It is usually asymptomatic and found incidentally. Occasionally it may cause intermittent vaginal or postcoital bleeding, a discharge or, in older women, postmenopausal bleeding. Endocervical polyps are more likely to bleed than their ectocervical counterparts. They appear as single, red, smooth or lobulated, polypoid growths projecting from the external os. They vary in size but typically are less than 1 cm.
Ectocervical polyps are pale, flesh-colored, smooth and rounded, often with a broad pedicle.
The lesion is characterized by overgrowth of benign stroma covered by epithelium. Endocervical polyps are covered by endocervical, squamocolumnar or metaplastic squamous epithelium while ectocervical ones are covered by stratified squamous epithelium. The stroma, which contains thick-walled blood vessels at the base and many small vessels in the center, is more fibrous in ectocervical polyps. Endocervical glands may be present within the stroma but are usually very few or absent in ectocervical polyps. The polyp may become ulcerated at the apex with extravasation of blood causing intermittent bleeding and marked stromal inflammatory cell infiltrate.