Most women associate an enlarged uterus with pregnancy, but that’s not the only reason your uterus can become enlarged. Large or multiple fibroids can cause an expansion of the uterus. Some women may notice weight gain, a bloated belly, or a feeling of fullness in the lower abdomen, while others may not notice it at all. However, it’s important to know enlarged uterus causes to ensure you get the right treatment.
Many of our patients reveal they first noticed a change when their pants did not fit or their belly felt full or looked expanded. A pelvic exam or an imaging test such as an ultrasound or MRI can be used to diagnose an enlarged uterus.
Uterine fibroids are benign growths that can be found inside or on the outside of the uterus. As they receive nutrients from the blood supply of the attached artery, these fibroids can continue to grow.
You may have one or several, growing separately or in clusters. As they get larger, these fibroids can cause your uterus to expand and make you look like you’re pregnant.
Symptoms of Uterine Fibroids
Every woman’s experience with fibroids is very different. Some women with fibroids may not experience any symptoms; however, others may struggle with chronic pain. Having an expanded uterus is just one of the possible symptoms you may experience if you have fibroids, others include:
Heavy period lasting more than 10 days per month is the most common symptoms of fibroids
Severe pelvic pain or cramping which occurs before or during the period
Anemia caused by heavy bleeding and longer than normal menstrual cycles
Bleeding between menstrual cycles, caused by fibroids that distort the uterine lining
Pain during intercourse, which may occur if the fibroid is located near the cervix
Frequent urination or difficulty emptying the bladder because the fibroid presses against the organ
Constipation, which often occurs when the fibroid grows larger and presses against the rectum or bowel
Lower back, or leg pain
Want to learn more about uterine fibroids? Take our quiz to find out if fibroids could cause your painful symptoms.
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What Causes An Enlarged Uterus
Adenomyosis is one of the causes of an enlarged uterus. It is a condition that occurs when the inner lining of the uterus grows into the muscular wall of the organ. This tissue can cause the uterus to expand up to twice or triple its normal size. It will break down and cause pain that is often more severe during your period than what would be expected.
Ovarian cysts are fluid-filled growths that develop inside or outside the ovary. You may not have any symptoms or even be aware that a cyst has developed. However, they can grow quite large and cause pain and other symptoms. While the cysts don’t grow in the uterus or affect its size, they can make you look like you’ve gained weight, similar to an enlarged uterus.
You can develop cancerous tumors in the uterus separate from uterine fibroids. These cancerous growths can grow quite large, causing the uterus to be extended as if you were pregnant.
Pregnancy is the most common and well-known reason for an enlarged uterus. The uterus must expand during pregnancy to accommodate the growing baby. To accurately convey the change in size, think of a normal uterus as about the size of a lemon that grows to the size of a watermelon during pregnancy.
The Emotional and Physical Toll of Fibroids
Struggling with fibroids is usually associated with physical pain or discomfort, but we often forget about the emotional toll it can take. Having an enlarged uterus can affect a woman’s self-confidence, body image, and even love life.
We all know that having an expanded abdomen shouldn’t prevent you from enjoying life, but for some women, it still does. Some of our patients have shared that they couldn’t wear what they wanted when going out with friends, were embarrassed by wearing a bathing suit to the pool, or didn’t feel confident with their partner during intimacy.
Not only do body image and insecurities cause distress, but the constant worry and fear of bleeding through your clothes in public or not having enough feminine hygiene products while away from the house can be exhausting. Many women state that living with fibroids caused them to feel as if they had no control over their bodies and were preventing them from enjoying the things they used to love. This is primarily due to the difficulty of managing and predicting heavy periods. Along with the problem of an enlarged uterus, you may also have to deal with fibroid pain that can inhibit your ability to enjoy your day-to-day life.
