Enlarged Uterus: Causes, Symptoms, and Treatment

Introduction to Enlarged Uterus

Enlarged Uterus – The uterus is a hollow organ in the pelvis and comprises two parts: the endometrium, which thickens during pregnancy, and the myometrium, which supports the uterus internally. Three layers comprise the uterus: the innermost layer is called the glandular or functional layer; this portion of the uterine wall secretes mucus and blood vessels that feed the endometrium.

The middle layer is called the serous or storage layer; this portion of the uterine wall stores blood in case of anemia. Finally, there is an outermost layer called muscular or adventitial; this portion of the uterine wall helps support and shape the uterus. A woman’s reproductive organs comprise her cervix, vagina, fallopian tubes, and ovaries (the ovary).

The term “enlarged uterus” describes a condition in which the size of the endometrium (uterine lining) increases beyond normal limits. The syndrome may start after menopause or present at birth and last for the rest of one’s life. Significant uterus syndrome is sometimes called leiomyomata.

The most common cause of significant uterus syndrome is an inherited disorder called uterine leiomyoma (unlike fibroids, leiomyomas are not cancerous). Leiomyomas are usually benign tumors composed of smooth muscle cells which frequently line the uterus’ interior. They can grow and increase over time, resulting in a larger uterus with an enlarged endometrium.

The most common cause of infertility is an enlarged uterus (endometriosis). An enlarged uterus can occur due to pelvic inflammatory disease (PID), endometriosis, or adenomyosis (a condition in which endometrial tissue grows outside of the uterus). 

Causes of Enlarged Uterus

Causes of Enlarged Uterus

The common causes of an enlarged uterus may be medical illnesses in the background, like polycystic ovarian syndrome (PCOS), endometriosis, or pelvic inflammatory disease (PID). However, other factors, such as excessive weight gain or breastfeeding, can play a role occasionally.

1. Uterine Fibroids

Fibroids are benign tumors that usually occur in the uterus, although they can sometimes be found elsewhere in the body. The fibroid may be a single tumor, or it may consist of several smaller tumors. Fibroids can cause pain at the time of menstruation, as well as abnormal bleeding and other problems. If a woman thinks she has fibroids, she should see her doctor to get checked out.

2. Adenomyosis

Adenomyosis is when the muscle layer around your uterus becomes thick and lumpy instead of smooth and elastic like normal muscle tissue. This can cause problems with your periods and make them irregular or heavy, possibly leading to anemia or blood clots that may cause a stroke or a heart attack.

If you have adenomyosis, you may also experience painful cramps or bleeding between periods or irregular intervals during your cycle. Your doctor will check for adenomyosis based on the symptoms you report, your medical History, and any physical exam findings he observes during an exam of your cervix (the lower part of your uterus).

3. Endometrial Hyperplasia

Endometrial hyperplasia can develop if a woman has multiple risk factors for endometrial cancer, such as:

  1. Women after 35 years of age.
  2. Previous History of breast cancer
  3. History of blood clots in your veins (deep-vein thrombosis)
  4. Family history of endometrial cancer
  5. A family history of uterine polyps

Symptoms and Impact on Fertility

Symptoms of Enlarged Uterus

1. Abnormal Uterine Bleeding

Abnormal uterine bleeding can be a sign of an enlarged uterus. This is also known as menorrhagia. It occurs because the blood flow to the uterus is restricted due to an enlarged uterus. In most cases, it happens due to pregnancy and childbirth. An enlarged uterus may be to blame for lower back or abdomen pain and bleeding between periods.

2. Pelvic Pain and Discomfort

If your uterus has grown too large for its good, it may press against other organs in your pelvis (it comprises two bones: ilium and pubic bone). This pressure can cause pelvic pain, back pain, and lower abdominal discomfort. Another symptom is constipation due to pressure on the rectum from the enlarged uterus pressing against it during childbirth or periods (for example, during menopause).

3. Pelvic Area Pressure or Fullness

Pelvic pain and discomfort are common complaints of women with enlarged uteri. This can be due to pressure or fullness in the pelvis and may also result in spasms or cramping that can be uncomfortable for both you and your doctor to deal with. 

