Uterus 101: Functions, Common Disorders & Essential Diagnostic Tests

What Is the Uterus?

The uterus, also known as the womb, is a hollow, pear-shaped organ situated in the female pelvis. As the central organ of the reproductive system, the uterus is where a fertilised egg implants and develops during pregnancy. When pregnancy doesn't occur, the uterus sheds its inner lining each month during menstruation. The uterus is incredibly resilient, capable of expanding to accommodate a growing foetus and then contracting forcefully during labour to help push the baby out.

Functions of the Uterus

The primary uterus function is to support reproductive processes, including:

• Shedding the uterine lining (endometrium) monthly if pregnancy doesn't occur
• Expanding to accommodate the growing foetus
• Contracting during labour to facilitate childbirth
• Secreting hormones like prostaglandins and prolactin

The uterus also helps maintain the position of other pelvic organs like the bladder and rectum.

What Happens to Your Uterus During Menstruation?

Each month, hormonal changes trigger the uterus to prepare for a potential pregnancy by thickening its inner lining, the endometrium. If no fertilisation occurs, oestrogen and progesterone levels drop, signalling the uterus to shed this lining. The endometrium breaks down and is expelled through the vagina as menstrual blood, along with tiny amounts of tissue. This process, known as menstruation or a period, typically lasts 3-7 days and recurs every 21-35 days in healthy cycles.

What Happens to Your Uterus During Pregnancy?

When an egg is fertilised, it implants into the uterus lining, triggering a cascade of changes. The uterus begins to expand to accommodate the developing embryo, which is nourished by the thickened endometrium. As pregnancy progresses, the uterus stretches significantly, eventually reaching the size of a watermelon by the third trimester. The muscular walls also strengthen to support the growing baby. During labour, intense uterine contractions help dilate the cervix and push the baby through the birth canal.

Anatomy of the Uterus

The uterus anatomy consists of three main regions:

• Fundus: The rounded upper portion of the uterus
• Corpus (body): The main triangular-shaped part where a fertilised egg implants
• Cervix: The narrow, cylindrical lower portion that connects to the vagina

The uterine wall is composed of three layers:

• Endometrium: The inner mucosal lining that thickens and sheds monthly
• Myometrium: The thick, muscular middle layer responsible for contractions
• Perimetrium: The thin outer serous layer

Two fallopian tubes extend from the upper uterus to the ovaries on either side.

Where Is the Uterus In Your Body?

The uterus is located centrally in the pelvis, posterior to the bladder and anterior to the rectum. It is held in place by ligaments and connective tissues that attach it to the pelvic sidewalls, sacrum, and pelvis floor.

What is Your Uterus Made Of?

The uterus is primarily composed of smooth muscle tissue (myometrium) that allows it to stretch and contract. The inner cavity is lined with a specialised mucous membrane called the endometrium, which responds to hormonal changes throughout the menstrual cycle. The outer perimetrium is a thin serous membrane that covers the uterus and part of the broad ligaments.

How Big is Your Uterus During Pregnancy?

During pregnancy, the uterus undergoes an incredible transformation in size. From about the dimensions of a pear pre-pregnancy, the uterus expands to the size of a watermelon by the third trimester. This gradual growth accommodates the developing foetus, placenta, and amniotic fluid. By 20 weeks, the uterus reaches the level of the belly button, and by 36 weeks, it extends up to the bottom of the rib cage.

What are the Positions of the Uterus?

The uterus can be positioned differently in each woman. In most cases, it tips slightly forward towards the bladder (anteverted). However, it may also be positioned straight up and down (midline) or tilted backwards toward the rectum (retroverted). These variations are usually normal and don't affect uterine function.

Common Uterine Disorders

Several conditions can affect the uterus, causing symptoms like abnormal bleeding, pain, and fertility issues. Some common uterine disorders include:

1. Uterine Fibroids

Uterine fibroids are noncancerous growths that develop within the uterine wall. They can range in size from tiny seedlings to large masses that distort the uterus. Symptoms may include heavy menstrual bleeding, pelvic pain, frequent urination, and fertility issues. Treatment options depend on the size, location, and symptoms of the fibroids.

2. Endometriosis

Endometriosis occurs when tissue similar to the uterus lining grows outside the uterus, often on the ovaries, fallopian tubes, and other pelvic structures. This misplaced tissue responds to hormonal changes, causing pain, inflammation, and scar tissue. Endometriosis can lead to painful periods, chronic pelvic pain, pain during intercourse, and fertility problems.

3. PCOS (Polycystic Ovary Syndrome)

PCOS is a hormonal disorder characterised by irregular periods, high levels of androgens, and multiple small cysts on the ovaries. This imbalance disrupts ovulation and can cause issues like acne, weight gain, excess hair growth, and fertility challenges. PCOS is also associated with insulin resistance and an increased risk of diabetes and heart disease.

4. Uterine Cancer

Uterine cancer, also known as endometrial cancer, starts in the inner lining of the uterus (endometrium). It is the most common gynaecologic cancer, typically affecting postmenopausal women. Abnormal vaginal bleeding is the most frequent symptom. Other signs may include pelvic pain, unexplained weight loss, and difficult or painful urination. Early detection and treatment are crucial for the best outcomes.

