Sexual Health > Uterine Health > Overview

The Facts About Uterine Health

Keeping the uterus in good shape is key to reproductive and overall health.

The female reproductive system is drawn in white on a pink background.
Illustration by: Illustration by Tré Carden

The uterus is a pear-shaped organ located between a woman's rectum and bladder. Sometimes referred to as the womb, it's where a fetus grows when a woman becomes pregnant.

You've likely heard the uterus referred to by the sections that comprise it: the cervix, the corpus and the fundus. The cervix is the narrow, lower section of the womb that sits at the top end of the vagina. The corpus refers to the broad middle section of the uterus, while the fundus is the dome-shaped top section of the organ.

Of course, keeping your reproductive health in top shape is important. Here's a breakdown of some basic principles of your uterus and common conditions to monitor.

Characteristics of a healthy uterus

While we may not give a lot of thought to the uterus unless we're pregnant or menstruating, it serves a core purpose in our reproductive system. Built with thick muscular walls and measuring, on average, 3 inches long and about 2.5 inches wide, the uterus is an impressive organ. It's often compared to an upside-down pear for its shape and size. When a woman becomes pregnant, the uterus can stretch to the size of a watermelon as it serves as the shelter for a growing fetus.

The uterus serves multiple reproductive purposes, one of which is menstruation. Menstruation occurs when a woman of reproductive age goes through ovulation, a term that refers to the monthly release of an egg from the ovaries. Each month, the lining of the uterus grows thicker to prepare for pregnancy in coordination with ovulation.

When the egg produced during ovulation goes unfertilized, the uterus sheds its lining, causing the monthly bleeding we know as a period. When an egg is fertilized, it is implanted into the lining of the uterus, which provides nourishment to the embryo until it becomes a fetus and later becomes ready for birth.

Uterine fibroids and endometrial cancer

It's important to be familiar with the signs of uterine complications so you can alert your doctor right away if you experience any symptoms or notice anything out of the ordinary.

Fibroids

Uterine fibroids are one of the more common complications of uterine health. These fibroids usually appear during childbearing years and are considered noncancerous growths of the uterus. According to the Cleveland Clinic, up to 80 percent of women have uterine fibroids at some point in their lives. The good news is that uterine fibroids do not cause an increased risk of uterine cancer and rarely ever become cancerous.

Some women have a single fibroid, while others may have multiple. Fibroids also vary in size, with some of them being too small to see with the human eye, while others appear as larger masses. In rare cases, fibroids can be so numerous and large that they expand the uterus to the point that it touches the rib cage.

Often, women aren't even aware they have uterine fibroids because they regularly come without symptoms. In these cases, fibroids are sometimes found by chance during a prenatal ultrasound or pelvic exam. Fibroids can cause some symptoms, depending largely on the location, size and number of fibroids that are present. Some women experience heavy menstrual bleeding, periods that last longer than a week, pelvic pain or pressure, lower back pain, problems urinating or constipation, and find out they have fibroids after following up with their doctor.

There are rare cases in which a fibroid will lead to acute pain. This happens only when the fibroid outgrows the supply of blood and starts to die as a result. If you experience any symptoms of uterine fibroids, be sure to consult with your doctor right away.

Endometrial cancer

Another major complication to uterine health is endometrial cancer, a cancer that starts in the layer of cells that line the uterus. Medical experts have found that another type of cancer called uterine sarcoma can also occur in the uterus, though it's much less common than endometrial cancer.

While the cause of endometrial cancer isn't entirely known, some risk factors for it that have been identified include starting menstruation at an early age, experiencing menopause at a late age, changes in the balance of female hormones, obesity, older age, diabetes, hypertension, never having been pregnant and hormone therapy for breast cancer. Women who have untreated polycystic ovary syndrome (PCOS) have a higher risk of endometrial cancer later in life.

Symptoms of endometrial cancer include pelvic pain, vaginal bleeding in between periods and bleeding after menopause. Fortunately, endometrial cancer is often found and treated early because of the abnormal vaginal bleeding it causes. When it's found early, endometrial cancer is typically able to be cured by the removal of the uterus.

Other complications to uterine health

Other complications to uterine health include conditions such as uterine prolapse, endometriosis and structural anomalies.

Uterine prolapse

Uterine prolapse occurs when a woman's pelvic floor muscles and ligaments stretch out and weaken to the point that they no longer provide adequate support to the uterus. When this happens, the uterus sags down into the vagina.

Uterine prolapse can happen in women of any age, though it most often affects women who have already gone through menopause and have had at least one vaginal delivery.

To maintain your uterine health, it's important to understand your anatomy.

In mild cases of uterine prolapse, treatment usually isn't necessary. Mild cases often don't cause any signs or symptoms at all. Moderate and severe cases of uterine prolapse show symptoms and sometimes require treatment by surgery (usually vaginal hysterectomy) or with the use of a vaginal pessary, which is a plastic or rubber ring that is inserted into the vagina to support any bulging tissues.

Symptoms of moderate and severe uterine prolapse include a heavy and pulling sensation in the pelvis as well as urinary and bowel issues. A woman with moderate or severe uterine prolapse may feel like something is falling out of her vagina or as if the tissue of her vagina is abnormally loose. In extreme cases, the condition can even cause part of the uterus to protrude from the vagina. If you experience any of these symptoms, you should contact your doctor right away.

Endometriosis

Endometriosis can be a particularly painful complication of uterine health. This is a disorder in which endometrial tissue grows outside of the uterus. During menstruation, the endometrial tissue that has spread outside of the uterus acts just as the endometrium does in the uterus, breaking down and shedding. Unlike the lining of the uterus, this tissue does not have a way to exit the body and gets trapped. When this happens, cysts and scars can form along with adhesions, which are fibrous tissue that can cause pelvic tissues and organs to stick together.

Women with endometriosis often experience severe pain, especially during their periods. They may also face fertility issues, which can sometimes be treated. If you experience abnormal bleeding during your period or pelvic pain, be sure to let your doctor know.

Structural anomalies

When talking about uterine health, we should remember that not every woman's uterus looks like the photograph you would find in an anatomy textbook. According to experts, congenital uterine anomalies occur in less than 5 percent of all women, but have been detected in nearly a quarter of women who have had miscarriages or premature deliveries.

The most common uterine anomaly is a septate uterus, which occurs when the uterus looks normal on the outside, but the uterine chamber is divided into two chambers by a fibrous or muscular septum on the inside. Another uterine anomaly is known as a bicornuate uterus, which also involves two separate chambers on the inside of the uterine cavity, but a bicornuate uterus is abnormally shaped on the outside, too. Other structural anomalies involve the development of two uteruses, a condition known as uterus didelphys.

Women with congenital structural issues often experience no symptoms or fertility issues. However, in some cases, structural problems can lead to pain or miscarriage. The only way to find out if you have a structurally atypical uterus is through an imaging test, so some women do not find out until they become pregnant.

Maintaining uterine health

To maintain your uterine health, it's important to understand your anatomy, be aware of symptoms to look out for and, most important, attend regular gynecological health exams.

Most uterine health complications involve abnormal vaginal bleeding as well as persistent pelvic pain and pressure. If you experience these symptoms or any other symptoms, such as urinary problems, constipation or abdominal pain, be sure to schedule a doctor's visit right away.

Ensuring that you maintain your uterine health will help your reproductive health and overall health.