4. Urinary and Bowel Symptoms

Urinary and bowel symptoms such as urgency, frequency, incontinence (leakage) of urine or stool, constipation, painful urination; sexual dysfunction including vaginal dryness or pain during intercourse

Diagnosing an Enlarged Uterus

1. Medical History and Examination

The medical history and physical examination should focus on ruling out pregnancy, fibroids, and cancer. Medical History includes:

  • History of recent illnesses, injuries, or surgeries that may have affected the uterus.
  • Any current or past health conditions may affect fertility or pregnancy, such as diabetes and high blood pressure.
  • The woman’s age, race, and medical History should be considered when diagnosing a possible enlarged uterus since the condition is more common in older women than in young women.

2. Imaging Tests

The diagnosis is usually benign if an ultrasound shows an enlarged uterus with a thin wall. However, if there is no evidence of pregnancy (e.g., vaginal bleeding or missed period), the diagnosis may be more likely to be uterine fibroids or endometriosis. In this case, a laparoscopy may be performed to confirm the diagnosis and remove any fibroids if they are found during surgery. An MRI may also help assess the embryo’s viability so that it can be frozen for future use if needed.

3. Biopsy or Sampling

A biopsy sample can be obtained with laparoscopy; however, there are risks involved in obtaining this type of tissue (invasive surgery).

Treatment Options for Enlarged Uterus and Infertility

Treatment of Enlarged Uterus

1. Uterine Fibroids

Uterine fibroids are benign tumors that grow in the fibrous lining of the uterus. Numerous symptoms, such as painful or irregular periods, heavy menstrual flow, pain during sex, or bowel motions, might be brought on by them. If fibroids push on the Fallopian tubes and prevent them from carrying eggs from the ovary to the uterus, this can also result in infertility.

2. Adenomyosis

Adenomyosis is when the lining of the uterus becomes thicker than usual and grows into adjacent tissues. The condition may cause infertility, abdominal pain, and urinary symptoms such as an increased need to urinate and blood in the urine.

3. Endometrial Hyperplasia

Endometrial hyperplasia is a disorder when the lining of the uterus experiences an increase in cells, thickening and expanding abnormally. Women with endometrial hyperplasia may have irregular periods or heavy bleeding. 

4. Uterine Polyps

Uterine polyps are growths on the villi or fingerlike projections that line the end of the fallopian tubes — structures that carry eggs from ovaries to the uterus — or other body areas such as the cervix (neck of the womb). Polyps can cause cervical cancer if they become large enough to block the cervical opening (birth canal).

Fertility Treatment Planning and Considerations

An enlarged uterus is a common medical condition, which is more common in women of childbearing age. The uterus is the organ that holds and nourishes the developing fetus during pregnancy.

Although the exact etiology of this ailment is unknown, it could be brought on by hormone imbalances, pregnancy, tumors, growth hormones, or other factors. It usually affects women after the age of 35 and is more common in those with children.

1. Individualized Approach

For mild cases, there are no special considerations for fertility treatment. However, IVF Treatment may be considered if there is no chance of conceiving naturally. If there is a possibility of having problems conceiving later on, egg donation may be an option.

2. Collaboration with Fertility Specialists

In the case of a large size of uterus, Fertility specialists recommend surgical treatment for the removal of extra tissue or organ from the body or removing part of an organ from the body with minimized damage to surrounding tissues. The procedure has been successfully performed using laparoscopy(minimally invasive surgical technique), which provides several advantages like minimized pain during surgery, no open abdomen surgery required, and less risk of infection compared to open abdomen surgery like laparotomy.

Conclusion

It would be best to see a doctor to find the underlying cause of your enlarged uterus. Making an appointment with your gynecologist is an intelligent approach to accomplish this. Calling their office and making an appointment over the phone is an option if you cannot visit them in person.

A regular doctor will check your health history and ask questions about your menstrual cycle, fertility, family history, and other relevant information. They will also conduct a physical exam and ask you questions about your health. This way, they can look at all possible causes of your enlarged uterus and find suitable treatment options.

Why Choose Imprimis IVF for Enlarged Uterus Treatment

Imprimis IVF is ideal for enlarged uterus treatment due to its specialized expertise, advanced technology, comprehensive approach, diverse treatment options, and supportive care. Their team of experienced fertility specialists focuses exclusively on reproductive medicine, ensuring personalized and effective treatment for an enlarged uterus. Equipped with state-of-the-art facilities, Imprimis IVF provides accurate diagnosis and utilizes cutting-edge technology for optimal treatment outcomes. 

