The uterus in a nutshell – take it and examine it!

What does the uterus look like?

For some, the uterus looks like an inverted and flattened pear, while others see it more like a bull's skull. However, if you look at it from the side, you can see that the front wall (vesical surface) is flattened, while the back wall, which is the intestinal surface, is convex.

The wall of the uterus is made up of three membranes:

• serous membrane (serosal membrane) – a membrane that is part of the peritoneum,
• muscularis musculature (also known as uterine muscle) – the thickest of the walls, made of smooth muscles,
• endometrium – lying directly on the muscular layer; the mucosal layer is covered by cylindrical epithelium; it is in this part of the uterine cavity that the egg cell nests after fertilization.

Uterus – anatomical structure

Cervix

The cervix connects the uterus to the vagina. It is made of connective tissue, as well as muscle fibers (running in different directions), which allow it to open during labor. Additionally, it has its own mucous membrane – the endocervix.

The mucous membrane of the cervical canal produces what is known as cervical mucus, the viscosity and density of which change depending on the phase of the menstrual cycle. The cervix plays an important role in the fertilization process – it is through it that sperm pass from the vagina to the fallopian tubes and ovaries.

Isthmus of the uterus

A short, several millimeter-long part that constitutes the passage of the uterine body into the cervical canal. During pregnancy (around the 12th week), the uterine isthmus widens.

Body of the uterus

It is its thickest and widest part. The body of the uterus is made up mainly of smooth muscle, and its inner walls form the uterine cavity , which is lined with the endometrium (uterine mucosa). The uterine cavity is the place where the fertilized egg is implanted.

Fundus of the uterus

This is the most distant part of the uterine body, or rather its tip - the fundus of the uterus is its upper element.

Position of the uterus

The uterus is located in the middle of the pelvis, between the urinary bladder and the rectum. At the bottom, the uterus is connected to the vagina, while at the top are the openings of the fallopian tubes, which connect it through fimbriae to the ovaries.

Uterus – functions

The uterus is a key part of the female reproductive system.

• It enables the development of the fetus and protects it from the moment of fertilization until birth;
• the endometrium and the chorion form the placenta, which provides the nutrients necessary for the development of the fetus during pregnancy and also receives metabolic products;
• The muscles of the uterus cause contractions during labor, thus facilitating the expulsion of the baby.

If fertilization does not occur, additional layers of the endometrium are shed, causing menstrual vaginal bleeding.

The uterus during pregnancy – what does it look like? Where is it located?

The uterus is an extremely flexible organ that adapts to the size of the baby during pregnancy .

During pregnancy, the uterus changes and grows significantly. Its volume can increase from just a few milliliters to as much as 5 liters!

During the development of the fetus, the uterus enlarges and its fundus changes its position and gradually rises towards the sternum - at the end of pregnancy it is located in the area of ​​the umbilicus, and a few days after birth - again above the pubic symphysis.

During pregnancy, the cervix becomes sealed with thick mucus (plugs), which protects the fetus from external factors and is intended to prevent premature birth. Over time, the cervix gradually softens, and just before birth, it shortens and opens.

Retroverted uterus – is it dangerous?

Relax – the uterus is generally slightly curved. If it tilts forward, towards the bladder, we call it anteversion. Correspondingly, if its body turns towards the spine, this condition is called retroversion.

It is estimated that one in five people with this organ has it. Retroverted uterus can be congenital or acquired - as a symptom of endometriosis, salpingitis or uterine fibroids. It is important not to treat retroverted uterus as a disease or pathology in itself. If it is diagnosed, no treatment is undertaken.

Retroverted uterus does not cause problems with fertilization or with carrying a pregnancy to term. The uterus, as it grows, finds a convenient place and angle of position on its own - it makes every effort to ensure that the fetus develops as best and most effectively as possible ;)

Congenital defects of the uterus

In contrast to anteversion and retroversion of the uterus are congenital defects that can cause problems with getting pregnant. The classification was made by the European Society of Human Reproduction and Embryology and the European Society of Gynaecological Endoscopy. They distinguished 7 groups of such defects*, and the most frequently diagnosed and treated is the so-called group V, or uterus with a septum. This developmental defect consists of the failure to close the gap between the paramesonephric ducts that connect during fetal life. In most cases, the applied (and sufficient) treatment is hysteroscopy, but sometimes, in the case of additional, other abnormalities, the procedure is extended to laparoscopy.

* Material for those interested! :) In the sources I'm posting an article where you will find information on what each group looks like and what its characteristics are.

The most common diseases of the uterus

Gynecological ailments are still quite an embarrassing topic for many people. A mixture of embarrassment and fear often discourages from tests, which sometimes determine the diagnosis and appropriate therapy at the last minute.

The most commonly diagnosed uterine disorders include:

Uterine fibroids

These are benign tumors that arise from the proliferation of muscle cells in the uterus, usually in the body. In most cases, uterine fibroids do not cause any symptoms – any symptoms depend on the specific location of the lesions.

