Enlarged Uterus (Adenomyosis) Vs. Normal Uterus: Overview

Key Takeaways

• Common causes include uterine fibroids, adenomyosis in uterus, pregnancy, Polycystic Ovarian Syndrome (PCOS), ovarian cysts, and uterine cancer.

• Symptoms include pelvic pressure, bloating, prolonged and heavy menstrual bleeding, severe menstrual cramps, frequent urination, constipation, back pain, discomfort during intercourse, and unexplained weight gain.

• Diagnosis involves a pelvic examination, transvaginal or transrectal ultrasound, and MRI for accurate confirmation.

• Treatments include anti-inflammatory drugs, birth control pills, minimally invasive surgeries, hysterectomy in severe cases, and uterine fibroid embolisation.

• Annual physical and pelvic examinations are essential for early detection and preventing complications.

As a woman, you may have wondered at some point about the size of your uterus and what is the healthy or normal uterus size. While the uterus is a small organ, it can vary in size from person to person. However, when the uterus becomes enlarged, it can cause discomfort and may even impact your fertility. If you’re concerned about an enlarged uterus, you’re not alone. Many women experience this condition, which can be caused by various factors such as uterine fibroids, adenomyosis in uterus, or enlarged uterus during pregnancy.

In this article, we’ll explore the differences between an enlarged uterus vs normal uterus, including the causes, symptoms, and available treatments. By understanding what’s the normal uterus size and what’s not, you can take steps to protect your reproductive health and seek the care you need. So, let’s dive in and learn more about this important topic.

What is the Normal Size of the Uterus in Cm?

The uterus, also known as the womb, is a hollow, muscular organ that plays a crucial role in the female reproductive system. In a healthy, non-pregnant woman, the normal uterus size varies depending on factors such as age, parity (number of pregnancies), and hormonal changes. On average, a normal uterus measures:

• Length: 7.0-9.0 cm

• Width: 3-5 cm

• Thickness: 2.5-4.0 cm

However, these measurements can differ slightly from person to person. The uterus tends to be smaller in women who have never been pregnant and larger in those who have given birth. Additionally, the uterus may enlarge during certain phases of the menstrual cycle due to hormonal fluctuations.

A slight variation in uterine size is not necessarily a cause for concern. However, if the uterus appears significantly larger or smaller than the expected range, it may warrant further investigation by a doctor.

Should I Be Worried About an Enlarged Uterus?

An enlarged uterus, also known as a bulky uterus, can be a cause for concern in some cases, depending on the underlying reason and the severity of the enlargement. While some causes of uterine enlargement, such as an enlarged uterus during pregnancy or benign conditions like fibroids, may not require immediate medical attention, others can have more serious implications.

A bulky uterus in early pregnancy can occur due to various factors such as fibroids or adenomyosis. While the uterus naturally expands during pregnancy to accommodate the developing foetus, an excessively large uterus may lead to complications like infertility, miscarriage, or preterm labour. Regular medical evaluations are essential to monitor the reasons for uterus swelling and manage any potential risks effectively.

Enlarged Uterus Symptoms

Women with an enlarged uterus may experience various symptoms, depending on the underlying cause. Common signs and symptoms of enlarged uterus include:

• Heavy or prolonged menstrual bleeding

• Pelvic pain or pressure

• Frequent urination or difficulty emptying the bladder

• Constipation or bloating

• Pain during intercourse

• Infertility or recurrent miscarriages

These symptoms can significantly impact a woman’s quality of life, leading to discomfort, fatigue, and emotional distress. If you experience any of these symptoms, it’s essential to consult your healthcare provider for a proper evaluation and treatment plan. However, it is important to note that some women with an enlarged uterus may not experience any symptoms at all.

Enlarged Uterus vs Normal Uterus

When comparing an enlarged uterus vs normal uterus, there are several key differences to consider:

There are numerous enlarged uterus causes, ranging from benign conditions to more serious health concerns. In contrast, a normal uterus typically does not present with any symptoms and maintains a consistent size and shape throughout a woman’s reproductive years, except during pregnancy.

Enlarged Uterus Causes

There are several potential causes of an enlarged uterus, including:

Fibroids

Fibroids are non-cancerous growths that develop within the uterine walls. They are one of the most common causes of an enlarged uterus from fibroids. Fibroids can range in size from small seedlings to large masses that distort the shape of the uterus. There are three main types of fibroids:

1. Subserosal fibroids: These grow on the outer surface of the uterus and can cause abdominal enlargement.

2. Intramural fibroids: These develop within the muscular wall of the uterus and can cause the uterus to expand.

3. Submucosal fibroids: These grow in the inner lining of the uterus and can lead to heavy menstrual bleeding.

Adenomyosis

Adenomyosis is a disorder in which the endometrial tissue that normally borders the uterus develops into the uterine muscle wall. This might cause the uterus to expand, resulting in painful and heavy periods. Adenomyosis in the uterus can be difficult to diagnose, as its symptoms often mimic those of other conditions like fibroids.

