Common Conditions That Can Affect the Uterus

Several health conditions can affect the uterus or womb. Some are serious, while others need minimal treatment. Many involve similar symptoms such as pelvic pain or irregular bleeding. It's important to see a healthcare provider so you can get the right diagnosis and treatment.

This article explores some of the most common uterine health conditions. It also takes a look at how they are diagnosed and treated.

Uterus Structure

The uterus is a pear-shaped structure in the pelvis. It sits behind the bladder and in front of the rectum. The uterus grows during pregnancy. Afterward, it shrinks back almost to its original size within weeks.

On each side of the uterus are the fallopian tubes and ovaries. The uterus, vagina, ovaries, and fallopian tubes make up the female reproductive system. Because these organs are so close to each other, pain in the pelvis could be related to the uterus or something else entirely.

Uterine Conditions

Some of these health conditions begin in the uterus. Others are caused by factors outside the uterus, such as hormones.

Dysmenorrhea

Dysmenorrhea is menstrual pain. It can occur before and/or during your period. Period pain is not necessarily a sign of a medical condition on its own. It often improves with pain medication or hormone therapy.

Menorrhagia

Menorrhagia is very heavy menstrual bleeding. It can also refer to bleeding that lasts too long. It can occur without any known cause, or it can be a symptom of:

  • Hormone imbalances
  • Fibroids
  • Polyps
  • Some types of birth control
  • Cancer
  • Other health conditions

Heavy bleeding can cause iron deficiency anemia, a low red blood cell count. If your red blood cell count is low, you may need treatment to control the bleeding as well as the anemia.

Recap

Pain and heavy bleeding may be related to a uterine problem. Pain on its own isn't always a sign of a disorder. Heavy bleeding may be from hormone changes, growths, medications, or even cancer.

Common causes of heavy menstrual bleeding
 Verywell / Brianna Gilmartin

Uterine Prolapse

Uterine prolapse means the muscles and ligaments that hold the uterus in place have weakened. The uterus drops. Many people have mild to moderate uterine prolapse when they get older.

The most common symptoms are:

  • An urgent feeling that you need to urinate
  • Urine leaks
  • Pain during or after sex in severe cases

Retroverted Uterus

With this condition, the uterus tilts too far back towards the spine. Most of the time, it doesn't cause symptoms. In rare cases, it can cause problems during pregnancy. Your healthcare provider may detect the condition during a pelvic exam.

Congenital Uterine Malformation

Sometimes the uterus has an atypical shape. This can make it harder to get pregnant and can raise the risk of miscarriage. Your healthcare provider may spot the condition on an ultrasound. It can also be found with an abdominal computed tomography (CT) scan.

These differences can include:

  • Septate uterus: The uterus has two separate sides. Uterine tissue nearly or completely separates one side from the other.
  • Bicornate uterus: The uterus is shaped like a heart. The two halves are almost equal-sized. They are not as walled off from each other as with a septate uterus.
  • Didelphys uterus: The uterus is divided, usually near the lower opening. Each section has a separate cervical opening.
  • Unicornate uterus: The uterus is smaller, and there is only one fallopian tube. Sometimes there's a second section that doesn't fully develop.

Recap

Some conditions change the shape or orientation of the uterus itself. If your uterus sits too low in your abdomen, tilts back, or has an unusual shape, it can cause pain, urinary leaks, or pregnancy problems. For some people, these differences don't cause any symptoms at all.

Pelvic Inflammatory Disease

Sometimes, bacteria or microbes enter the cervix and spread upward. The infection can affect one or more of the pelvic organs, including the uterus, cervix, and fallopian tubes. This is called pelvic inflammatory disease (PID).

Symptoms can include:

  • Discharge
  • Foul smell
  • An urgent need to urinate
  • Pain

Polyps

Uterine polyps are common. These small, soft growths in the uterus may cause heavy menstrual bleeding, spotting between periods, and bleeding after sex.

Fibroids

Fibroids are growths in the walls or lining of the uterus. Sometimes, they attach to the outside of the uterus by a stalk. They can be as small as a seed or larger than an orange.

Symptoms include:

  • Heavy or prolonged bleeding during your period or between periods
  • Pelvic pain or pressure
  • Back pain
  • Pain during sex
  • Difficulty getting pregnant 

Although fibroids are sometimes called tumors, they are not cancer. They do not invade tissue or travel to other parts of the body the way cancer does.