Their holistic approach considers various factors contributing to the condition, addressing underlying causes and developing individualized treatment plans. Imprimis IVF ensures that patients receive the most appropriate and effective care with a wide range of treatment options available, including medications, minimally invasive procedures, and fertility preservation techniques.

What is AMH Test – Purpose, Levels, and Treatment

What is AMH Test – AMH is a female hormone produced by the ovaries. An anti-mullerian hormone is so named because it binds to receptors on cells that line the inside of the fallopian tubes. These receptors are part of a complex system that assists sperm in approaching and fertilizing an egg.

Your doctor may additionally order an AMH test to identify an ovarian mass. An AMH test is a simple blood test; if you take it after your period begins and before ovulation (the release of an egg from one ovary), you may see results in one week or less. An AMH test determines anti-mullerian hormone levels related to an individual’s egg count. It is related to your egg count but does not predict your fertility.

Importance of AMH Levels

AMH levels are essential for determining your ovarian reserve but don’t directly correlate with age. AMH levels increase as you age. After menopause, a woman’s AMH level increases as she ages. The higher the AMH level, the more eggs and ovarian reserve.

AMH levels also vary between women.

Some women have more eggs than others, which means they can produce more eggs in their ovaries. It is called having a high ovarian reserve. Others may have fewer eggs or a lower ovarian reserve, which means they may not be able to produce as many eggs in their ovaries and could experience infertility issues if they decide to get pregnant.

Purpose of the AMH Test

AMH is a hormone that’s produced by the ovaries. It helps maintain an egg’s structure and signals the brain to release hormones that make it possible for a woman to conceive.

The test aims to determine whether or not you are at risk for developing cervical cancer. A positive result means that you might have an increased risk of developing cervical cancer and should undergo regular screening tests for this disease.

The AMH test also helps in assessing ovarian reserve. Suppose you have low or no measurable levels of AMH. In this particular situation, you might be at risk for diminished ovarian reserve or premature menopause — two conditions affecting your fertility options and quality Of life.

Predicting Response to Fertility Treatments:

 The test is commonly performed on postmenopausal women to check for signs of estrogen deficiency or osteoporosis, but it can also be used to assess ovarian reserve and fertility status. In some cases, women may request an AMH test if they have irregular periods or have had their uterus removed due to cancer treatment.

AMH Levels

A higher number means more eggs in your ovaries, which means more egg follicles to help produce healthy eggs. A lower number means you may produce fewer eggs than before and may soon lose those eggs.

A woman’s AMH levels are usually between 1.0 ng/mL to 3.0 ng/mL. (nanograms per millilitre). It is the level at which ovulation is most likely to occur, usually within this range.

Low AMH levels, under 1.0 ng/mL, may indicate that the pituitary gland functions normally. The presence of abnormally low levels of certain hormones in the body might suggest an underlying problem within the hypothalamus or the anterior pituitary gland, which plays a crucial role in hormone production and regulation.

Causes of low AMH:

Ovarian cancer or other conditions that affect the ovaries (liver disease, kidney disease, thyroid problems) may cause low levels of AMH. It can also signify early menopause in women who have not gone through menopause. Your doctor can request an AMH test to confirm the diagnosis if she suspects you are going through perimenopause or early menopause. However, this is not a common indication for testing at this time because most women do not go through menopause until after age 50.

Implications for Fertility:

Because low levels of AMH are associated with advanced reproductive age, they may indicate a woman has less menstrual bleeding and will have fewer eggs than younger women. Conception challenges may additionally be experienced by these women, making it harder for them to achieve pregnancy. In addition, some doctors recommend that women with low levels of AMH get fertility treatment if they have trouble conceiving or carrying a pregnancy past six months. 

High AMH levels can be caused by several factors, including:

High AMH Levels Factors

Hormone Imbalance:

If you’re not getting enough progesterone or estrogen, your body will produce more AMH to compensate for the lack of hormones. It may be caused by a condition like Polycystic ovary syndrome (PCOS) and hypothyroidism (an underactive thyroid gland), which can also contribute to these symptoms in women.

Ageing: 

Our bodies naturally produce less AMH and more follicle-stimulating hormone (FSH) as we age. It can lead to higher estrogen levels and lower progesterone levels, which can cause high AMH levels.

Genetic:

If you have a family history of high blood pressure, heart disease, or type 2 diabetes, you could also inherit high levels of AMH from your parents — conditions often linked to high blood pressure or heart diseases risk factors like smoking and obesity.”