Other Causes

Other potential causes of an enlarged uterus include:

• Pregnancy

• Hormonal imbalances, such as oestrogen dominance

• Genetic factors

• Pelvic inflammatory disease

• Uterine cancer (rare)

Tests to Detect Enlarged Uterus

To diagnose an enlarged uterus and determine its underlying cause, your doctor may recommend one or more of the following tests:

Diagnostic Imaging Techniques

• Ultrasound: This non-invasive test uses sound waves to create images of the uterus and can help identify abnormalities like fibroids or adenomyosis. An adenomyosis in ultrasound may show a thickened, heterogeneous uterine wall.

• MRI: In addition to offering detailed pictures of the uterus, MRIs can assist in distinguishing between different reasons for an enlarged uterus.

• CT scan: Although less commonly used for uterine imaging, a CT scan may be ordered if other conditions are suspected.

Clinical Examinations

• Pelvic exam: During a pelvic exam, your doctor will manually feel your uterus to assess its size, shape, and texture.

• Medical history: Your doctor will ask about your symptoms, menstrual history, and any relevant family history to help determine the potential cause of your enlarged uterus.

Enlarged Uterus Treatment

Treatment options for an enlarged uterus depend on the underlying cause, severity of symptoms, and individual patient factors. Some common enlarged uterus treatment approaches include:

Medical Treatments

• Hormonal therapies: Birth control pills, progesterone injections, or hormonal intrauterine devices (IUDs) can help regulate menstrual bleeding and reduce the size of fibroids or adenomyosis.

• Pain management: Prescription drugs or over-the-counter painkillers like ibuprofen can help reduce the pain and discomfort brought on by an enlarged uterus.

Surgical and Minimally Invasive Procedures

• Uterine fibroid embolisation (UFE): The goal of uterine fibroid embolisation (UFE), a minimally invasive surgery, is to reduce fibroids by cutting off their blood supply.

• Myomectomy: For women who want to preserve their fertility, this surgical technique removes fibroids while leaving the uterus intact.

• Hysterectomy: A hysterectomy, or surgical removal of the uterus, may be advised in extreme circumstances or when no other treatments work.

• Surgery for adenomyosis: For women with severe adenomyosis, a hysterectomy may be the only definitive treatment. However, less invasive options like endometrial ablation or uterine artery embolisation may be considered in some cases.

Lifestyle Changes

• Dietary modifications: Eating a balanced diet rich in fruits, vegetables, and whole grains may help reduce inflammation and manage symptoms.

• Exercise: Regular physical activity can help maintain a healthy weight, reduce stress, and alleviate pain and discomfort.

• Stress management: Techniques like deep breathing, meditation, or yoga can help manage stress and promote overall well-being.

Preventive Measures and Early Detection

While not all causes of an enlarged uterus can be prevented, there are steps you can take to promote early detection and overall uterine health:

• Schedule regular gynecological check-ups: Annual exams can help your healthcare provider monitor your uterine health and identify any changes or abnormalities early on.

• Be aware of your body: Pay attention to any changes in your menstrual cycle, pain levels, or other symptoms, and report them to your doctor promptly.

• Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and managing stress can contribute to overall reproductive health.

• Consider genetic testing: If you have a family history of uterine conditions like fibroids or cancer, genetic testing may help assess your risk and guide preventive strategies.

By staying proactive and informed about your uterine health, you can work with your doctor to detect and address any issues as early as possible.

Endometrial Cancer and Uterine Enlargement

In rare cases, an enlarged uterus may be a sign of endometrial cancer, which is cancer that develops in the lining of the uterus. Some factors that can increase the risk of endometrial cancer include:

• Obesity

• Hormonal imbalances (especially oestrogen dominance)

• Family history of endometrial or colorectal cancer

• Older age (most cases occur in women over 55)

To screen for endometrial cancer, your doctor may recommend:

• Pelvic exam: To check for any abnormalities in the uterus or ovaries

• Transvaginal ultrasound: To assess the thickness of the endometrial lining and identify any suspicious masses

• Endometrial biopsy: To remove a small sample of endometrial tissue for laboratory analysis.

If endometrial cancer is suspected, tests like a hysteroscopy or dilation and curettage (D&C) may be ordered. Depending on the cancer’s stage and grade, endometrial cancer treatment options can include hormone therapy, chemotherapy, radiation therapy, or surgery.