Bulky Uterus

The uterus is a small, muscular female reproductive organ which is responsible for keeping and nourishing the foetus until it is ready for birth. The bulky uterus is a condition in which the uterus is bigger in size than it is supposed to be. This condition is not common, but it can be serious if not treated in time and can affect fertility in women.

WHAT IS BULKY UTERUS?

A bulky uterus is the generalised swelling of the uterine wall. This means the uterine size is above the normal size of a uterus. A woman’s uterus is responsible for holding the foetus and provide nourishment until the baby is born. It is shaped like an upside-down pear and is roughly the size of a fist. The normal dimensions of the uterus are around 3 to 4 inches by 2.5 inches. The uterus can enlarge in some conditions, including pregnancy. Enlargement of the uterus during pregnancy is a normal thing (growing of the uterus in size allows the foetus to get space and grow inside).

If the uterus enlarges because of reasons other than pregnancy, it is a serious condition and needs medical attention. A female with a bulky uterus can feel some heaviness in her lower abdomen, and the condition can also lead to extreme pain and bleeding.

SYMPTOMS OF BULKY UTERUS

There are several causes of the bulky uterus, and the symptoms may differ based on the cause of it. The common symptoms are as following:

  • Abnormalities in the menstrual cycle
  • Heavy bleeding and cramping in the pelvic region
  • Swelling and cramping in the legs
  • Pressure on the uterus and the surrounding region
  • Backaches
  • Bleeding after menopause
  • Vaginal discharge
  • Frequent and quick urge to urinate
  • Pain during sexual intercourse
  • Excessive bleeding during periods which may cause Anaemia
  • Gaining weight around the lower abdomen
  • Gaining mass over the lower abdomen
  • Acne
  • Excessive hair growth
  • Tenderness in breasts
  • Constipation
  • Paleness of the skin and general weakness

Read More: Bulky Uterus in Hindi

CAUSES OF BULKY UTERUS

It can be found in reproductive age group women. The most common noticeable symptoms are a heaviness in the pelvic region and a bulky mass in the lower abdomen. Still, it may go unnoticed for a long time as a diagnosis of the enlarged uterus is not expected most of the time. Routine check-ups by a gynaecologist can help to track down the problem in time.

There are several factors which can cause the uterus to enlarge. The most common and known causes of the bulky uterus are:

 PREGNANCY –

The most common reason for the uterus to enlarge is pregnancy. The uterus houses the foetus and is the place where the embryo gets nutrition until it grows on to become a child. As the foetus grows, the uterus also enlarges. From the size of a fist, the uterus can grow to the size of a watermelon.

Adenomyosis is the diffuse thickening of the uterus that happens when the endometrium, i.e. the tissue coating the uterus, moves into the external muscle mass of the uterus. It is a noncancerous condition that has similar symptoms as that of fibroids. When the condition is localised (affecting a smaller region), it is termed as adenomyoma. Upon examination, the adenomyoma feels like a fibroid, and it might even be mistaken for one on an ultrasound. The symptoms include heavy menstrual bleeding causing pain and cramping, which eventually gets worse. Women with adenomyosis can have a uterus that is double or even triples its ordinary size.

This condition is found in females who are above the age of 30 and particularly in them who have had a previous uterine medical procedure or have given birth to a baby through C-section. The exact reason for the condition is not exactly known; however, adenomyosis is associated with increased levels of oestrogen. Most women see a decline in the symptoms after menopause because, at that point, the oestrogen level starts decreasing.

One of the most commonly known reasons behind a bulky uterus is fibroids. Fibroids are non-cancerous tumours that are like little lumps or bulges that can weigh up to a few pounds. They are found along the lining of the uterus and are very common in women between the ages of thirty and forty. A few fibroids may not bring about any detectable harmful effects. Others can develop so big that they might weigh a few pounds and can extend the uterus to such a degree that the woman may look a few months pregnant. Hormonal changes or genetic disorders may add to the growth of these tumours.

Fibroids might be asymptomatic or may cause heavy and painful menstrual cycles. Fibroids likewise put weight on the bladder and the rectum, causing a frequent urge to urinate. Fibroids can cause excruciating periods, heavy bleeding in periods, pain in the lower back and discomfort during sexual intercourse.

In a report in Obstetrics and Gynaecology Clinics of North America, fibroids were found in up to 10 percent of women with stated infertility. Also, up to 40 percent of pregnant women with fibroids encountered several difficulties in their pregnancy, for example, requiring a caesarean delivery, experiencing premature labour pains, or encountering heavy bleeding after the delivery.

