Womb Enlargement

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By peace | May 14, 2007

Uterine fibroids are benign tumors of muscle and connective tissue that develop within or are attached to the uterine wall. Almost always benign, these masses of muscle tissue can quietly grow in your uterus for years without causing any problems.

The most common cause of enlargement of the womb is pregnancy. But sometimes the womb is enlarged by a muscle tumour, or by a tumour called an adenomyoma.

The muscle tumours are called myomata or ‘fibroids’(benign enlargements of the smooth muscle wall of the womb). For some unknown reason, one or more of the muscle fibres which make up the uterus start developing, and quite soon a few small pea-sized tumours appear deep in the muscle wall of the uterus. At this stage, no one can detect them, but as the months or years pass — for they grow very slowly — the tumours become the size of a golf ball, a tennis ball or even of a grapefruit. By this time, the patient can feel a lump in her abdomen, or if the tumour has grown inwards and distorted the shape of the cavity of the uterus, she may have heavier or irregular menstrual periods. Usually she goes to her doctor, who performs a pelvic examination and can tell from this if there is a single fibroid, or if the womb is misshapen and enlarged by several fibroid tumours.

It is unusual for a woman who has children early in life to develop fibroids, and the tumours are more likely to occur in women who have never had a baby or who have delayed childbirth until after the age of 30. This has led to the saying that ‘fibroids develop in a disappointed womb’.

The tumours are very common, and more than 20% of women have fibroids in their womb. Fibroids are usually symptomless. In 20 to 50 percent of cases, women have heavy, prolonged, and painful menstrual bleeding, painful intercourse, intermittent spotting, frequent urination, or constipation. In many cases, no treatment is required, as the tumour is not causing any symptoms, but in the few women who have symptoms, treatment is needed. The treatment chosen depends upon the patient’s age and her desire to have further children.

If a young woman, who is anxious to have children, is found to have fibroids which are causing symptoms, the doctor can often operate to remove the fibroids and leave the uterus. It is a bit like a complicated shelling of peas, and although there is a slight chance that the fibroids may grow again, the chances of pregnancy are good.

In an older woman, or a woman who wants no further children, the operation chosen is usually that of hysterectomy, in which the womb is removed.

The second kind of muscle tumour is called an adenomyoma. This leads to a smooth enlargement of the uterus. It is not malignant, and is a form of endometriosis(womb lining tissue in place in the pelvis where it should not normally be).

Endometriosis is a common gynecological condition, particularly among women of childbearing age, affecting an estimated 2 to 10 percent of American women in this age group. Endometriosis can be a debilitating disease for some women who experience ongoing pain, while others may be asymptomatic. It is also a factor in infertility, with about 30 to 40 percent of women with endometriosis experiencing difficulty conceiving a child.

In a few women hormone imbalance, leading to an excess production of oestrogen, may cause an enlargement of the uterus over a period of time. The hormone imbalance may be caused by the emotions, but this has never been proved. Often the woman has heavy menstrual periods. Often this leads the doctor to suggest a hysterectomy. Hysterectomy may be the right treatment, but often, although the bleeding ceases, the emotional problems remain. It is important to try hormones first to see if they will relieve the symptoms, before deciding on hysterectomy.