We distinguish fibroids:

• subserosal – located between the serosa and the muscular layer, they are most often lesions protruding “outside” the uterus;
• intramural – located inside the muscular membrane;
• submucosal – arising between the muscular and mucosal membranes, often responsible for heavy periods or intermenstrual bleeding.

Sometimes fibroids are accompanied by symptoms such as:

• heavy periods,
• lower abdominal pain,
• intermenstrual bleeding,
• frequent urge to pass urine or rectum (especially in the case of large lesions).

After diagnosing fibroids, it is most often recommended to observe them in order to monitor their potential growth. Surgical removal is necessary in the case of symptomatic fibroids. A less invasive method (for people who are afraid of surgery and general anesthesia) is embolization . It consists of closing the vessels supplying blood to the fibroid through the femoral artery. Qualification for the procedure itself is extremely important, because it is necessary to exclude other pathologies of the reproductive system that may be a contraindication to embolization.

Cervical polyps

In the vast majority of cases, they are benign (in a very small percentage of diagnosed changes, cancer cells are detected). Polyps usually do not cause any symptoms, but in some cases they can cause intermenstrual bleeding, spotting after intercourse, or brownish-yellow vaginal discharge.

Treatment of polyps is pharmacological or surgical.

Endometrial polyp

It arises from an overgrown fragment of the uterine mucosa and takes the form of a club-shaped nodule (or nodules).

The frequency of such changes increases with age. Detection of a polyp in the postmenopausal period is associated with a greater risk of the change becoming cancerous.

Most polyps do not cause any symptoms, but when they do occur, they are usually intermenstrual bleeding or heavy, heavy periods.

Endometriosis

Endometriosis is an immune-mediated disease that is caused by the presence of endometrial cells outside the uterus.

In the case of endometriosis, efficient and quick diagnosis is extremely important , but it is often difficult due to the multiple symptoms – the symptoms of endometriosis are often confused with other diseases, such as inflammation of the intestines or pelvic organs.

Endometriosis can make it difficult to get pregnant, and in people with very advanced disease, it may be necessary to use assisted reproductive techniques.

Endometriosis treatment is a complex process – hormonal pharmacotherapy is used, and lesions can also be removed laparoscopically. An extremely important form of complementary treatment in the course of endometriosis is diet . Its proper selection can bring relief from inflammation and reduce the level of estrogens responsible for their formation.

Cervical cancer

This cancer is one of the most frequently diagnosed diseases of this type in women. The main cause of cervical cancer is infection with the human papillomavirus (HPV, and especially its highly carcinogenic varieties HPV16 and HPV18). In the initial stage, the disease usually does not cause any symptoms - they appear only at significant stages of its advancement. The asymptomatic nature of the disease is a silent "trap" that we can avoid thanks to preventive tests.

Symptoms of the disease include: bleeding (between periods, after intercourse, after a gynecological examination and after menopause), bloody vaginal discharge, pain in the lower abdomen and lumbar region, as well as difficulty urinating.

Treatment depends on the stage of the cancer, the age of the person and the general state of health. In practice, the uterus is always removed (sometimes with the adnexa) – this procedure is called a hysterectomy . In cases where the disease is too advanced, a hysterectomy is not performed, and only palliative treatment (radiotherapy) is used. After the uterus is removed, complementary therapy is often included.

Endometrial cancer

Caused by the abnormal and continuous development of cancer cells originating from the uterine lining. Endometrial cancer makes its presence known relatively quickly – it is accompanied by abnormal bleeding from the genital tract (if it affects premenopausal people) and vaginal discharge. As the disease progresses (in later stages), lower abdominal and spine pain may also appear.

The treatment for endometrial cancer is the same as for the previously mentioned cervical cancer.

Prevention of uterine diseases

In the prevention of uterine diseases, the most important thing is to prevent cancer. We already know that they often do not cause any symptoms, which does not make diagnosis easier. However, a sufficiently early diagnosis and further treatment almost 100% of the time determine full recovery. So, are we getting tested? ;)

Three extremely important issues regarding diseases of the reproductive organs

• Primary prevention – vaccination against HPV viruses can protect against the development of cervical cancer.
• Cytological tests – i.e. taking exfoliated cells from the surface of the cervical canal and then evaluating them under a microscope.
• Ultrasound examinations (transvaginal) – ultrasound can quickly detect pre-cancerous changes or early endometrial cancers (even those that do not yet cause any symptoms).

My friend the uterus

Taking care of yourself is not only about a healthy diet, the right amount of physical activity and broadly understood self-care . I know, I know – I'm repeating myself ;) But having information about how the uterus functions and what it is needed for, it is worth surrounding it with proper protection and care. On the Internet, you can find a whole lot of self-proclaimed doctors who, after you enter your symptoms, will give you various diagnoses – we politely thank such "specialists" ;) As always, we encourage you to deepen your knowledge (in which we are happy to accompany you) and perform professional gynecological examinations.