Uterus - The Birthright of a Woman
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Uterus - The Birthright of a Woman

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 27 Feb 2014 - 19:52.

Human uterus is the right of a woman. If women have a birthright of the uterus, only the uterus has the birthright for pregnancy.

Human uterus is where a child is born from. Universally called the womb, the uterus is a muscular pear-shaped organ of female reproduction. This pear shaped muscular organ situated in the pelvic cavity of females, is a specialized organ engineered and designed for holding and nourishing a developing embryo from implantation to birth.

For the formation of the human embryo, fertilization has got to take place. If fertilization of the egg or the ovum occurs, the lining of the uterus undergoes a physiological change that makes it hospitable for the attachment and nurturing of the embryo in its early stages.The muscular and elastic elements of the human uterus is designed to expand to accommodate the growing fetus and also in the expulsion of the new baby at birth.

Uterus structure: The uterus, which has never experienced pregnancy, is about 8 cm in length and approximately 5 cm in width. The cavity of the uterus is triangular in shape. This cavity called the uterine cavity is widest at the fundus, which is the top portion of the uterus where both the fallopian tubes, one from each ovary, enter the uterus opening in the cavity. These two tubes connecting ovaries to the uterus allow the ripened eggs to move into position for successful fertilization. The cavity is narrowest at the lower end called the cervix, which leads to a tubular structure called the vagina.

The uterus is composed of three layers namely, the outer perimetrium made of connective tissue, the thick and elastic tissue myometrium and the mucosal lining covering the interior of the cavity called endometrium.

Uterus function: The endometrium is divided into two zones in relationship to their functions. Endometrium functionalis is the zone built up and sloughed every month during menstruation and the endometrium basalis, which consists of the epithelium, and glandular elements, remain and supply the cells to generate the functionalis zone for the following month’s menstrual period.

The average menstrual cycle is 28 days, closely matching the lunar cycle. Menstruation occurring for the first time in the life of a female is called menarche, which normally starts at the age of 12 to 15 years. From then on menstrual periods occur once every month until it finally stops when we call the woman to have attained menopause. Normally menopause occurs approximately between 45 to 50 years of a woman’s life.

The uterus, which is used to have menstrual periods month after month for an average period of 30 years, suddenly finds itself devoid of this routine between 45 to 50 years. Therefore, it needs to adjust itself to welcome this phase called menopause. It is during this period of adjustment that a woman experiences irregular periods, excessive bleeding and in some women some emotional changes termed PMS (Pre-Menstrual Syndrome). In extreme cases, some women experience severe emotional instability requiring medical attention.

Uterus disorders: Human uterus can be subjected to several problems including cancer, endometritis, endometriosis, pelvic inflammatory disease, and hormonal imbalances that may affect a woman's ability to bear children or could threaten her life. Regular gynecological check-ups can lead to medical treatment before these problems become serious.

From conception till the birth of the baby the uterus may be subjected to several problems. Most importantly, the position of the grown up fetus and the presenting part differs in different ladies and at different pregnancies in the same person. Normally the presenting part i.e., the part that comes first during delivery is the head. We call this as vertex presentation. In some cases the buttocks present first which is called breach presentation, when we need to perform a forceps delivery for the incoming head.

In very few cases the baby lies in a transverse position which if it doesn’t correct itself during delivery, may need a cesarean section. In some cases the presenting part turns out to be the face and in some the placenta positions before the head (Placenta previa) and in some other cases the umbilical cord either prolapses or winds itself around the neck (cord prolapse) and all these conditions warrant immediate surgical intervention through a procedure called cesarean section. In very rare cases conception takes place in the fallopian tube, when we call it tubal pregnancy, which if not diagnosed and attended to immediately might prove fatal to the mother.

Abortions of various types may disappoint the pregnant uterus. If these occur repeatedly, known as habitual abortion, thorough investigations to pinpoint the cause must be undertaken or alternatively pregnancy must be avoided until the cause is ascertained and corrected.

When the lady delivers through a caesarian section for whatever reasons, it is advisable not to go in for a second child or at least be prepared for a caesarian section if pregnant for the second time. In such cases rupture uterus is a distinct possibility and must be kept in mind to tackle any eventuality.

Until the first pregnancy occurs we call the uterus as Nulliparous. When pregnancy occurs we call it gravid uterus. If it is the first pregnancy we call it primigravida. If pregnancy repeats more than once, including abortions if any, it is known as mutigravida. If the number of pregnancies exceeds ten, it is called grandmal.

Except when menstruation stops during pregnancy a woman loses blood for about 3 to 5 days during each menstrual period. Some women have frequent periods at an interval of 15 to 20 days. Some women have prolonged duration say once in 40 to 45 days. Some ladies bleed excessively though the cycle lasts only 3 to 4 days.  In some the bleeding is scanty. Yet in some cases the first periods called menarche doesn’t occur even when she is past 20 years. Some women experience pain during menstrual periods, which is known as dysmenorrhea. Those women who are lucky will have timely menarche, normal periods and timely menopause.

All these variations do occur in some women due to hormonal problems. Whatever be the variation, a lady bleeds once every month for about 3 to 5 days. It is therefore essential for every Indian woman to take iron supplements to make good, the loss of hemoglobin.

Of all the ailments affecting the uterus the most dreaded ones are cancer cervix and infertility. Cancer cervix if detected early can be cured without any problem. It is only the late stage cancer, which poses a challenge for surgical intervention. It is therefore essential for all ladies to undergo Pap Smear examination once in a year as a routine to rule out malignancy.

Fibroids uterus considered as a benign growth in the body of the uterus is another problem affecting a uterus. Though fibroid is considered as a cause for infertility depending on the location and size, it is essential to rule out malignancy whenever there is a fibroid.

Infertility when present due to some cause or other in the female is a major cause to psychologically upset a lady that may lead to marital problems.

DUB (Dysfunctional Uterine Bleeding) mainly due to hormonal imbalance is a common disorder in most of the women and warrants thorough evaluation and prompt treatment. Similarly Polycystic Ovarian disease is also quite common, complained by many women, which also needs immediate attention.

There are many more conditions, which affect the uterus. Only few of the common entities have been explained. One condition, which deserves mention, though of rare occurrence is congenital absence of the uterus due to developmental anomalies.

As a rule every woman from menarche to menopause should consult a gynecologist to detect any problem that can be nipped in the bud.

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.