The cause of the enlarged uterus can be pathological and non-pathological circumstances, among the main pathological causes are: adenomyosis, uterine fibroids and tumors of the endometrium and cervix; the main non-pathological causes, on the other hand, include: pregnancy and perimenopause.
For the diagnosis of an enlarged uterus, information provided by a pelvic examination and, sometimes, a pelvic ultrasound is essential.
The enlarged uterus does not always require the use of therapy; when the latter is needed, treatments vary according to the cause and symptoms (which may include pelvic pain and cramps, excessive bleeding during menstruation, increased volume of the " lower abdomen, back pain etc.).
Brief reminder of the uterus
Learn and hollow, the uterus is the female genital organ, which serves to accommodate the fertilized egg cell (ie the future fetus) and to ensure its correct development, during the 9 months of pregnancy.
It resides in the small pelvis, precisely between the bladder (anteriorly), the rectum (posteriorly), the intestinal loops (above) and the vagina (below).
In the "span of life, the uterus changes its shape; if up to pre-pubertal age it has an elongated appearance similar to a glove finger, in adulthood it looks a lot like an inverted (or inverted) pear, while in the post-menopausal phase it gradually reduces its volume and becomes crushed.
From a macroscopic point of view, doctors divide the uterus into two distinct main regions: a more enlarged and voluminous portion, called the body of the uterus (or uterine body), and a smaller portion, called the neck of the uterus (or cervix).
How big is the uterus under normal conditions?
When it comes to an enlarged uterus, it is right to inform readers interested in the topic that, under normal conditions, the uterus of an adult woman measures:
- 6-7 centimeters in length;
- From 2.5 to 4 centimeters in width;
- 2.5cm in thickness.
Using a comparison, a normal uterus (where by "normal" s "means" in the absence of conditions that cause it to "enlarge") is the size of a closed fist.
Did you know that ...
Under normal conditions, the weight of the uterus is approximately 50-60 grams.
Who develops an enlarged uterus the most?
According to statistics, the condition of an enlarged uterus is more common among women over 30 and women who are about to enter menopause.
uterine.Pregnancy
Pregnancy is a major non-pathological cause of an enlarged uterus.
During a gestation, the "enlargement of the uterus" is an indispensable process to guarantee the fetus the space necessary for its growth; if absurdly, in fact, the uterus lacked the ability to swell and enlarge, the future unborn child would not have the opportunity to develop properly.
Did you know that ...
During a pregnancy, a woman's uterus progressively goes from being the size of a clenched fist to being the size of a watermelon.
Uterine Fibroids
Known as leiomyomas or uterine myomas, uterine fibroids are benign tumors of the uterus, which can develop on both the inner and outer sides of the organ.
Uterine fibroids appear as nodular masses of predominantly fibrous tissue, masses whose size can vary from a few millimeters to 15-20 centimeters.
Due to the fibrous component that constitutes them, uterine fibroids can, if they are large, drastically alter the elastic properties of the uterus (N.B: fibrous tissue is similar to scar tissue, which is a not very elastic, retracting tissue).
Uterine fibroids are very common; according to statistics, in fact, at least 80% of women can say, at the age of 50, that they have developed at least one uterine fibroid up to that moment.
A uterine fibroid can be the cause of an enlarged uterus, when it is large or when it appears in multiple modalities (in practical terms, there are many close-together fibroids of medium to small size).
Did you know that ...
In 2016, a medical journal published the case of a patient who, due to a number of uterine fibroids, possessed an enlarged uterus weighing almost 3 kilograms.
Adenomyosis
By the term "adenomyosis" doctors mean a benign (therefore non-cancerous) condition, in which a portion of the endometrium develops, abnormally, in the direction of the myometrium, invading the space reserved for the latter (the "endometrium is the the innermost cellular layer of the uterus as well as the mucous membrane of this organ; the myometrium, on the other hand, is the layer of muscle cells immediately preceding the endometrium).
The precise cause of adenomyosis is still unclear; however, it seems that estrogens play a key role in the development of the condition in question (when the level of these hormones drop with menopause, adenomyosis tends to resolve itself).
Adenomyosis is responsible for an enlarged uterus, because it causes the unexpected development of layers of the endometrium.
Severe adenomyosis can enlarge the uterus 2-3 times its normal size.
