Other Common Uterine Conditions

Tilted Uterus
A titled uterus is not abnormal, but it is what is called a “variation” in anatomy that causes the uterus to tip backward rather than forward toward the cervix (as is usually the case.) Women with a tilted uterus can have children, but it may cause other problems, such as increased pain during premenstrual cramps. This is not serious and can be treated with mild pain medication.

Endometriosis
Endometriosis is a disorder in which the lining of the uterus grows outside of it. The condition can be quite painful, especially before and during menstrual periods. This lining tissue is called the endometrium, and it is the lining material that thickens and bleeds during the menstrual cycle. When it grows outside of the uterus, it can no longer exit through the vaginal opening during a period. Therefore, it remains caught inside the body but outside the uterus, irritating the surrounding tissues. Eventually, scar tissue develops, causing extreme pain and sometimes even infertility.

The degree of pain does not always signal the degree of the disease, however. Women with advanced cases of endometriosis may experience very little pain, while those with mild endometriosis sometimes report extreme pain. Painful urination, bowel movements, and sexual intercourse are additional symptoms that may point to endometriosis. Less common symptoms include fatigue, nausea, and constipation. Because the symptoms are similar to so many other disorders and diseases, endometriosis can be misdiagnosed as an ovarian cyst, irritable bowel syndrome (IBS), or pelvic inflammatory disease (PID).

While the causes of endometriosis are uncertain, retrograde menstruation is believed to be a likely source. Retrograde menstruation is a disorder in which the endometrium (menstrual blood) flows in the wrong direction, up the fallopian tubes into the body rather than out of the vaginal opening. The endometrium then attaches to the tissues of the body, growing and causing problems.

Studies have shown that certain issues make a woman more likely to develop endometriosis. These include never having had a child, genetic factors (others in the family with the condition), shorter menstrual cycles with longer than normal periods, and pelvic infections.

When a woman with endometriosis becomes pregnant, however, the symptoms generally subside until the pregnancy is over. After menopause, endometriosis abates entirely. Besides the pain that women experience with this disorder, the worse result from endometriosis in many cases is infertility. Nearly half of women who have endometriosis may not be able to get pregnant. The reason for this is that the endometrium gets in the way of the sperm in its quest to fertilize an egg. Even if the sperm is successful, the endometrium may prevent the fertilized egg from attaching to the wall of the uterus and growing into a fetus. Women with endometriosis are advised to try to have children at a young age since the condition becomes worse over time.

Uterine Polyps
Uterine polyps are less common than fibroids and are different in terms of their make-up. While fibroids are made of muscle tissue, polyps are made of endometrial tissue. Polyps may become smaller or disappear without medical intervention, while fibroids do not become smaller except possibly after menopause. Fibroids are of varying sizes, while polyps are always small – no larger than a few centimeters, which is about the size of a golf ball. Most polyps are much smaller than that, though – even as small as a seed. Despite this fact, only invasive surgical methods are effective in treating polyps.

Polyps attach to the walls of the uterus and, like fibroids, sometimes protrude outside of the uterus. They are the result of excessive growth of the endometrium and are most frequently seen in women in their 40s and 50s. On rare occasions, the polyps can descend into the vagina.

Symptoms include irregular periods that are sometimes characterized by excessive bleeding. If a woman has polyps after menopause, she may experience vaginal bleeding even though her periods have stopped. In more severe cases, infertility may result, although many physicians believe that polyps alone are not enough to cause a woman to become infertile. Pregnancy is not generally affected by polyps, but women who are trying to get pregnant through in vitro fertilization (IVF) may be more prone to miscarriage if they have polyps. For this reason, some doctors recommend that women who wish to attempt pregnancy through IVF undergo surgery to remove polyps prior to attempting the IVF procedure.

No one knows what causes uterine polyps, but hormones are believed to be involved. Risk factors include obesity and hypertension (high blood pressure.) Women who have taken tamoxifen, a medication used in the treatment of breast cancer, may also be placed at a higher risk of developing uterine polyps.

Polyps are usually benign (non-cancerous), and if there are no troublesome symptoms, a physician may opt to just wait and watch them to see if they go away without treatment. If surgical treatment is necessary, it is usually a minor procedure which is done on an outpatient basis without the need for an incision. A thin scope is inserted into the vagina and cervix until it reaches the uterus so that the surgeon can see the polyps inside the body. Small surgical instruments can then be inserted through the scope, called a hysteroscope, in order to remove the polyp. The procedure can be conducted under a local anesthetic while the patient is awake. Because this is a minimally invasive procedure, the risks are few.

While there are a number of disorders that can plague the uterus, including uterine cancer, a prolapsed uterus is one of the most common, particularly in older women. For younger women, uterine fibroids are the most common disorder of this reproductive organ.

Since the symptoms are so similar for these varied conditions, a woman must see a doctor in order to properly diagnose the source of her symptoms and determine the best course of treatment to alleviate any pain and discomfort, as well as reduce her risk of further complications.