Why Fibroids Sometimes Cause An Enlarged Uterus
One of the most common enlarged uterus causes is fibroids. The exact cause of fibroid growth is still unknown; however, researchers know they grow and shrink when there is an increase or decrease in estrogen and progesterone.
While some fibroids are as tiny as seeds, they can grow as large as a melon. Their location isn’t limited to inside the uterine cavity; they can develop on the outside of the uterus, within the lining of the uterus, and can even attach themselves to the uterus wall by a stalk. If the fibroid(s) grow larger within the uterine cavity, they may expand the uterus just like a pregnancy does. If the fibroid(s) grow larger outside the uterine wall, they may press on surrounding organs.
How Fibroids Affect Surrounding Organs
Fibroid symptoms and pain are often associated with pelvic pain or heavy bleeding, but there are other organs that can be affected as well.
Bladder – Many women who have large fibroids may feel the need to run to the bathroom frequently. They may also have difficulty emptying their bladder if the expanded uterus puts too much pressure on the tube leading to the urethra.
Rectum – A large fibroid can push down on the rectum, making bowel movements difficult. This is why it is also possible that some women experience constipation or pain while defecating.
Stomach – Some women may experience the feeling of fullness and may not be able to eat as much as they used to. This can even lead to significant weight loss.
You may have another health condition with symptoms that mimic uterine fibroids. For instance, polycystic ovarian syndrome (PCOS) is a disorder that causes cysts on the ovaries. Many women have PCOS or ovarian cysts and fibroids at the same time.
Another common diagnosis is endometriosis, which is where the uterine tissue grows on the outside of the uterus. You may require treatment of this condition along with fibroids. Diagnosis can be difficult for multiple enlarged uterus causes, so it’s important to see a specialist.
Treatment For An Enlarged Uterus
If you think your expanded uterus is caused by fibroids, it’s a good idea to schedule a consultation to get checked. An interventional radiologist will use an ultrasound or MRI to diagnose your fibroids and then work with you to create a comprehensive treatment plan. It’s important to consider your treatment options and understand that invasive surgery is not the only solution.
Non-surgical treatments like Uterine Fibroid Embolization offer many benefits such as no hospitalization, a shorter recovery, the ability to preserve your uterus and retain fertility.
Schedule Treatment for Enlarged Uterus
If you’re ready to take the following steps and want to find out more about enlarged uterus causes, or just want to get more information about treatment, give us a call at 855-615-2555 for a consultation.
Enlarged Uterus Causes
Written by Mary Anne Dunkin
Medically Reviewed by Traci C. Johnson, MD on April 19, 2021
In this Article
Other Causes of an Enlarged Uterus
Symptoms of an Enlarged Uterus
From conception to delivery, a woman's uterus can grow from the size of a pear to the size of a watermelon. But pregnancy isn't the only potential reason for an enlarged uterus. An enlarged uterus is common and can be a symptom of a variety of medical conditions, some of which require treatment.
Two of the most common causes of an enlarged uterus are uterine fibroids and adenomyosis.
Uterine fibroids. Uterine fibroids are common noncancerous tumors of the muscular wall of the uterus, affecting as many as eight in 10 women by the age of 50. Fibroids more commonly affect women over age 30. They are also more common in African-Americans than Caucasians. Overweight and obese women also have a greater risk of developing fibroids. Hormonal and genetic factors contribute to their growth.
While some fibroids are very small, others grow to weigh several pounds. A woman may have a single fibroid or multiple fibroids. In addition to an enlarged uterus, symptoms of uterine fibroids may include:
Feeling of fullness or pressure in the lower abdomen
Heavy, painful, and/or long-lasting periods, sometimes with the passage of blood clots
Bleeding between periods
Pain during intercourse
Pregnancy or delivery complications
If symptoms are severe, treatment may involve a procedure called uterine artery embolization to cut off the blood supply to the fibroids so that they shrink and eventually die, or surgery to remove the fibroids (myomectomy) or the entire uterus (hysterectomy). Other treatments include endometrial ablation. This procedure is performed for small submucosal fibroids (when the inside lining of the uterus is removed, burned or frozen) and laparoscopic myolysis (when freezing or an electric current is used to destroy the fibroids). Medications to help control painful periods or for pain may also be used. Other treatment options include focused ultrasound surgery and an intrauterine device (IUD) to decrease bleeding.
