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The uterus is one of the internal organs of the female reproductive system and plays the most important role in human reproduction. It is connected to the vagina and to the fallopian tubes. Compared to other organs, the uterus is a small organ, but also one that has the ability to increase its volume many times over so that the growing fetus can develop freely. Learn about the structure of the uterus and its functions and find out about diseases of the uterus.
The uterus(Latinuterus ) resembles a pear or, as some describe it, a bull's head seen from the front. If you look at the uterus from the side, you would see that the front part of the uterus is flattened and the back part is slightly convex. How big is the uterus?
Usually the uterus is about 7 centimeters long and 4 centimeters wide. Its thickness is 2.5 centimeters, although it may vary slightly depending on the weight of the woman. A properly built and developed uterus weighs about 50-60 g. During pregnancy, the uterus increases its volume many times. Its standard volume is just a few milliliters, but in the ninth month of pregnancy it can increase to as much as 5 liters.
Contents:
- Construction
- Incorrect construction
- Functions
- Diseases
- uterine polyps
- uterine fibroids
- endometritis (endometritis, endometritis)
- cervicitis
- endometrial cancer
Uterus: structure
The uterus is located in the center of the minor pelvic cavity between the anus and the bladder.
There are two surfaces and two edges in the uterus. The anterior surface is flattened and is called the blistering surface, while the convex posterior surface is the intestinal surface. Both surfaces meet on the right and left banks.
From the bottom, the uterus is connected to the vagina, and in its upper part there are the openings of the fallopian tubes, through which it is connected to the ovaries.
The uterus is surrounded by the so-called palpebrates, i.e. the serous membrane that is part of the peritoneum. And they support the uterus with ligaments and fibrous tissues.
During pregnancy, the bottom of the uterus changes its position, rising towards the sternum, but towards the end it falls to the level of the navel.
Anatomically, the uterus is made up of four sections. They are:
- The cervix , mainly made of elastic connective tissue. The mucosa of the cervical canal produces an alkaline discharge that facilitates the penetration of sperm. In a pregnant uterus, the cervix acts as a closing sphincter.
- The isthmus of the uterusis a few millimeters of the cervical canal, below the internal opening.
- The body of the uterus(in which the uterine cavity is located) is composed mainly of smooth muscles. Its inner walls are lined with the lining of the uterine cavity (endometrium), which is essential for the implantation of a fertilized egg. The embryo matures within the uterine cavity, and the fetus later in pregnancy.
- The bottom of the uterus- is the most distant part of the uterine body. The bottom of the uterus connects to the uterine parts of the fallopian tubes.
Uterus: abnormal structure
A properly built and located uterus has a body slightly pointing forward in relation to the pelvic bones (the so-called "fore flexion"). However, it is estimated that in approximately 20% of women the uterine body points backwards. This is called Uterine retroflexion, which until recently was considered a pathological change. Currently, this uterine shape is considered normal. Retracted uterus can make conception difficult or cause painful intercourse. However, for the course of pregnancy, retroflexion does not matter, because as the uterus grows, it finds a convenient place for itself, and the position angle usually changes spontaneously.
The uterus develops during a girl's womb. During this period, various defects in its structure may also develop. The frequency of uterine defects is estimated at 3-4%. It rises to 5-10% in women with recurrent miscarriages and up to 25% in women with late miscarriages and premature births.
Congenital abnormalities of the uterus are classified according to the following groups:
Group I- congenital absence or dysgenesis of the cervix. The only way to have a child for women with this defect is to use the in vitro fertilization procedure.
Group II- unicorned uterus (about 10% of defects). The defect arises as a result of the inhibition of the development of one of the Muller flows. A single fallopian tube is also most often seen because the other, like part of the uterus, has not developed. In some cases, the second part of the uterus is present, but in the rudimentary stage of development (the so-called vestibular horn).