Did you know that ...
Adenomyosis produces symptoms very similar to those of a large uterine fibroid. This explains why specific diagnostic investigations are needed to distinguish the two conditions in question.
Perimenopause
Perimenopause is the phase immediately preceding menopause, that is the physiological (therefore natural and non-pathological) period of a woman's life, which marks the end of her fertility as well as the repetition of menstruation.
Perimenopause is the cause of an enlarged uterus, because it is a period of hormonal upheavals, which affect the behavior and the anatomy of the reproductive system.
Did you know that ...
With the onset of menopause, the enlarged uterus condition related to perimenopause tends to resolve spontaneously, with the involved organ returning to its standard size.
Cancer of the Endometrium and Cancer of the Uterine Cervix
Endometrial cancer is a neoplasm resulting from the uncontrolled proliferation of one of the cells that take part in the endometrial tissue.
Also known as cervical cancer, cervical cancer is cancer resulting from the uncontrolled proliferation of one of the cells that make up the aforementioned part of the uterus.
Cancer of the endometrium and cancer of the uterine cervix are responsible for an enlarged uterus, because they cause the formation of an abnormal mass, which increases the total volume of the organ.
Did you know that ...
According to National Cancer Institute,
- The diagnosis of endometrial cancer mainly concerns women between 55 and 64 years of age;
- Endometrial cancer is the sixth most common malignancy in the female population;
- In 2012, endometrial cancer registered 320,000 new cases all over the world.
- Presence of a protruding mass at the level of the lower abdomen;
- Increase in the circumference of the waist;
- Sense of pressure on the pelvis. This symptom can be connected to the uterus pushing on the internal abdominal wall or on the neighboring organs;
- Anemia due to excessive bleeding during menstruation and related symptoms;
- Pain and cramps in the pelvis;
- Constipation;
- Swelling and cramps in the legs
- Backache;
- Urgency to urinate and frequent urination;
- Watery vaginal discharge
- Pain during sexual intercourse (dyspareunia).
Complications
The enlarged uterus can face complications when it is the result of serious pathological conditions and / or not subjected to the right treatments.
Among the possible complications that can affect those suffering from a pathological form of severe or inadequately treated enlarged uterus, include:
- The decline or loss of fertility;
- Problems during a pregnancy;
- Inflammation of the uterus (metritis).
Once the diagnosis has been made, the next step is to understand the cause of the condition; to identify the causal factor at the origin of the enlarged uterus, the doctor may benefit from the investigations indicated above or may need to resort to further more specific tests (magnetic resonance or CT scan of the pelvis).
Researching what causes the enlarged uterus condition is essential for planning the most appropriate treatment.
Pelvic exam
The pelvic exam is an objective examination, during which the doctor (usually a gynecologist) examines manually, first from the outside and then also from the inside (thanks to a speculum), the vagina, the uterus (cervix in particular), the rectum, the ovaries and the pelvis. In other words, it is an analysis of the major pelvic organs.
Lasting a few minutes, the pelvic exam allows a general assessment of a woman's gynecological health.
In the presence of a condition such as an enlarged uterus, the pelvic exam is usually highly significant; only in rare circumstances, in fact, is it insufficient for definitive diagnosis.
Pelvic ultrasound
Pelvic ultrasound is a simple external ultrasound of the lower abdominal area.
Completely painless and without any repercussions on the health of patients (NB: it uses ultrasound and not ionizing radiation), pelvic ultrasound allows a sufficiently detailed study of all pelvic organs, that is: bladder, terminal part of the intestine ( rectum and sigmoid), the prostate-vas deferens-seminal vesicles complex in men, and the uterus-vagina-fallopian tubes-cervix-ovaries complex in women.
In a context of enlarged uterus, pelvic ultrasound represents the diagnostic confirmation examination, which ascertains and enriches the data emerged during the pelvic examination (it could provide information regarding the causes of the condition).
- Whether the enlarged uterus depends on the pregnancy, there is no therapeutic plan, because the condition resolves spontaneously starting after the birth;
- If the "enlarged uterus is related to"adenomyosis, the treatment involves the use of painkillers and contraceptive pills, in less severe cases, and hysterectomy, in the most severe cases (cases in which there is a strong invasion of the myometrium by the endometrium).