The cause of fibroids is not known, but the tumors seem to rely on estrogen to grow. After menopause, they often shrink naturally and cause no symptoms.
Adenomyosis. Adenomyosis is a diffuse thickening of the uterus that occurs when the tissue that normally lines the uterus (endometrium) moves into its muscular outer wall and behaves like the endometrium. When this happens in a small area, or is localized, it is called an adenomyoma.
While the cause of adenomyosis is unknown, the condition usually occurs in women older than age 30 who have had children. It is more common in women who have had uterine surgery, including a cesarean section.
In addition to uterine enlargement, symptoms may include:
Long periods or heavy bleeding
Painful periods, which get continually worse
Pain during intercourse
Most women have some adenomyosis at the end of their childbearing years. Most don't require treatment, but some need medication to relieve pain. Birth control pills and an intrauterine device (IUD) containing progesterone may help decrease heavy bleeding. Women with severe symptoms may need a hysterectomy to relieve symptoms.
Other Causes of an Enlarged Uterus
In some cases, an enlarged uterus can be a symptom of uterine cancers, including endometrial cancer (affecting the lining of the uterus) and cervical cancer (affecting the lower portion of the uterus where it joins the vagina). Treatment depends on the location, the extent of the cancer, and other factors.
Symptoms of an Enlarged Uterus
If you have an enlarged uterus, you won't necessarily notice it yourself. Your doctor may discover it during a physical exam or on imaging tests. Many conditions that cause an enlarged uterus are benign and don't require treatment unless symptoms are severe.
If you experience problems such as irregular bleeding; painful, heavy periods; pain during intercourse; or feelings of fullness or pressure in the lower abdomen, see your doctor, who can help determine the cause and best treatment.
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What causes the uterus to increase in size and how dangerous it is
The reasons may be different, but in most cases they require immediate medical attention.
Normally our uterus is about the size of a fist - not that small! During pregnancy, this organ naturally increases and can be equal in volume to a large watermelon, but some time after childbirth, it usually returns to its previous state. But it happens that in a non-pregnant woman, the uterus increases in size - and often this may indicate undesirable and very serious processes occurring in the body. We will tell you why the uterus can grow, what symptoms indicate its undesirable enlargement, and we remind you: for any unusual signs and symptoms, it is important to see a doctor as soon as possible!
Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.
Why the uterus grows in size
The most natural and safest reason is, of course, pregnancy. But most of the other "culprits" of changing the size of the uterus, alas, are not so harmless. Doctors recommend that women do an ultrasound scan of the pelvic organ at least once a year, including in order to notice the abnormal size of the uterus or ovaries in time and take action in time. So, the uterus can increase in size for the following reasons:
Myoma is a non-tumor formation in the uterine cavity, the size of which can vary from one or two centimeters to 30-40. According to doctors, up to 80% of women experience uterine fibroids during their lifetime, but, fortunately, in most cases these formations are so small that they do not affect either the health or well-being of a woman. But if the fibroid is large, if it changes in size, removal is recommended. Otherwise, the formation may degenerate into a malignant tumor.
This is a condition in which the endometrial mucosa, which normally lines the uterine cavity during the menstrual cycle, grows too large. With adenomyosis, women often complain of severe pain during menstruation, heavy bleeding, pain in the back and pelvis, problems with urination.
Cells in the lining of the uterus begin to divide at an increased rate, forming a tumor that can also spread to nearby organs. Symptoms to look out for include "inappropriate" bleeding, pain when urinating, during intercourse, and pain in the pelvic area. Most often, endometrial cancer is diagnosed in women who have gone through menopause, but women of childbearing age should also be attentive to their health and not ignore the described symptoms.