Interpretation of AMH Test Results

Some of the considerations that are to be kept in mind while interpreting the AMH Test results are:

Age-related Considerations

A woman’s age does not influence the results of the AMH test. As early as the age of 20, individuals can undergo this test and receive accurate results as late as 44, with most women having a typical result between ages 25 and 35. The AMH level for a woman between 20–25 years old is 4.23 ng/mL.

Relationship to Fertility Potential

The AMH test has been used to predict fertility potential in older women who wish to conceive. A woman’s AMH level is believed to decline with age, which may be related to decreased production of eggs or sperm, decreased ovulation rate, or both.

Other Factors Affecting Interpretation

Women who have undergone cancer treatment or had multiple pregnancies may have slightly lower levels of AMH than those without these conditions. However, these factors do not affect the interpretation of the result and should be considered if they are high enough to cause concern about fertility potential.

Treatment Options

High AMH Levels Treatment

 There are various treatment options available based on different AMH levels.

  • Treatment for Low AMH Levels

In the case of low levels of AMH, various treatment options are available to women with diminished ovarian reserve. Some of these treatments include:

  • Assisted Reproductive Techniques (ART)

ART treatment is designed to help a woman who cannot become pregnant on her own through natural means become pregnant by using assisted reproductive technology such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Assisted reproductive techniques can help a woman conceive if her eggs are not viable enough for IVF or ICSI. For women with low amounts of AMH and a compromised ability to make eggs, this may occasionally also be a possibility.

  • Ovarian Stimulation

This treatment uses hormones to stimulate the release of one or more eggs from your ovaries during a menstrual cycle. The amount of stimulation depends on the woman’s age and her response to previous stimulation treatments, which can vary widely from woman to woman. Because this method involves injecting hormones directly into your bloodstream, there is always a risk that you might develop side effects such as nausea, vomiting, or headaches while receiving medications through your IV line.

  • Egg or Embryo Freezing

In some cases, women may have low levels of AMH due to low levels of progesterone production caused by premature ovarian failure or menopause. Conditions that may require medical treatment before freezing embryos can occur.

Treatment for High AMH Levels

  • Management of Polycystic Ovary Syndrome (PCOS)

Among the many treatment options for women with high AMH levels, ovary-intact women with PCOS often benefit from medication. PCOS are at increased risk of developing endometrial cancer and should be monitored regularly. In addition, ovarian stimulation is an option for women undergoing IVF or other fertility treatments.

  • Treatment for Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) can occur when a woman ovulates multiple times more than usual during ovulation induction. This syndrome can be life-threatening if left untreated, so doctors may recommend that patients take medications to reduce the high levels of AMH in their bodies.

At any point in your menstrual cycle, you have the flexibility to undergo the AMH test. A straightforward blood test that provides valuable insights into your reproductive health. It means you or a health care provider can perform it.

In addition to being an excellent diagnostic tool, the AMH test has many other benefits. It can:

  1.  Identify if your ovaries are making too much estrogen. This imbalance of sex hormones can ensue, causing a disruption in their normal levels and functions within the body.
  2.  Identify if there are any issues with egg development or fertilization;
  3.  Evaluate treatment options for PCOS, OHSS, or other conditions related to abnormal ovulation.

Why Choose Imprimis IVF for AMH Testing?

What is AMH Test

 Imprimis IVF may be a suitable choice for your AMH test due to the following reasons:

 Specialization: Imprimis IVF specializes in reproductive medicine and fertility treatments, ensuring expertise in conducting AMH tests.

  1. Advanced Facilities: They have state-of-the-art laboratory facilities and advanced diagnostic technology for accurate and reliable testing.
  2. Comprehensive Services: Imprimis IVF offers a range of fertility treatments beyond AMH testing, providing integrated care.
  3. Positive Reputation: The clinic has a strong reputation for delivering high-quality care and achieving successful outcomes.
  4. Patient-centered Approach: Imprimis IVF focuses on compassionate and personalized care throughout your fertility journey.
  5. Affordability: They offer cost-effective options and may partner with insurance providers to help manage expenses.

Conclusion

It’s essential to take note of both your age and your AMH levels when trying to conceive. You can use an AMH blood test for the same reasons as the anti-mullerian hormone (AMH) test. It’s a few days long but a relatively quick and easy procedure. If you’re concerned about your fertility and want to do everything possible, including affordable testing. Check with your fertility clinic or IVF experts to learn more about an AMH blood test.