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Causes of an Enlarged Uterus

author image Kate Killoran
Katherine Killoran is a board certified OB/GYN practicing in Rockport, Maine. She graduated from Boston University School of Medicine in 1999 but really learned how to be healthy and well from her own breast cancer diagnosis. She blogs about healthy lifestyle habits on her website
Causes of an Enlarged Uterus
Pregnant woman talking to her doctor Photo Credit: byryo/iStock/Getty Images

The uterus, or womb, is the place in the body where a baby grows. Located in the pelvis, the female reproductive organ can become enlarged for a variety of reasons. The most likely cause depends on a woman's age. In women of childbearing age, pregnancy -- either normal or abnormal -- is the most common reason for an enlarged uterus. Benign uterine tumors, known as fibroids, can also be a cause. Occasionally, in young women who are just starting their periods, a blockage of menstrual blood flow leads to an enlarged uterus. In older women, cancer involving the uterus is a potential cause for enlargement.

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Doctor examining pregnant woman
Doctor examining pregnant woman Photo Credit: EmiliaU/iStock/Getty Images

Within the first few weeks of a normal pregnancy, the uterus begins to grow. It starts at a weight of approximately 70 g and grows to about 1,100 g at term. A miscarriage, when a fetus or embryo is no longer living, or an ectopic pregnancy, when a pregnancy is implanted outside of the uterus, can also result in an enlarged uterus. Yet another type of abnormal pregnancy, called a molar pregnancy, can lead to excessive uterine growth.


Doctor speaking with pregnant woman in hospital.
Doctor speaking with pregnant woman in hospital. Photo Credit: Purestock/Purestock/Getty Images

Uterine fibroids, or leiomyomas, are the most common tumor found in the pelvis. According to the American College of Obstetricians and Gynecologists, uterine fibroids occur in up to 70 percent of white women and 80 percent of black women by age 50. They are rare in adolescence and usually shrink after menopause. They can be so small that they are only visible with a microscope, or in rare cases they can exceed 25 lbs. Although most of the time they do not cause symptoms, they can cause abnormal bleeding, pelvic pressure, painful periods and urinary frequency.

Adenomyosis and Hematometra

Doctor taking blood pressure of female patient
Doctor taking blood pressure of female patient Photo Credit: IPGGutenbergUKLtd/iStock/Getty Images

Adenomyosis occurs when the endometrium -- the lining of the uterus -- grows into the walls of the uterus, causing it to grow up to 2 to 3 times normal size. It affects approximately 20 percent of women. Classic symptoms of adenomyosis are heavy, painful periods, but -- like fibroids -- it is most often asymptomatic. Also like fibroids, it affects women of childbearing age. Hematometra is another disorder that can cause an enlarged uterus. It occurs when the uterus expands with blocked menstrual blood flow. This can happen in young women who are just starting to menstruate or in older women who have scarring within the pelvis, usually from radiation or surgery.


Nurse holding hand of a senior woman in the hospital
Nurse holding hand of a senior woman in the hospital Photo Credit: Lighthaunter/iStock/Getty Images

Cancer involving the uterus can cause enlargement. The most common cancer of the uterus is endometrial cancer. It will be diagnosed in approximately 54,870 women in the United States annually, according to the American College of Obstetricians and Gynecologists. Rarely, cancer occurs within the muscular wall of the uterus. This is known as a sarcoma. Cancer can also occur within a fibroid -- this is called a leiomyosarcoma. Cancers are most likely to occur in postmenopausal women.

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