The uterus (technical term: uterus) is an organ in the female pelvis. It serves as a fruit holder in the event of pregnancy. In addition, the uterus influences a woman’s sexual sensation and hormone balance.
What is the uterus?
The anatomy of the female reproductive and sexual organs clearly shows the uterus and ovaries. The uterus is a muscular hollow organ that is approximately the size and shape of an upside-down pear. Outside of pregnancy, it measures 7-9 cm in length and about 5 cm in width. Its weight varies from 30 to 120 g. The uterus is one of the internal sexual organs of a woman. It is located outside the peritoneum (extraperitoneal) between the bladder and the rectum. The uterus is held in position by a holding apparatus consisting of various ligaments and the muscular pelvic floor. Normally, the uterus is slightly tilted forward in relation to the vagina (anteversio) and bent forward in itself (anteflexio).
Anatomy and structure
Different anatomical sections are distinguished on the uterus: The upper end is called the uterine fundus (fundus uteri) – a fallopian tube enters each side here. The body of the uterus (corpus uteri) is attached at the bottom. This finally narrows to form the uterine isthmus (isthmus uteri) and the cervix (cervix uteri). As the lower end of the uterus, the cervix (portio vaginalis uteri) protrudes into the vaginal vault. The wall of the uterus shows a three-layered structure: The outer perimetrium is covered by peritoneum. The middle and thickest layer, the myometrium, consists of smooth muscle. Inside, there is the endometrium, a layer of mucous membrane that is subject to strong hormonal changes. The mucosa at the exit of the uterus is very different from the mucosa in its main body.
Functions and tasks
Primarily, the uterus serves as a fruit holder in case of pregnancy. In women of childbearing potential, the endometrium prepares to receive a fertilized egg during each menstrual cycle. If fertilization does not take place, the superfluous parts of the mucous membrane are shed again during menstruation. If, on the other hand, a fertilized egg does implant, the endometrium continues to grow, controlled by hormones, and stores nutrients so that the uterus can accommodate and nourish the growing embryo. In the process, the uterus can grow to 20 to 30 times its normal size during pregnancy. This enormous enlargement capacity is made possible by its special spiral-shaped muscle fibers. During the birth process, the powerful muscles of the uterus also perform the expulsion of the child. Meanwhile, medicine knows that the uterus is significant not only in the context of pregnancy, but also for a woman’s sexual life. Contractions of the uterus play a role in female orgasm. In addition, cervical mucus plays a part in moistening the vagina. Patients who have had their uterus removed often experience depression and earlier onset of menopause in addition to sexual dysfunction. Therefore, it is believed that the uterus also affects ovarian hormone production.
Diseases
Diseases of the uterus are called metropathies. One well-known disease is cervical cancer (cervical carcinoma). Globally, cervical cancer is the second most common malignancy in women and is often due to human papillomavirus (HPV) infection. Routine Pap testing at gynecologic screenings is used for early detection, and HPV vaccination is used for prevention of cervical cancer. Tumors also frequently develop in the mucous membrane of the uterine body. These are called endometrial carcinomas and in Germany occur about twice as often as cervical carcinomas. Initial symptoms are spotting or flesh-water colored discharge. Very common, but usually benign, are growths of the uterine muscles (fibroids). In addition to tumor diseases, there are various congenital uterine malformations. These are due to the fact that the uterus is formed embryonically from the fusion of two so-called Müller ducts. If this fusion does not occur or occurs only partially, anomalies develop that also affect fertility. In older women, the uterus often descends due to weakness of the pelvic floor.In extreme cases, the uterus prolapses (uterine prolapse). Removal of the uterus (hysterectomy) is performed very often in Germany: It is the second most common operation in women aged 40 to 49 and accounts for about 50% of all gynecological operations performed overall.
Typical and common conditions
- Uteritis
- Myoma (uterine tumor)
- Cervical cancer
- Cancer of the uterus (endometrial cancer)