( See also: Endometrial cancer: 5 signs that you are at risk)
may affect the size and condition of the uterus. If the cysts are too large, they can cause uterine bleeding, back pain, difficulty urinating, and even inflammation of the uterus.
( See also: Ovarian cysts: causes, symptoms and treatment)
Signs and symptoms of an enlarged uterus
If you have any of the following symptoms, you should make an appointment with your doctor and possibly have a pelvic ultrasound to rule out an enlarged uterus.
The most common symptom associated with uterine enlargement is increased menstrual bleeding. As a rule, periods become longer and more severe, and bleeding becomes profuse, with blood clots.
Most often, patients with an enlarged uterus complain of pain in the lower abdomen, but pain in the lower back, upper abdomen and even in the legs can also be noted.
An enlarged uterus can press on nearby digestive organs, causing bloating and increased gas.
If the uterus presses too hard on the intestines, it can interfere with its normal functioning and lead to constipation.
Another organ that suffers from an enlarged uterus is the bladder. The stronger the pressure on him, the more often he wants to go to the toilet.
In addition to more heavy bleeding, uterine enlargement can cause menstrual irregularities, as well as bleeding between periods. Also, due to large blood loss, iron deficiency can develop.
Both the enlarged uterus itself and the hormonal disorders that accompany diseases that cause it to enlarge often lead to rapid weight gain.
Most of the reasons why the uterus grows in size, as a rule, negatively affect a woman's ability to conceive and bear a child. In addition, if the uterus becomes very enlarged during pregnancy, it can provoke a miscarriage or premature birth.
Changes in the cervix during pregnancy
Pregnancy is always pleasant, but sometimes not planned. And not all women have time to prepare for it, to be fully examined before its onset. And the detection of diseases of the cervix already during pregnancy can be an unpleasant discovery.
The cervix is the lower segment of the uterus in the form of a cylinder or cone. In the center is the cervical canal, one end of which opens into the uterine cavity, and the other into the vagina. On average, the length of the cervix is 3–4 cm, the diameter is about 2.5 cm, and the cervical canal is closed. The cervix has two parts: lower and upper. The lower part is called the vaginal, because it protrudes into the vaginal cavity, and the upper part is supravaginal, because it is located above the vagina. The cervix is connected to the vagina through the vaginal fornices. There is an anterior arch - short, posterior - deeper and two lateral ones. Inside the cervix passes the cervical canal, which opens into the uterine cavity with an internal pharynx, and is clogged with mucus from the side of the vagina. Mucus is normally impervious to infections and microbes, or to spermatozoa. But in the middle of the menstrual cycle, the mucus thins and becomes permeable to sperm.
Outside, the surface of the cervix has a pinkish tint, it is smooth and shiny, durable, and from the inside it is bright pink, velvety and loose.
The cervix during pregnancy is an important organ, both in anatomical and functional terms. It must be remembered that it promotes the process of fertilization, prevents infection from entering the uterine cavity and appendages, helps to "endure" the baby and participates in childbirth. That is why regular monitoring of the condition of the cervix during pregnancy is simply necessary.
During pregnancy, a number of physiological changes occur in this organ. For example, a short time after fertilization, its color changes: it becomes cyanotic. The reason for this is the extensive vascular network and its blood supply. Due to the action of estriol and progesterone, the tissue of the cervix becomes soft. During pregnancy, the cervical glands expand and become more branched.