Group III- double uterus (about 8% of defects). It arises in the absence of fusion of Muller wires. It results in a doubling of the body and cervix, and sometimes also the vagina. In women with this condition, there are usually no symptoms to draw attention toabnormalities. Double uterus is conducive to miscarriage or malposition of the fetus and the so-called premature miscarriages (about 2%). A woman with a double uterus may not have any problems with conception and termination of pregnancy (approx. 20%).
Group IV- two-horned uterus. It arises with incomplete fusion of Muller wires. It is characterized by the presence of one cervix and one uterine body with distinct horns. It accounts for about 30% of all uterine defects. The chance of delivering at the scheduled time is greater than 60%, but some doctors believe that the possibility of pregnancy termination by women with this defect is lower.
Group V- septal uterus, resulting from abnormal septal resorption between Muller's ducts. The septum can separate the entire uterus, which worsens the prognosis for pregnancy and termination. In the diagnosis of this defect, three-dimensional transvaginal ultrasound and diagnostic hysteroscopy are of the greatest importance. This defect can be removed by performing an operative hysteroscopy. After the removal of the septum in the uterus, the miscarriage rate drops from 88% to 14%, and the rate of full-term births increases from 3% to 80%.
Group VI- arcuate uterus. It is considered a normal uterine form and is not associated with an increased risk of miscarriage and premature birth.
Uterus: functions
The cervix is the cervix that connects the vagina with the uterine cavity closest to the genital tract. The cervix plays an important role in the fertilization process and in pregnancy. This is the way sperm pass from the vagina deep into the genital tract and this is where their fate is decided.
Depending on the phase of the menstrual cycle, the alkaline discharge produced by the cervical mucosa is either a natural barrier for sperm or a favorable environment conducive to their faster movement. If fertilization occurs, the cervix closes during pregnancy to protect the fetus from external influences.
Behind the cervix there is the isthmus of the uterus, a narrowing of several millimeters that separates the cervix from the uterine body. The body is the largest part of the uterus.
Within it, the uterine cavity is distinguished, which is an important place for the fertilization process and then for the development of the fetus. It is in the mucosa of the uterine cavity that the fertilized egg nests (implementation process).
Then, from the mucosa of the cavity and the so-called chorion, the placenta is formed, i.e. the place where the fetus develops and which supplies the child with oxygen and nutrients. Metabolic products are also carried away through the placenta.
The body of the uterus is builtfrom smooth muscles. Their contractions at the end of pregnancy enable the baby to be born. The bottom is the deepest part of the uterus. Its position helps to determine the age of the fetus.
Uterus: diseases
Like all organs of our body, the uterus is also exposed to many diseases. It is better not to ignore any of them, as they can be infertile and sometimes life-threatening.
Uterine polyps
Uterine polyps are overgrown parts of the mucosa that can develop in various parts of our body, such as the uterus, but also in the nose, ear, esophagus and larynx. The risk of developing uterine polyps is higher with hormonal disorders, especially high estrogen levels.
Polyps do not cause any characteristic or distinct ailments. But, when they grow large, they cause abnormal bleeding during the menstrual cycle and during intercourse. They can also cause prolonged periods.
Polyps can make it difficult to get pregnant or cause a miscarriage. They are treated with hormone therapy or by curettage. Increasingly, a historescope is used to remove polyps, i.e. a speculum ended with a camera, which allows you to see even very small polyps and remove them. Then they are submitted to a histopathological examination to see if they contain cancerous cells. If this is the case, your uterus may need to be removed.
Uterine fibroids
Uterine fibroids are among the most common benign tumors of the female reproductive organ. It is estimated that about 40% of women between 35 and 55 have them.
Many ladies do not know that they have fibroids because they often do not give any symptoms. Complaints arise when the tumors grow larger and cause prolonged and heavy menstrual bleeding or pain.
Myomas are detected during a gynecological examination, intrauterine ultrasound, computed tomography, magnetic resonance imaging or during hysteroscopy, i.e. endoscopy of the uterine cavity.
Myomas are made of smooth muscle, just like the wall of the uterus. They are formed when muscle cells multiply excessively in one area of an organ and form a tumor there, i.e. a myoma. Usually it is a spherical structure located within the uterus.
