Do endometrial polyps feel painful? Generally, endometrial polyps do not cause any pain unless there is malignant transformation. In such cases, one might experience discomfort or a dragging pain in the lower abdomen. How are endometrial polyps typically diagnosed? They are diagnosed due to clear changes such as excessively heavy menstrual flow. An ultrasound can reveal polyps, or if the menstrual flow is too heavy, a dilation and curettage (D&C) procedure is performed, and the material removed is sent for pathological examination to confirm the presence of endometrial polyps. If the polyp is small, it can be left alone as 27% of them resolve on their own. However, if the polyp is large and causes changes in menstruation or affects fertility, a hysteroscopy is necessary.