Uterine Conditions

Uterine
Conditions

The uterus, or womb, is a crucial organ in the female reproductive system.

It plays a pivotal role in menstruation, pregnancy, and childbirth. However, various conditions can affect the uterus, impacting a woman’s health and fertility.

Common Uterine Conditions

Uterine Fibroids

Uterine fibroids are non-cancerous growths of the uterus that often appear during childbearing years. They are also known as leiomyomas or myomas. These growths are typically benign and vary in size and number.

Causes

The exact cause of uterine fibroids is unknown, but several factors may contribute, including genetic changes, hormonal imbalances (particularly in oestrogen and progesterone), and other growth factors.

Symptoms

Symptoms of uterine fibroids can vary based on their size, number, and location. Common symptoms include:

Heavy menstrual bleeding
Prolonged menstrual periods
Pelvic pain or pressure
Frequent urination
Constipation
Backache or leg pains

Risk Factors

Age: Fibroids are more common in women aged 30-40.
Family history: Having a family member with fibroids increases the risk.
Ethnic origin: African-Australian women are more likely to develop fibroids.
Obesity: Women who are overweight are at higher risk.
Diet: A diet high in red meat and low in green vegetables and fruit can increase the risk.

Treatment Options

Treatment options depend on the severity of the symptoms and the size of the fibroids:

Medications: To regulate the menstrual cycle and reduce symptoms.
Non-invasive procedures: MRI-guided focused ultrasound surgery.
Minimally invasive procedures: Uterine artery embolisation and laparoscopic myomectomy.
Traditional surgical procedures: Hysterectomy (removal of the uterus) and abdominal myomectomy.

Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain and potentially leading to infertility.

Causes

The exact cause of endometriosis is not well understood. Possible causes include retrograde menstruation, genetic factors, immune system disorders, and hormonal influences.

Symptoms

Pelvic pain, often associated with menstrual periods
Pain during intercourse
Pain with bowel movements or urination
Excessive bleeding during periods
Infertility
Fatigue, diarrhoea, constipation, bloating, and nausea

Risk Factors

Family history: Higher risk if a close relative has endometriosis.
Menstrual history: Starting periods at an early age, short menstrual cycles, and heavy periods.
Never giving birth: Women who have never given birth are at higher risk.

Treatment Options

Pain relief medications: Nonsteroidal anti-inflammatory drugs (NSAIDs).
Hormone therapy: Birth control pills, Gn-RH agonists, and antagonists.
Conservative surgery: Laparoscopy to remove endometrial tissue.
Fertility treatment: Assisted reproductive technologies if fertility is affected.
Hysterectomy: In severe cases, removal of the uterus and ovaries.

Adenomyosis

Adenomyosis occurs when the endometrial tissue, which normally lines the uterus, grows into the muscular wall of the uterus. This can result in an enlarged uterus and painful, heavy periods.

Causes

The exact cause of adenomyosis is unknown. It is thought to be related to invasive tissue growth, uterine inflammation, or developmental origins.

Symptoms

Heavy or prolonged menstrual bleeding
Severe cramping or sharp pelvic pain during menstruation
Chronic pelvic pain
Painful intercourse
Blood clots during periods

Risk Factors

Age: Most common in women in their 40s and 50s.
Childbirth: Women who have given birth are at higher risk.
Previous uterine surgery: Such as a C-section or fibroid removal.

Treatment Options

Pain relief medications: NSAIDs.
Hormonal treatments: Birth control pills, hormonal IUDs, and Gn-RH agonists.
Surgery: Endometrial ablation or hysterectomy in severe cases.

Uterine Cancer

Uterine cancer is the most common cancer of the female reproductive organs. It primarily affects the lining of the uterus (endometrium) and is known as endometrial cancer.

Causes

While the exact cause of uterine cancer is unknown, several factors can increase the risk, including hormonal imbalances, genetic mutations, and lifestyle factors.

Symptoms

Abnormal vaginal bleeding or discharge
Pelvic pain
Pain during intercourse
Unexplained weight loss

Risk Factors

Age: Most common in women over 50.
Hormone therapy: Using oestrogen without progesterone.
Obesity: Excess body fat can alter hormone levels.
Reproductive history: Never being pregnant or starting menstruation at an early age.
Family history: A history of uterine or colorectal cancer.

Treatment Options

Surgery: Hysterectomy, often with removal of fallopian tubes and ovaries.
Radiation therapy: To kill cancer cells.
Hormone therapy: To block hormones that fuel cancer growth.
Chemotherapy: To target and kill cancer cells.
Targeted therapy: Using drugs to target specific weaknesses in cancer cells.

Uterine Prolapse

Uterine prolapse occurs when the uterus descends from its normal position into the vaginal canal due to weakened pelvic floor muscles and ligaments.

Causes

The main cause of uterine prolapse is the weakening of pelvic floor muscles and tissues, which can be due to childbirth, ageing, hormonal changes, or increased pressure in the abdomen.

Symptoms

Sensation of heaviness or pulling in the pelvis
Tissue protruding from the vagina
Urinary problems, such as incontinence or retention
Bowel movement difficulties
Low back pain
Sexual dysfunction

Risk Factors

Childbirth: Multiple vaginal deliveries.
Age: Post-menopausal women are at higher risk.
Obesity: Excess body weight increases abdominal pressure.
Chronic coughing: Conditions causing chronic cough can weaken pelvic muscles.
Hysterectomy: Previous uterine removal can affect pelvic floor support.

Treatment Options

Lifestyle changes: Weight loss and avoiding heavy lifting.
Pelvic floor exercises: Kegel exercises to strengthen muscles.
Pessary: A device inserted into the vagina to support the uterus.
Surgery: To repair the pelvic floor and support the uterus, or hysterectomy in severe cases.

Conclusion

Uterine conditions can significantly impact a woman’s quality of life and fertility. Early diagnosis and treatment are crucial for managing symptoms and improving outcomes.

Women in Australia are encouraged to seek regular gynaecological check-ups and consult their healthcare providers if they experience any symptoms related to uterine conditions.

With appropriate medical care and lifestyle modifications, many women can manage these conditions effectively and maintain a healthy reproductive system.

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We are a general gynaecology clinic based in Melbourne, dedicated to the latest Minimally Invasive (MI) gynaecological diagnostic and surgical techniques. We are leaders in laparoscopic and cutting-edge robotic “keyhole” surgery.

If you have a question about a condition or treatment, or would like to book an appointment, please get in touch.

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