Cervical polyps: symptoms, removal and what the results mean

The cervix is the neck of the womb, with a canal that connects the vagina to the womb. Doncaster and Bassetlaw Teaching Hospitals describe a polyp as a growth of tissue from either the outside of the cervix or inside the cervical canal. Chelsea and Westminster Hospital explains that a polyp is a piece of overgrown skin sticking out from the delicate skin found in certain areas of the body, and that a cervical polyp sticks out from the surface of the cervical canal.

Finding one can be worrying, but both trusts stress that most are harmless. Polyps can occur on their own or with other polyps in the womb, which is why an ultrasound scan may sometimes be suggested.

Many people have no symptoms at all. When symptoms occur, the Doncaster leaflet lists bleeding after sexual intercourse, bleeding between periods, bleeding after the menopause and a discharge. Chelsea and Westminster describes irregular vaginal bleeding.

• Bleeding after sex.

• Bleeding between periods.

• Bleeding after the menopause.

• Unusual vaginal discharge.

• No symptoms, with the polyp noticed at a cervical screening test or pelvic examination.

Bleeding after sex, between periods or after the menopause should always be checked by a GP, because there are several possible causes and it is not possible to tell which from symptoms alone. A polyp is only one of them. If you are bleeding heavily, have severe pain or feel faint, seek urgent medical help through NHS 111, or call 999 or go to A&E in an emergency.

The leaflets also describe signs to look out for after removal: Doncaster says an offensive, bad-smelling discharge is a sign of infection and that you should contact the clinic or your GP if you suspect an infection.

Polyps are usually removed in an outpatient clinic. Doncaster and Bassetlaw describe removal using polyp forceps, which grasp the base of the polyp so that it can be removed with a gentle twisting motion. If the base cannot be seen, a hysteroscopy, in which a small camera is passed through the neck of the womb, may be done to see whether the polyp starts in the cervix or the womb. If there is bleeding, silver nitrate can be applied to stop it.

Chelsea and Westminster says small polyps can be twisted off the cervix without local anaesthetic, while larger polyps may need local anaesthetic to numb the cervix and removal using a heated wire loop. Doncaster says that some polyps are too large to be removed in the outpatient department and may need to be removed in theatre, in which case a further appointment will be arranged.

Doncaster says having a cervical polyp removed is not painful, although you may feel mild discomfort similar to period pain afterwards, and a mild painkiller is offered if needed.

Doncaster says you will have some discharge which can continue for 7 to 14 days, dark brown for the first few days if silver nitrate was used, and that you should avoid tampons, sex, swimming, long baths and strenuous exercise while you are bleeding or have discharge. Chelsea and Westminster advises no sex, tampons or vigorous exercise or swimming for one week, or up to four weeks if a local anaesthetic and wire loop were used, and says discharge or light bleeding can last up to two weeks.

Chelsea and Westminster adds that there may be lingering abdominal pain, for which over-the-counter painkillers are recommended. Doncaster lists risks: bleeding after removal, a very small risk of infection, and a need for theatre if the polyp is too large for clinic removal.

Both leaflets say the polyp is sent to the laboratory for analysis. Chelsea and Westminster says most polyps are completely harmless and that results are posted within four weeks. Doncaster says a follow-up appointment is arranged in approximately 4 to 6 weeks, with a letter to you and your GP with the results, which will also say whether you need further follow-up.

Doncaster explains why removal is advised. A small percentage of polyps (between 2 and 15 in every 1,000) are abnormal and may develop into cancer if left. Removal should also settle symptoms such as bleeding after sex or between periods, and a polyp can sometimes make it difficult to take an adequate HPV screening test, which could mean more frequent screening. If left, a polyp may continue to grow.

On the NHS, a polyp may be found at a screening test or examination and removed in an outpatient clinic, as the Doncaster and Chelsea and Westminster leaflets describe.

Private gynaecology clinics also remove cervical polyps, often with quicker access. The procedure and the laboratory analysis are the same, and the main differences are waiting time and cost. Whichever route you choose, make sure the sample is sent for analysis and that someone will give you the result.