A women’s uterus is the size of a clenched fist
but can grow as big as a soccer ball or larger during pregnancy. In addition to
pregnancy, there are many other reasons why a woman’s uterus may become
enlarged.
An enlarged uterus can be the result of a
medical condition that not only causes it to grow but also to bleed and become
painful. A condition that results in an enlarged uterus may require treatment.
Causes and risk factors
A woman can be unaware that she has an enlarged
uterus. Most often, women discover they have a problem during a pelvic exam.
It is possible a woman may notice a bloated
belly or that clothes seem too tight, but for most, a diagnosis of an enlarged
uterus is unexpected.
There are multiple reasons why the uterus may
become enlarged. An enlarged uterus may be more common in menopausal women, but
women in their childbearing years can develop this condition too.
Fibroids
Fibroids are one of the most common causes of an
enlarged uterus.
Fortunately, fibroids are noncancerous. Fibroids are small lumps that can weigh
up to several pounds. They are found along the walls of the uterus.
According to the Office on Women’s Health (OWH)
of the U.S. Department of Health and Human Services, between 20 or 80 percent
of women develop fibroids before the age of 50. They are most common in women
who are in their 40s and
early 50s.
Fibroids may be asymptomatic, or may cause pain
and heavy menstrual cycles.
Fibroids also put pressure on the bladder and
the rectum, causing frequent urination and rectal pressure. If they get too
big, fibroids may cause the uterus to become enlarged.
Adenomyosis
Adenomyosis is a noncancerous condition that
mimics symptoms of fibroids. It results in the lining of the uterus becoming
embedded directly in the muscle wall of the uterus. During the menstrual cycle,
the cells of the muscle bleed, causing pain and swelling.
The adenomyoma is the swollen part of the
uterine wall. Upon examination, the adenomyoma feels like a fibroid, and it may
even be confused with one on an ultrasound.
Adenomyosis may not cause any symptoms. In other
severe cases, it can lead to heavy bleeding and cramping during menstruation.
One study of 985 women reported in the medical
journal Human Reproduction found that adenomyosis was present in approximately
20 per cent of participants.
However, all participants in the study had
attended a gynecology clinic with existing symptoms. It is possible, then, that
the prevalence of adenomyosis is higher in the general population.
Polycystic ovarian syndrome
Polycystic ovarian syndrome (PCOS) also causes
an enlarged uterus. It is the result of hormonal imbalances in menstruation and
the shedding of the endometrial lining of the uterus. It affects 1 in 10 women
of childbearing age, according to the OWH.
The body typically sheds the endometrial lining
during the menstrual cycle, but in some women, the lining is not entirely
discarded and interferes with their monthly cycle.
The accumulation of the endometrial lining
causes inflammation and enlargement of the uterus.
Endometrial cancer
According to the National Cancer Institute
(NCI), endometrial cancer is most often diagnosed in women ages 55 to 64. The
NCI estimates there will be 61,380 new cases in 2017.
One of the symptoms of endometrial cancer is an
enlarged uterus, although it can also be an indicator of advanced stage cancer.