PERIMENOPAUSE –

Perimenopause is referred to as the stage before menopause. Fluctuating hormone levels during this stage may cause the uterus to enlarge. These cases are temporary, and the uterus returns to the normal size once the woman has attained menopause. However, sometimes, it might not return to its normal size and cause further problems. So, it is advisable to get it checked by a gynaecologist as soon as you face such a condition.

PCOS –

Polycystic Ovarian Syndrome or PCOS is a medical condition that can make the uterus grow. It is the aftereffect of hormonal imbalance that leads to abnormal menstruation cycle and the shedding of the endometrial lining. The endometrial lining is commonly shed during the menstrual cycle, but in few women, the uterine lining is not shed leading to enlarged uterus. As per the reports by WHO, it affects around 10% of women of childbearing age.

OVARIAN CYSTS –

Ovarian cysts are either solid or fluid-filled sacs that develop on the surface of an ovary or inside it. Ovarian cysts are usually asymptomatic and go on their own. However, in some cases, these structures can bring about various health complications, including the enlargement of the uterus. Other than that, it can cause inflammation, excessive bleeding during periods, pain in the back, and difficulty while passing urine.

ENDOMETRIAL CANCER –

Uterine cancers can cause the uterus to enlarge, thus resulting in a bulky uterus. Generally, this problem happens in females 50 years or above in age, as found in a report by the USA’s National Cancer Institute (NCI). Usually, it is caught rapidly in the beginning stages, as a bulky uterus is one of the symptoms of endometrial cancer. Other than that, it can cause frequent and irregular vaginal bleeding. Women should promptly visit a doctor to identify the problem before it grows into untreatable cancer.

COMPLICATIONS THAT CAN ARISE IN BULKY UTERUS

The reasons for uterine growth may prompt health issues if the symptoms of the condition are ignored or are left untreated. A bulky uterus doesn’t usually cause any health complexities, but the conditions because of which it happens can. The two most regular reasons for a bulky uterus, fibroids and adenomyosis, are seldom fatal, and may adversely affect the overall health. Following are some possible complications that may arise:

  • Pain and pressure in the pelvic region: The expanded size of the uterus can put weight on the tissues and organs in its vicinity. It may likewise prompt obstruction, frequent urination, incontinence, swelling and gas, or cramps in the pelvic region.
  • Infertility: Fibroids and adenomyosis may likewise cause an increased rate of pregnancy failure or miscarriage. If any of these are present in a female, the woman can have difficulties in carrying a child to a full term and may require restorative medical procedure before delivery.
  • Prolapse: This is a condition in which the uterus expands out through the birth canal and distends outside the body. It happens because the pelvic floor muscles get weak. In such a situation, having multiple births is also very dangerous, however in rare cases, fibroids might be the reason.
  • Excessive Bleeding: Bulky uterus caused due to fibroids and adenomyosis can cause heavy menstrual bleeding.
  • Infection: Due to uterine inflammation, some women may also experience vaginal infections or infections in some other part of the reproductive system.

DIAGNOSIS OF BULKY UTERUS

The symptoms of a bulky uterus are commonly first felt by the woman herself, which calls for a visit to the gynaecologist. Moreover, during a routine pelvic examination, a doctor may recognize a bulky uterus. It can also be detected if your specialist is treating you for a different problem, like irregular menstruation cycles.

When it has been picked up by your gynaecologist, she will ensure that it hasn’t grown because of any malignant condition or pregnancy. A pregnancy test is done to rule out pregnancy and imaging tests, for example, an ultrasound, an MRI or a CT scan are done to look for any complications in the uterus.

IMPACT OF BULKY UTERUS ON FEMALE FERTILITY

Bulky uterus is majorly diagnosed in Infertile women since many women nowadays delay in planning their first pregnancy until they are in their mid-30’s or early 40’s. Bulky uterus caused due to adenomyosis, or any other reason has a negative impact on female fertility.

Presence of Adenomyosis impairs fertility by affecting the uro-tubal transport and by altering the endometrial function and receptivity hence reducing implantation and pregnancy rate in women undergoing IVF. So, it is advisable to consult an Infertility Specialists if the cause of infertility is due to adenomyosis. A specialist will first treat you to reduce your symptoms, thus increasing your chances of becoming pregnant. Some women conceive a few months after undergoing hormonal therapy. If pregnancy does not occur, then surgery might be recommended.

