What is the difference between uterine polyps and uterine fibroids?

Jul 15, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, the main differences between endometrial polyps and uterine fibroids lie in their nature, location, size, symptoms, and treatment methods. If you experience any discomfort, it is recommended to seek timely medical attention at a qualified hospital. Maintaining healthy lifestyle habits, balanced nutrition, avoiding excessive fatigue and mental stress, and undergoing regular gynecological examinations in daily life can help with early detection and management of issues.

Generally, the main differences between uterine polyps and uterine fibroids involve their nature, location, size, symptoms, and treatment methods. If discomfort occurs, it is recommended to seek timely consultation and treatment at a reputable hospital. Detailed analysis is as follows:

1. Nature

Uterine polyps are benign overgrowths formed by localized hyperplasia of the endometrium, with a low risk of malignancy. Uterine fibroids are benign tumors composed of uterine smooth muscle and connective tissue, with an extremely low probability of malignant transformation, rarely developing into sarcomas.

2. Location

Uterine polyps mainly grow on the surface of the endometrium, can exist singly or in multiples, and a few may protrude outside the cervix. Uterine fibroids can develop in various parts of the uterus and are categorized by location into intramural fibroids, subserosal fibroids, and submucosal fibroids.

3. Size

Uterine polyps are usually small, with diameters mostly under 1 cm, although some may reach several centimeters. Uterine fibroids vary greatly in size, ranging from a few millimeters to as large as a full-term pregnant uterus, or even larger.

4. Symptoms

Common symptoms of uterine polyps include intermenstrual bleeding, menorrhagia, prolonged menstruation, or irregular bleeding. Some patients may experience abnormal vaginal discharge, and if the polyp protrudes from the cervix, contact bleeding may occur. Symptoms of uterine fibroids depend on their size and location and commonly include increased menstrual flow, prolonged menstrual periods, abdominal masses, increased vaginal discharge, lower abdominal heaviness, backache, and other discomforts. If fibroids compress the bladder or rectum, symptoms such as frequent urination, urgency, difficulty in urination, and constipation may also occur.

5. Treatment Methods

Small, asymptomatic uterine polyps can be observed temporarily with regular follow-up examinations. For symptomatic or larger polyps, hysteroscopic polypectomy is commonly performed, followed by pathological examination to confirm the nature of the polyp. Small fibroids without symptoms usually require no treatment, only regular follow-up. Patients with mild symptoms, those nearing menopause, or those whose general health conditions are unsuitable for surgery may be treated with medication. When fibroids are large, symptoms are significant, or drug treatment is ineffective, surgical treatment is required. Surgical options include myomectomy and hysterectomy, with the specific approach determined by factors such as the patient's age and fertility requirements.

Maintaining good lifestyle habits, balanced nutrition, avoiding excessive fatigue and mental stress, and undergoing regular gynecological examinations help in the early detection and management of problems.

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Why did uterine fibroids grow again after surgery?

In general, the recurrence of uterine fibroids after surgery may be caused by hormonal fluctuations, unhealthy lifestyle habits, adenomyosis, polycystic ovary syndrome, hyperprolactinemia, or other factors. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, maintain a light diet and avoid high-fat and high-sugar foods.

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Can I take dydrogesterone tablets if I have uterine fibroids?

If uterine fibroids are less than 5 cm in diameter, grow slowly, and the patient has no obvious symptoms such as heavy menstrual bleeding or abdominal pain, and if the patient also has conditions like menstrual irregularity or low progesterone levels in early pregnancy requiring fetal preservation, oral dydrogesterone tablets may be prescribed for short-term use after physician evaluation. In such cases, the medication primarily serves to regulate hormones and maintain pregnancy, with minimal impact on the fibroids.

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Can uterine fibroids be completely removed by hysteroscopic surgery?

Whether uterine fibroids can be completely removed during hysteroscopic surgery depends on the location and size of the fibroids. Submucosal fibroids or intramural fibroids protruding into the uterine cavity can usually be thoroughly excised. However, deeply intramural fibroids, subserosal fibroids, or cases with multiple or large fibroids are more difficult to completely remove and are prone to residual tissue. After surgery, patients should follow medical advice regarding medication to prevent infection and maintain external genital hygiene.

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Is it serious if uterine fibroids cause absence of menstruation?

If uterine fibroids are small in size and located subserosally (not invading the uterine cavity), and only slightly affect endometrial shedding leading to delayed or temporarily absent menstruation, menstrual cycles can usually gradually return to normal through medication regulation or regular monitoring—especially when the fibroids show no significant growth. In such cases, the impact on fertility and overall health is minimal, and the condition is not considered serious.