In this guest blog, Dr Aziza Sesay talks us through cervical polyps, from diagnosis to treatment.

What are cervical polyps?

If you’ve just been informed that you have cervical polyps, you’re probably thinking, what are cervical polyps and how did they get to my cervix?

Don’t panic!

Polyps are actually quite common. They are growths that protrude out of the surface of delicate skin, usually stalk-like or elongated and quite fragile. They occur in a number of different parts of the body including the large bowel, nose, womb and (of course) cervix (also known as the neck of the womb).

When they occur in the cervix, they can stick out within its inner canal walls, known as endocervical polyp, or along its outer surface leading into the vagina, known as ectocervical polyp.

They are sometimes described as a ‘cherry on a stalk’ because of their appearance, but they can also appear broad and flat as though they are directly attached onto the surface.

Polyps are usually (benign) harmless and do not often cause any symptoms. You may only have one polyp or a number of them at the same time. They vary in shape, size, location, colour and consistency.

How and why do cervical polyps occur?

There is no clear understanding as to why cervical polyps occur, however there are some theories which include:

• An abnormal response to high levels oestrogen (a female sex hormone).
• Inflammation or irritation of the cervix either from chemicals or infections.
• Clogged-up blood vessels on the surface of the cervix.

Are there any risk factors and can they be prevented?

In-keeping with the suggested causes, risk factors of cervical polyps include pregnancy, STIs, using soaps or such irritants internally, multiple vaginal births and having a previous cervical polyp.

It’s difficult to explicitly say whether cervical polyps can be prevented but reducing changeable risk factors where possible may potentially help to minimise the likelihood of their occurrence. For instance, refraining from inserting any irritants into the vagina including soaps or douching, or using barrier contraception like condoms to decrease the chances of contracting STIs, and so on.

Do cervical polyps cause symptoms?

As mentioned earlier, in most instances, they do not cause any symptoms, so you may not know if you have a cervical polyp.

However, polyps are quite fragile and if they have blood vessels within them, they are prone to bleeding. In this way, they can sometimes cause irregular vaginal bleeding (in between periods, during or after intercourse or after menopause) and/or abnormal vaginal discharge (brown, red or yellow).

It’s crucial to remember that these symptoms must always be assessed to exclude other more serious causes such as cancer. They do not automatically mean you have it, but it’s always best to get checked.

How are cervical polyps diagnosed?

As patients with cervical polyps often don’t have any symptoms, they are frequently found during procedures where the cervix is visualised e.g. during cervical screening appointments or a routine pelvic examination. If you do have any of the symptoms listed then your Doctor would perform an internal examination.

In both instances, a speculum, which is the tool used to separate the walls of the vagina to clearly visualise the cervix, is used so that the cervix can be assessed for polyps.

How are cervical polyps treated?

Once found, the treatment is usually to remove them. The process of removal depends on the size, type, location, visibility and number of polyps. Most are done as an outpatient procedure:

• Smaller polyps can be removed quite easily, by using forceps to twist and pull them off. This may lead to minimal bleeding and mild cramp like discomfort.
• Larger polyps are removed using a heated wired loop and this may cause heavy bleeding and more pronounced abdominal discomfort, but please be reassured that local anaesthetic is often used and you would always be encouraged to take some analgesics to ease the pain. The procedure would never be done without your consent.
• Occasionally, you may need to have the procedure done under general anaesthetic, where a camera called a hysterscope is inserted into the cervix to better visualise endocervical polyps and remove them.

The samples are then sent off to the lab to be analysed and the results are received in a few weeks. Depending on the results, you may have further treatment or your cervix would most likely be monitored routinely.

In some instances, the Doctor may opt to monitor cervical polyps instead of removing them. This is patient-dependent and is usually the case if the polyps are quite small and do not cause any symptoms.

Are there any long-term complications of having cervical polyps?

• Sometimes cervical polyps can potentially affect your fertility if they grow big enough to close off the opening of the cervix so sperm cannot go through.
• They may make collecting a sample during cervical screening difficult thereby potentially affecting results, so you may need to have your screening done more regularly.
• They may become infected or inflamed.

Should I be worried?

Polyps are usually benign and harmless. So, my immediate response would be: no, please don’t worry. There are some factors to consider, however, such as how old you are, your previous medical history, family history and so on. Because of their tendency to rarely change and develop into cancer over time (0.2-1.5%), it is often advisable to have them removed and assessed to eliminate this risk. In the long term, it is important to have your cervix monitored regularly as polyps can recur.

About Dr Sesay

Dr. Aziza Sesay is an NHS GP with a passion for health education, awareness, advocacy and empowerment. She channels this through her platform ‘Talks with Dr. Sesay’ where she shares short informative videos, infographics, live discussions and tips on a variety of topics including women’s/gynae health, cancer awareness, mental health and health inequity.

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The information provided in this blog is meant to raise awareness on cervical polyps and its management and not to be used for personal medical advice. Please, speak to your Doctor for further support and guidance if you have concerns.