Endometrial Hyperplasia

Endometrial hyperplasia occurs when too many cells grow in the lining of the uterus. The uterus becomes very thick as a result. The condition can cause abnormal bleeding.

It is not cancer, but in some cases, it can lead to cancer of the uterus. Symptoms include:

  • Abnormal vaginal bleeding
  • Discharge
  • Abnormal Pap test

Endometriosis

With endometriosis, the same kind of tissue that lines your uterus grows in other parts of the body. Most of the time, it grows in the abdomen or ovaries. This can cause scar tissue to build up around the affected organs. People who have endometriosis often have endometrial hyperplasia, but not always.

Symptoms include:

  • Painful or heavy periods
  • Irregular bleeding or spotting
  • Pain during or after sex
  • Pain in the abdomen or intestines
  • Pain during urination or bowel movements 

Uterine Scars (Asherman's Syndrome)

Sometimes, scars form after uterine surgery, radiation, or injury. These scars are also called adhesions or Asherman's syndrome. It may lead to not having periods or light bleeding during your periods. Severe cases can cause pain or infections.

Cancer

Uterine cancer causes abnormal vaginal bleeding. The most common type is endometrial cancer. It requires aggressive treatment if it has spread beyond the uterus.

Recap

Abnormal cells can sometimes grow in or on the uterus. Polyps, fibroids, scar tissue, cancer, microbes, and extra uterine tissue can cause bleeding, pain, and other symptoms.

Chronic Pelvic Pain

If your healthcare provider can't identify the cause of your pain, you may be diagnosed with chronic pelvic pain. You may need treatment when your pain becomes worse. You may also be more sensitive to other painful conditions, such as gastrointestinal or bladder infection.

Symptoms

Symptoms of diseases of the uterus include:

  • Irregular periods
  • Discharge
  • Pelvic pain or discomfort
  • Low back pain
  • Trouble urinating
  • Difficulty getting pregnant

In each phase of your menstrual cycle, the uterus changes. Symptoms may get better or worse throughout the month.

Diagnosis

Your medical history and symptoms can help your healthcare provider decide which tests you need. Some of the most common tests are:

  • Pelvic exam: This can identify problems such as a prolapsed or retrograde uterus. A pelvic exam can't fully assess what's happening inside the uterus. You may need other tests to confirm your diagnosis.
  • Pap smear: This test can identify changes in the cells of the cervix. That's the opening of the uterus. If you have not had a recent Pap smear, this test may be a good starting point if you have symptoms of a uterine condition.
  • Urinalysis: This test checks for signs of infection and, sometimes, cancer cells in your urine.
  • Blood samples: Sometimes these tests identify hormonal changes that could affect the uterus.
  • Imaging tests: Ultrasound or computed tomography (CT) scans produce an image of the uterus. They can reveal differences in shape, size, or location. For some CT scans, doctors may inject dye into a blood vessel to create a clearer picture.
  • Interventional procedures: These tests use tiny cameras to explore the inside of the uterus without surgery. In a hysteroscopy, doctors place a tube into the cervix to look at the inside of the uterus. In a hysterosalpingography or a sonohysterogram, doctors inject fluid or dye into the cervix to see the inside of the uterus.

Recap

If you're having pain, bleeding, urinary leaks, or pregnancy problems, a pelvic exam and Pap test may be enough to pinpoint the problem. If not, you may need urine, blood, imaging scans, or "scope" tests to confirm a diagnosis.

Treatment

The right treatment depends on what's causing your symptoms. Some of the most common treatments include:

  • Antibiotics: An infection such as PID requires antibiotics.
  • Hormonal treatment: Endometriosis is often treated with medications, such as birth control pills. Endometrial hyperplasia, dysmenorrhea, and menorrhagia may be treated with hormone therapy if symptoms are severe.
  • Embolization: Uterine fibroids can be treated with embolization. This procedure isn't as invasive as surgery. A healthcare provider uses a slender tube to insert a medication or material that cuts off blood supply to the fibroid. The fibroid then shrinks. The same treatment can be used to treat polyps if necessary.
  • Surgery: Uterine prolapse can be treated surgically. In severe cases, the uterus may be removed. Fibroids, polyps, adenomyosis, endometriosis, and cancer can also be treated with surgery.
  • Observation: Sometimes the best approach is to watch and wait. For example, healthcare providers may keep a close eye on your pregnancy if you have a uterine malformation. If you have a retrograde uterus, you can pay attention to bladder symptoms. At some point, you may need strategies to deal with urine leaks.

In some cases, treatments are combined. That's especially true in severe cases or those where a single treatment didn't work well.

