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A uterus that is bigger than a clenched fist is considered large. In some cases, it is cause for concern, though it also may be considered normal for some women. It is difficult to feel or measure the uterus without being pregnant, so many women are not aware of their large uterus until their gynecologist mentions it after an exam. Pregnancy and menopause are two common, harmless causes of an enlarged uterus. Uterine fibroids and adenomyosis are two causes for this condition that are painful but treatable, while uterine cancer is the most serious reason for an unhealthily large uterus.
Pregnancy is a common cause of a large uterus, because the womb needs to grow with the fetus. A negative pregnancy test may indicate a recent miscarriage, especially if the woman has other symptoms, such as vaginal bleeding and cramping. In women approaching menopause, a larger than normal uterus may be expected as a result of changing hormone levels. A hormonal imbalance may cause the body to assume it is pregnant and allow the uterus to grow, at which point other pregnancy symptoms may occur. While these causes of an enlarged uterus may not be serious, women are advised to get an ultrasound to ensure nothing else could be causing the issue.
In some cases, a uterus is large because of a slightly more serious reason, such as uterine fibroids. These are growths that can lead to excessive blood loss during menstruation, as well as pelvic pressure and pain in the uterus. Longer menstrual periods and difficulty urinating are other symptoms of uterine fibroids. Most women do not need treatment for fibroids unless the blood loss causes anemia or a lower quality of life, at which point medication or a hysterectomy may be considered.
Adenomyosis is another possible cause of an enlarged uterus. This is a condition in which the lining of the endometrium grows into the outer wall of the uterus. The result is a thicker uterus that causes cramping, excessive bleeding during menstruation and light bleeding between periods. It most commonly occurs in women who have had at least one child, are over the age of 30 and have had uterine surgery, such as a Caesarean section. Birth control pills and a hysterectomy are two treatment options.
A large uterus can be cause for concern, because it indicates a life-threatening condition such as uterine cancer. The most common type of uterine cancer is endometrial cancer, which affects the uterine lining. Cervical cancer, which impacts the lower area of the uterus, is another type. The main symptom of uterine cancer is typically abnormal bleeding after menopause, but some women have no idea they have this condition until a doctor performs an exam.