Screening examination of the cervix during pregnancy includes: cytological examination, smears for flora and detection of infections. Cytological examination is often the first key step in the examination of the cervix, since it allows to detect very early pathological changes that occur at the cellular level, including in the absence of visible changes in the cervical epithelium. The examination is carried out to identify the pathology of the cervix and the selection of pregnant women who need a more in-depth examination and appropriate treatment in the postpartum period. When conducting a screening examination, in addition to a doctor's examination, a colposcopy may be recommended. As you know, the cervix is covered with two types of epithelium: squamous stratified from the side of the vagina and single-layer cylindrical from the side of the cervical canal. Epithelial cells are constantly desquamated and end up in the lumen of the cervical canal and in the vagina. Their structural characteristics make it possible, when examined under a microscope, to distinguish healthy cells from atypical ones, including cancerous ones.
During pregnancy, in addition to physiological changes in the cervix, some borderline and pathological processes may occur.
Under the influence of hormonal changes that occur in a woman's body during the menstrual cycle, cyclic changes also occur in the cells of the epithelium of the cervical canal. During the period of ovulation, the secretion of mucus by the glands of the cervical canal increases, and its qualitative characteristics change. With injuries or inflammatory lesions, sometimes the glands of the cervix can become clogged, a secret accumulates in them and cysts form - Naboth follicles or Naboth gland cysts that have been asymptomatic for many years. Small cysts do not require any treatment. And pregnancy, as a rule, is not affected. Only large cysts that strongly deform the cervix and continue to grow may require opening and evacuation of the contents. However, this is very rare and usually requires monitoring during pregnancy.
Quite often, in pregnant women, during a mirror examination of the vaginal part, polyps cervix. The occurrence of polyps is most often associated with a chronic inflammatory process. As a result, a focal proliferation of the mucosa is formed, sometimes with the involvement of muscle tissue and the formation of a pedicle. They are mostly asymptomatic. Sometimes they are a source of blood discharge from the genital tract, more often of contact origin (after sexual intercourse or defecation). The size of the polyp is different - from millet grain rarely to the size of a walnut, their shape also varies. Polyps are single and multiple, their stalk is located either at the edge of the external pharynx, or goes deep into the cervical canal. Sometimes during pregnancy there is an increase in the size of the polyp, in some cases quite fast. Rarely, polyps first appear during pregnancy. The presence of a polyp is always a potential threat of miscarriage, primarily because it creates favorable conditions for ascending infection. Therefore, as a rule, more frequent monitoring of the cervix follows. The tendency to trauma, bleeding, the presence of signs of tissue necrosis and decay, as well as questionable secretions require special attention and control. Treatment of cervical polyps is only surgical and during pregnancy, in most cases, treatment is postponed until the postpartum period, since even large polyps do not interfere with childbirth.
The most common pathology of the cervix in women is erosion . Erosion is a defect in the mucous membrane. True erosion is not very common. The most common pseudo-erosion (ectopia) is a pathological lesion of the cervical mucosa, in which the usual flat stratified epithelium of the outer part of the cervix is replaced by cylindrical cells from the cervical canal. Often this happens as a result of mechanical action: with frequent and rough sexual intercourse, desquamation of the stratified squamous epithelium occurs. Erosion is a multifactorial disease. The reasons may be:
genital infections, vaginal dysbacteriosis and inflammatory diseases of the female genital area;
is an early onset of sexual activity and a frequent change of sexual partners. The mucous membrane of the female genital organs finally matures by the age of 20-23. If an infection interferes with this delicate process, erosion is practically unavoidable;
is an injury to the cervix. The main cause of such injuries is, of course, childbirth and abortion;
, cervical pathology may also occur with a decrease in the protective functions of immunity.
The presence of erosion does not affect pregnancy in any way, as well as pregnancy on erosion. Treatment during pregnancy consists in the use of general and local anti-inflammatory drugs for inflammatory diseases of the vagina and cervix. And in most cases, just dynamic observation is enough. Surgical treatment is not carried out throughout the entire pregnancy, since the excess of risks and benefits is significant, and after treatment during childbirth, there may be problems with opening the cervix.
Almost all women with various diseases of the cervix safely bear and happily give birth to beautiful babies!
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