Depending on the place where they arose, fibroids are distinguished:
- submucosa - bulge into the uterine cavity
- subserial - are under the uterine membrane from the outside
- intramural - located inside the uterine wall
- pedunched - they are movable, like a buttonon the leg and may suggest ovarian tumors
The presence of fibroids can be confirmed by:
- heavy periods
- pains in the lower abdomen or in the area of the back
- upławy
- pain during sexual intercourse
- feeling of fullness or heaviness in the lower abdomen, enlargement of the abdominal circumference
- frequent urination
- persistent constipation
- fever with abdominal pains
- strong contractions
- anemia
- bleeding between periods
- difficulty getting pregnant
The decision to start treatment is made by a doctor who takes into account the size and number of tumors, their location, growth rate, symptoms and ailments of the patient, her age, reproductive plans, expectations and preferences.
Small changes that do not cause any ailments are only subject to observation. It is then necessary to perform vaginal ultrasound every six months.
Treatment is necessary when fibroids are large, cause heavy bleeding, lead to anemia and are painful. Rapid medical intervention is also essential when they are growing rapidly. It is then that there is a suspicion that the myoma has turned into a sarcoma, i.e. a malignant tumor. Medical statistics report that this happens less than 1 in 100 fibroids.
Endometritis (endometritis, endometritis)
Endometritis is most often the result of improper curettage or a complication after childbirth. This is the result of bacteria being transferred from the vagina to the uterus. Inflammation manifests as spotting, bleeding, and pain in the lower abdomen. Sometimes there is an elevated temperature. Untreated endometritis may result in the formation of adhesions, which may end in infertility.
Cervicitis
Cervicitis is a common condition. According to estimated data, it affects about 50% of women. Most often it is caused by an infection. The disease has two varieties: acute and chronic.
Acute cervicitis is usually caused by a sexually transmitted disease such as chlamydiosis, gonorrhea, genital herpes, and the human papillomavirus (HPV). It may be related to an allergy to, for example, intimate hygiene products or spermicides.
Chronic cervicitis is a common side effect of labor.
Symptoms of cervicitis can be:
- abnormal vaginal bleeding
- vaginal pain
- pain during intercourse
- back pain
- feeling of pressure in the pelvis
- odorless white or gray vaginal discharge
Cervicitis is usually treated with antibiotics. If left untreated, it can lead to serious complications, including infertility.
Cervical cancer
The development of cervical cancer is favored by infection with the human papillomavirus (HPV). Most women find out about their condition way too late, although the cancer is easily detected by a normal Pap smear. Early detection of cancer enables a non-invasive procedure, after which complications are rare.
In Poland, only 40% of women can be cured because they see a doctor with an advanced form of cancer.
Cervical cancer symptoms can be:
- irregular menstrual cycles
- bleeding after intercourse
- postmenopausal bleeding
- foul-smelling discharge
- constipation
- pollakiuria
- pain in the lower abdomen and lumbar region
Endometrial cancer
The causes of endometrial cancer are not fully understood, but it is known that detected early is completely curable. That is why every woman should visit a gynecologist regularly and have a cytology and transvaginal ultrasound.
Women who have not yet given birth, women over 40, women who are overweight in the perimenopause or during the menopause are particularly vulnerable to uterine cancer.
Endometrial cancer can manifest as:
- vaginal bleeding when it should not occur (e.g. between periods or after menopause)
- brown vaginal discharge
- pain in the lower abdomen
- pain and bleeding during intercourse
- general weakness
- losing weight for no apparent reason.
Read also other articles about the uterus:
- Uterine curettage: what is it?
- Uterine contractions: what diseases do they indicate?
- IUD: how does this method of contraception work?
- Uterine varices: causes and symptoms
- Uterine defect and pregnancy: will it be at risk?
- Uterine prolapse: causes, symptoms, treatment
Anna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice "Crystal Pen" ina nationwide competition for journalists promoting he alth and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.
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