been trying to conceive without success and wondering if something inside the uterus might be affecting implantation. These can be signs of an endometrial polyp, a growth inside the uterine cavity that is usually benign but always worth investigating.

Endometrial polyps are among the most common causes of abnormal uterine bleeding and are frequently discovered incidentally during imaging performed for another reason. A pelvic MRI can identify them directly, often before they cause noticeable symptoms.

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What is endometrialpolyp?

An endometrial polyp is a localised overgrowth of the endometrium, the tissue lining the inside of the uterus. Polyps form when a small area of endometrial glands and stroma proliferates excessively, creating a soft, finger-like or rounded projection into the uterine cavity. They can be single or multiple, small or large enough to fill the entire cavity.

The vast majority of endometrial polyps are benign. However, a small proportion, estimated at 0.5 to 3% in premenopausal women and higher in postmenopausal women, contain atypical or malignant cells. Postmenopausal bleeding in the context of an endometrial polyp always warrants histological assessment.

Endometrial polyps are distinct from uterine fibroids. Fibroids are smooth muscle tumours arising from the uterine wall. Polyps arise from the endometrial lining and project into the cavity. MRI reliably distinguishes between the two.

Symptoms of endometrialpolyp

Many endometrial polyps cause no symptoms and are discovered incidentally on pelvic imaging. When symptoms occur, they include:

  • Irregular or unpredictable menstrual bleeding

  • Heavier or longer periods than usual

  • Bleeding or spotting between periods

  • Postmenopausal bleeding, which always warrants investigation regardless of the cause

  • Difficulty conceiving, particularly when polyps obstruct the fallopian tube openings or disrupt implantation

  • Pelvic discomfort or a feeling of pressure in rare cases when polyps are large

What causes endometrialpolyp?

Endometrial polyps develop through localised endometrial overgrowth driven by hormonal and genetic factors. Contributing causes include:

  • Oestrogen excess: the main trigger. Polyps grow in response to high oestrogen. Risks include PCOS, obesity, and the transition to menopause.

  • Age: most common in women in their 40s and 50s. Risk of the polyp being cancerous increases after menopause.

  • Tamoxifen use: this breast cancer medication can act like oestrogen in the uterus, significantly raising the risk of polyps.

  • Obesity: excess adipose tissue increases circulating oestrogen through peripheral aromatisation, promoting endometrial proliferation.

  • Hypertension: high blood pressure is linked to a higher chance of developing polyps, though the exact reason is still being studied.

  • Hormone replacement therapy: particularly oestrogen-only HRT, increases polyp risk in postmenopausal women.

  • Genetic factors: some polyps show specific gene changes, suggesting they may start from a single mutated cell.

How is an endometrial polyp detected?

Endometrial polyps are detected primarily through pelvic imaging, with bloods providing the hormonal and metabolic context.

Pelvic MRI Elfcare’s full-body MRI directly images the uterus to find polyps, assess their size, and distinguish them from other issues like fibroids. It also measures the thickness of the uterine lining, which is a key health marker after menopause. If a suspicious area is found, we coordinate follow-up hysteroscopy for direct visualization and sampling.

Blood tests assess the hormonal and metabolic environment most closely associated with endometrial polyp development. Relevant markers in Elfcare's panel include:

  • Oestradiol and progesterone: checks for the hormonal imbalances that cause the uterine lining to overgrow.

  • LH and FSH: determines your overall reproductive status and whether you are approaching menopause.

  • TSH: screens for thyroid issues that can cause bleeding symptoms similar to polyps.

  • HbA1c and glucose: assess insulin resistance, a known risk factor for uterine overgrowth.

  • CRP: measures systemic inflammation that can influence the metabolic environment of the uterus.

  • Haemoglobin and ferritin: checks for anemia caused by the heavy or irregular bleeding often associated with polyps.

Why early detection matters

Most endometrial polyps are benign, and some smaller polyps may resolve spontaneously in premenopausal women, though this is not the rule.. But postmenopausal polyps carry a meaningfully higher malignancy risk and always require histological assessment. In women trying to conceive, polyps occupying the uterine cavity reduce implantation rates and should be identified and removed before assisted reproduction is pursued. Identifying a polyp early, before it causes significant bleeding or fertility complications, allows for informed monitoring or timely removal under hysteroscopy, a straightforward minimally invasive procedure with excellent outcomes.

How Elfcare can help

Elfcare's pelvic MRI images the uterine cavity directly, identifying endometrial polyps, assessing endometrial thickness, and distinguishing polyps from other intracavitary pathology including submucosal fibroids and endometrial hyperplasia. For women with abnormal bleeding or fertility concerns, this structural assessment is the most clinically meaningful finding Elfcare can provide in this context.

Our blood panel covers oestradiol, progesterone, LH, FSH, TSH, HbA1c, and iron markers, providing the hormonal and metabolic context surrounding polyp development.

If our MRI or blood tests identify an endometrial polyp or related finding, we take care of further diagnostics or refer you to the appropriate specialist.

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Summary

Endometrial polyps are localised growths of the uterine lining that are usually benign but always clinically relevant, particularly in postmenopausal women where malignancy risk is higher. Elfcare's pelvic MRI images the uterine cavity directly, identifying polyps, assessing endometrial thickness, and distinguishing them from other intracavitary pathology. Our blood panel covers the hormonal and metabolic markers driving endometrial proliferation. Identifying endometrial polyps early allows for appropriate monitoring or timely removal, protecting both reproductive health and long-term uterine wellbeing.

Last updated: 25 May 2026
Reviewed by: Specialist doctors from the quality team at Elfcare

FAQ

  • An endometrial polyp is a localised overgrowth of the uterine lining that projects into the uterine cavity. Polyps are most commonly benign but a small proportion, higher in postmenopausal women, contain atypical or malignant cells. They are a common cause of abnormal uterine bleeding and are frequently discovered incidentally on pelvic imaging.

  • Irregular bleeding, heavier or longer periods, spotting between periods, and postmenopausal bleeding. Many polyps cause no symptoms and are discovered incidentally on imaging. Difficulty conceiving is a common presenting concern when polyps occupy the uterine cavity and disrupt implantation.

  • Oestrogen excess is the primary driver. Obesity, PCOS, tamoxifen use, hormone replacement therapy, hypertension, and age all contribute to the oestrogen-dominant environment that promotes endometrial proliferation and polyp formation.

  • Pelvic MRI identifies polyps, assesses endometrial thickness, and distinguishes them from submucosal fibroids. Hysteroscopy provides direct visualisation and tissue sampling for histological assessment, and is arranged as the follow-up step when imaging identifies a suspicious intracavitary lesion.

  • Yes. Elfcare's pelvic MRI images the uterine cavity directly and can identify endometrial polyps and assess endometrial thickness. Our blood panel covers the key hormonal and metabolic markers. If a polyp or suspicious finding is identified, we take care of further diagnostics or refer you to the appropriate specialist.

  • Yes. Small asymptomatic polyps in premenopausal women may be monitored as many resolve spontaneously. Symptomatic polyps, postmenopausal polyps, and those causing fertility difficulties are removed under hysteroscopy, a minimally invasive procedure with excellent outcomes and rapid recovery. Histological assessment of removed polyps confirms whether the tissue is benign, atypical, or malignant and guides further management. Addressing the underlying hormonal imbalance through weight management, metabolic treatment, or hormonal adjustment reduces the risk of recurrence.