What in the Uterus?! Fibroids vs. Polyps
Have you ever wondered about the difference between fibroids and polyps, or thought they may be the same thing? You're not alone. While these two uterine conditions share some similarities, they’re quite different when it comes to their makeup, symptoms, and treatment options. Let’s break it all down—and explore how pelvic floor physical therapy can support you through it.
What Are Uterine Polyps?
Uterine polyps are soft, overgrown clumps of tissue that develop in the endometrium—the lining of the uterus. These growths are typically benign (noncancerous), and while the exact cause isn’t known, hormones (and especially estrogen) are believed to play a role.
Size & Occurrence:
Polyps can range from the size of a sesame seed to a golf ball. You may have one or several, and they’re most common in people between the ages of 40–50 (perimenopausal to postmenopausal).
Risk Factors for Uterine Polyps
Perimenopause or menopause
Obesity
High blood pressure
Tamoxifen therapy
Hormone replacement therapy (HRT)
Estrogen-based birth control
Symptoms of Uterine Polyps
Vaginal bleeding after menopause
Bleeding between periods
Unpredictable cycles (with changes in length and flow)
Very heavy periods
Infertility
Curious if your period is “normal”? Check out our blog, What is a Normal Period, Really?
How are Uterine Polyps Diagnosed?
Hysteroscopy: A thin telescope is inserted into the uterus to view the lining. This is the most accurate method.
Ultrasound: A noninvasive imaging test using sound waves. However, this method can sometimes result in false positives, especially in menstruating individuals.
Hysterosalpingography: A special X-ray done after injecting dye into the uterus.
Treatment Options for Polyps
Small, asymptomatic polyps may resolve on their own.
If they cause symptoms or affect fertility, surgical removal may be recommended.
What Are Uterine Fibroids?
Fibroids (also called leiomyomas) are noncancerous tumors made of muscle and connective tissue that grow in or on the uterus. Like polyps, fibroids are linked to estrogen, but they behave differently in the body.
Size & Occurrence:
Fibroids can be tiny (1 mm) or as large as 20 cm (the size of a watermelon!). They’re most common in women aged 30–50. Around 75–85% of women will develop fibroids in their lifetime, with Black women being up to 3x more likely to have them.
Quick Stats:
17% of all hysterectomies in the U.S. are due to uterine fibroids. Fibroids are the leading cause of hysterectomy in pre-menopausal women.
Fibroids are responsible for approximately 70,000 ER visits annually in the U.S.
Only 25–50% of people with fibroids experience symptoms.
Types of Fibroids
Intramural: In the muscular wall of the uterus (this is the most common type)
Submucosal: Just beneath the lining of the uterus
Subserosal: On the outer wall of the uterus
Pedunculated: Attached by a stem (like a mushroom)
Risk Factors for Fibroids
High estrogen levels
Insulin-like growth factors
Genetics/family history
Ethnic background
Vitamin D deficiency
Endocrine disruptors (BPA, phthalates, etc.)
High dairy consumption
Obesity
Hypertension
History of trauma or abuse
Symptoms of Fibroids
Heavy or prolonged menstrual bleeding
Bleeding between periods
Frequent or urgent urination
Fullness or bloating
Constipation
Pain during sex
Pelvic or low back pain
Fatigue (often from anemia)
Vaginal discharge
Infertility
Difficulty emptying the bladder
Complications
Excessive bleeding and anemia
Infertility or pregnancy issues
Severe pelvic pain or pressure
Visible abdominal swelling
How are Fibroids Diagnosed?
Ultrasound: Noninvasive imaging to create picture of internal organs with sound waves.
MRI or CT scan: Detailed images are created of internal organs
Hysteroscopy: A thin telescope is inserted into uterine cavity allowing for doctor to visualize the inside of uterus.
Sonohysterography: Saline is injected into the uterus to provide clearer imaging during ultrasound.
Hysterosalpingography: A specialized X-ray that is used after filling uterus with dye.
Laparoscopy: A small camera is inserted through an incision in the abdomen to view the uterus and surrounding organs.
Treatment Options for Fibroids
Medications & Supplements:
Over-the-counter pain relievers
Iron supplements (for anemia)
Birth control (to regulate bleeding)
GnRH agonists
Oral therapies like Elagolix or tranexamic acid
Lifestyle & Nutrition Support
Certain dietary changes can help reduce symptoms and support hormone balance. Foods to focus on include:
Fruits (especially citrus and berries)
Vegetables (especially cruciferous ones like broccoli, kale, and Brussels sprouts)
Flax seeds
Fatty fish (like salmon and trout)
Whole grains like oats, quinoa, and brown rice
Supplements: Vitamin D, omega-3s, iodine, and vitamin A
Foods to Limit or Avoid:
Red meat
Alcohol
Sugar
Gluten
Reduce Exposure to Endocrine Disruptors:
Limit plastic use (especially in food packaging)
Choose BPA-free and phthalate-free products
Use mineral sunscreens (avoid oxybenzone)
Filter your water
Check personal care products with the Environmental Working Group’s (EWG) Healthy Living App
Surgical Options:
Myomectomy (removal of fibroids)
Via hysteroscopy, laparoscopy, or laparotomy
Uterine Fibroid Embolization (UFE)
Radiofrequency Ablation
Hysterectomy (removal of the uterus, only considered in severe cases)
How Can Pelvic Floor Physical Therapy Help?
Pelvic floor physical therapy focuses on the muscles, ligaments, and tissues that support the uterus, bladder, and bowel. Even though pelvic floor therapy doesn't remove fibroids or polyps, it plays a powerful role in managing the symptoms they cause.
Pelvic Floor PT Can Help With:
Pelvic pain or heaviness
Constipation or bowel dysfunction
Bladder urgency or difficulty emptying
Pain with intercourse
Low back or abdominal discomfort
Post-surgical rehabilitation (e.g., after hysterectomy or myomectomy)
Therapists use techniques such as manual therapy, neuromuscular reeducation, breathing and core work, posture support, and individualized exercises to reduce pressure on the pelvic organs and improve quality of life.
The Bottom Line
Uterine polyps and fibroids may sound similar, but they’re quite different in structure, size, and how they affect your body. If you're experiencing any unusual bleeding, pelvic pain, or pressure, it’s worth talking to your healthcare provider. And don’t forget—pelvic floor physical therapy can be an incredibly helpful, non-invasive tool in managing symptoms and supporting your overall pelvic health.
At Pelvic Health and Wellness, we treat symptoms related to uterine fibroids and polyps. Schedule a consultation today and take the first step toward feeling like yourself again.
About Pelvic Health & Wellness
Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, pelvic pain, uterine fibroids and polyps, bowel and gut health, pain, pelvic organ prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.
We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.