Symptoms of Uterine Problems to Watch Out For

While each condition has its specific symptoms, there are some general warning signs of uterine disorders to be aware of:

• Abnormal vaginal bleeding between periods or after menopause
• Excessively heavy or prolonged menstrual bleeding
• Pelvic pain or pressure that persists or worsens over time
• Pain during intercourse or urination
• Difficulty getting pregnant
• Unusual vaginal discharge

If you experience any of these symptoms, it's essential to consult your doctor for an accurate diagnosis and appropriate treatment.

What are the Types of Uterine Abnormalities?

Apart from the disorders mentioned above, the uterus can also have structural abnormalities:

• Congenital anomalies: Uterine malformations present from birth, such as a septate, bicornuate, or unicornuate uterus
• Polyps: Fingerlike growths attached to the inner uterine wall
• Adenomyosis: When endometrial tissue grows into the muscular uterine wall, causing enlargement and pain
• Endometrial hyperplasia: Thickening of the uterine lining, often due to excess estrogen

These abnormalities can impact fertility, pregnancy outcomes, and overall uterine health.

Essential Diagnostic Tests for Uterine Health

Regular gynaecologic check-ups and screening tests are vital for catching uterine disorders early. Some essential uterus diagnostic tests include:

• Pelvic exam: Assesses the uterus for size, shape, and any abnormalities
• Ultrasound: Uses sound waves to visualise the uterus and detect fibroids, polyps, or other growths
• Hysteroscopy: Involves inserting a thin, lighted scope through the cervix to examine the uterine cavity
• Endometrial biopsy: Takes a small tissue sample from the uterine lining to check for cancer or precancerous changes
• MRI: Provides detailed images of the uterus and surrounding structures

Your doctor will recommend the appropriate tests based on your symptoms, age, and medical history.

What Treatments are Used for Uterus Conditions?

Treatment for uterine disorders depends on the specific condition, its severity, and the woman's age and reproductive goals. Options may include:

• Medications: Hormonal therapies, pain relievers, or antibiotics to manage symptoms
• Minimally invasive procedures: Uterine artery embolization, endometrial ablation, or hysteroscopic removal of fibroids or polyps
• Surgery: Myomectomy to remove fibroids, hysterectomy (removal of the uterus) for severe cases, or resection of endometriosis lesions
• Fertility treatments: Ovulation induction, intrauterine insemination (IUI), or in vitro fertilisation (IVF) for women with PCOS or other fertility issues

Your doctor will work with you to develop a personalised treatment plan that addresses your unique needs and preferences.

How to Maintain Uterine Health?

While some uterine disorders can't be prevented, there are steps you can take to promote overall uterine health:

• Maintain a healthy weight through a balanced diet and regular exercise
• Practice safe sex to reduce the risk of sexually transmitted infections
• Quit smoking, as it can increase the risk of cervical and uterine cancers
• Stay up to date with routine gynecologic check-ups and screenings
• Report any unusual symptoms, such as abnormal bleeding or pelvic pain, to your doctor promptly
• Consider hormonal birth control options, which can help regulate periods and reduce the risk of certain cancers

By prioritising uterine health, you can catch potential issues early and ensure the best possible outcomes.

Conclusion

The uterus is a remarkable organ that plays a vital role in female reproductive health. By understanding its functions, recognising signs of common disorders, and undergoing essential diagnostic tests, women can take proactive steps to maintain optimal uterine health. If you have concerns about your uterus health or are due for a check-up, don't hesitate to schedule an appointment with your doctor.

At Metropolis Healthcare, we are committed to providing comprehensive, patient-centric diagnostic services to support women's health. Our team of experienced phlebotomists offers convenient at-home sample collection for uterus diagnostic tests, ensuring your comfort and privacy. With our state-of-the-art laboratories and rapid turnaround times, you can trust us to deliver accurate, reliable results to guide your healthcare decisions.

FAQs About Uterus and Related Disorders

How big is your uterus?

The non-pregnant uterus is about the size of a closed fist, measuring approximately 3-4 inches long and 2-3 inches wide. However, during pregnancy, the uterus can expand up to 500 times its original size to accommodate the growing foetus.

What is the removal of your uterus called?

The surgical removal of the uterus is called a hysterectomy. This procedure may be recommended for severe cases of uterine fibroids, endometriosis, uterine prolapse, or cancer.

What is the primary function of the uterus?

The main uterus function is to house and nourish a developing foetus during pregnancy. When fertilisation occurs, the uterus provides a nurturing environment for the embryo to implant, grow, and develop until birth.

Can uterine disorders affect fertility?

Yes, certain uterine disorders like fibroids, endometriosis, PCOS, and uterine abnormalities can impact fertility. These conditions may interfere with ovulation, fertilisation, or implantation, making it harder to conceive.

How can I keep my uterus healthy?

To maintain a healthy uterus, prioritise regular gynaecologic check-ups, practise safe sex, maintain a healthy weight, and avoid smoking. Stay alert for any unusual symptoms like abnormal bleeding or pelvic pain, and report them to your doctor promptly.