TREATMENT METHODS FOR A BULKY UTERUS

Some reasons behind a bulky uterus don’t usually require treatment. However, many might require medicine to help with the pain. Contraceptive pills and intrauterine devices (IUDs) containing progesterone can facilitate the manifestations of heavy bleeding in periods. In a few extreme cases, women may require a hysterectomy, which is the complete removal or part of the uterus from the body. The treatment depends on the cause of the condition. Some of the treatment options are:

  • For Adenomyosis: Drugs like ibuprofen and combined hormonal (oestrogen-progesterone) contraception pills can help soothe the pain and excessive bleeding related to adenomyosis. In some complicated cases, your specialist may prescribe a hysterectomy.
  • For Fibroids: Fibroids that are large and expand the uterus will presumably require some restorative treatment. Your specialist may recommend contraception pills that contain oestrogen and progesterone or an IUD. These pills may stop the development of the fibroids and reduce the bleeding during periods.

 

Uterine artery embolization is another treatment method used to solve the problem of fibroids. The principle behind it is to inject small particles into the uterine arteries with the help of a thin tube. This cuts of the blood supply to fibroids and they thus shrink and eventually die.

Sometimes, you may require a medical procedure, a surgery. Myomectomy is done to remove the fibroids. Based on the size and position of the fibroids, myomectomy can be done using the traditional surgical method or through a laparoscopy.

In more severe cases where fibroids cannot be removed by surgery, the uterus is completely removed from the body, which is called Hysterectomy. It is usually performed on women who are entering or have entered menopause or don’t want to have any children in the future or who have an extreme condition of fibroids. It is a permanent procedure hence done after complete counselling because once the uterus is out, there is no way back.

  • For Reproductive Cancers: Cancers or tumours of the uterus and endometrium are regularly treated with radiation, chemotherapy, surgery or a blend of these procedures.

Conclusion

It is vital for women to have routine pelvic exams with a gynaecologist to identify any issues early and save yourself from any future problems. Several reasons for a bulky uterus aren’t very serious, yet they can be discomforting and ought to be considered. The symptoms of a bulky uterus can negatively affect a woman’s life and might be the reason you have severe pelvic pain or having difficulty in getting pregnant. If you feel an irregular, severe, or prolonged problems like cramping, vaginal bleeding, heaviness or swelling in your pelvic region, a frequent urge to urinate and pelvic pain, you should see a gynaecologist at the earliest. An early diagnosis will prompt a quicker treatment.

You can contact Medicover Fertility, where you will get the best advice from experienced Infertility Specialists who will suggest the best possible treatment for a bulky uterus. If you are unable to get pregnant after several attempts, you should consult us and find a solution to your problem.

Related questions on bulky uterus:

Q1) I HAVE LARGE UTERINE FIBROIDS. IS IT POSSIBLE TO HAVE A NON-OPERATIVE PROCEDURE? KINDLY LET ME KNOW.

A) You have to do certain tests like ultrasound and MRI to be sure, and then only a decision can be taken by the gynaecologist whether to go for medicine or an operation.

Q2) IS ADENOMYOSIS A TUMOUR?

A) Adenomyoma is usually benign but can often be found in a progressing condition. It is said that adenomyosis does not have a risk of developing into cancer; it is a kind of endometriosis that occurs inside the uterine muscle wall.

Q3) AS PER MY SCAN REPORTS, MY UTERUS IS BULKY. WHAT TREATMENT PLAN SHOULD I FOLLOW?

A) Scans that suggests a bulky uterus must be confirmed with clinical findings and patient’s history and the cause of the condition should be known. Then only a decision can be taken.

Q4) CAN A BULKY UTERUS CAUSE PREGNANCY COMPLICATION?

A) A bulky or enlarged uterus doesn’t usually produce any health complications, but the conditions that have resulted in bulky uterus can. For example, if bulky uterus is due to uterine tumours, then they can cause pregnancy complications and even complications during childbirth.

 

Q5) IS BULKY UTERUS DANGEROUS?

A) There are many reasons behind the enlargement of Uterus. like fibroids or tumours. But a bulky uterus is usually not a cause of concern if the cause has been detected by CT scan or sonogram. 

 

Q6) WHAT IS THE TREATMENT OF BULKY UTERUS?

A) The treatment basically depends on the causes of the bulky uterus. from surgery to the removal of fibroids, or endometrial ablation are some of the treatments of bulky uterus. 

References:

1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049976/
2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304266/
3) https://www.belmarrahealth.com/enlarged-uterus-causes-symptoms-treatment-tips/