Summary

The uterus can be affected by many different conditions, some of which have similar symptoms. The conditions may be caused by the way the uterus is formed, by infection, by hormonal changes, or by scars and growths.

Most of the time, symptoms include pain, unusual bleeding, and urinary leaks. Physical exams, lab tests, and imaging scans can shed light on the problem. Medication, hormones, embolization, and surgery are all options for treating different conditions. You and your healthcare provider can work together to create a treatment plan.

A Word From Verywell

If you have symptoms of a uterine condition, it can be hard to know if something serious is going on. It's a good idea to talk with a healthcare provider about your symptoms. Treatment can improve many effects and may completely resolve some conditions.

Frequently Asked Questions

  • Which uterine conditions are considered emergencies?

    You should seek immediate medical help for anything that could lead to sudden blood loss. That includes ectopic pregnancies, PID with abscesses or fluid-filled pockets, fibroid complications, and uterine bleeding.

  • Which uterine conditions may cause pain during intercourse?

    Several uterine conditions can cause pain during sex. These conditions include fibroids, endometriosis, pelvic inflammatory disease, and ectopic pregnancy.

31 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. UT Southwestern Medical Center. What’s going on with my uterus? 3 conditions related to pelvic pain and bleeding.

  2. Gossman W, Fagan SE, Sosa-Stanley JN, et al. Anatomy, abdomen and pelvis, uterus. In: StatPearls.

  3. Sharghi M, Mansurkhani SM, Ashtary-Larky D, et al. An update and systematic review on the treatment of primary dysmenorrhea. JBRA Assist Reprod. 2019;23(1): 51–57. doi:10.5935/1518-0557.20180083

  4. Cleveland Clinic. Menorrhagia (heavy menstrual bleeding).

  5. Chung S, Kim WB. Various approaches and treatments for pelvic organ prolapse in women. J Menopausal Med. 2018;24(3):155-. doi:10.6118/jmm.2018.24.3.155

  6. UNC Department of Obstetrics & Gynecology. Pelvic relaxation and retroverted uterus.

  7. Saravelos SH, Cocksedge KA, Li T. The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage. Reproductive BioMedicine Online. 2010;20(3):416-422. doi:10.1016/j.rbmo.2009.11.021

  8. Colombia University Irving Medical Center. Uterine anomaly.

  9. Centers for Disease Control and Prevention. Pelvic inflammatory disease (PID) — CDC factsheet.

  10. Cleveland Clinic. Uterine polyps.

  11. UCLA Health. What are fibroids.

  12. Cleveland Clinic. Atypical endometrial hyperplasia.

  13. NIH National Institute of Child Health and Human Development. What are the symptoms of endometriosis?

  14. Cleveland Clinic. Asherman’s syndrome.

  15. Centers for Disease Control and Prevention. Uterine cancer. What are the symptoms?

  16. Speer LM, Mushkbar S, Erbele T. Chronic pelvic pain in women. American family physician. 2016;93(5):380-7. 

  17. U.S. Department of Health & Human Services. Vaginal discharge.

  18. Centers for Disease Control and Prevention. Common reproductive health concerns for women.

  19. Pinkerton JV, Guico-Pabia CJ, Taylor HS. Menstrual cycle-related exacerbation of disease. American Journal of Obstetrics and Gynecology. 2010;202(3):221-231. doi:10.1016/j.ajog.2009.07.061

  20. Planned Parenthood. What is a pelvic exam?

  21. Planned Parenthood. Pap smear test.

  22. MedlinePlus. Urinalysis.

  23. MedlinePlus. Hormone levels.

  24. Wong L, White N, Ramkrishna J, Júnior EA, Meagher S, Costa FDS. Three-dimensional imaging of the uterus: The value of the coronal plane. WJR. 2015;7(12):484-. doi:10.4329/wjr.v7.i12.484

  25. Acholonu UC, Silberzweig J, Stein DE, Keltz M. Hysterosalpingography versus sonohysterography for intrauterine abnormalities. JSLS. 2011;15(4):471-474. doi:10.4293/108680811X13176785203923

  26. NIH National Institute of Child Health and Human Development. What are the treatments for endometriosis?

  27. Harvard Medical School Harvard Health Publishing. Ask the doctor: Heavy bleeding, fibroids, and polyps.

  28. Cleveland Clinic. Vaginal and uterine prolapse: Management and treatment.

  29. Penn Medicine. Mullerian anomalies

  30. Iraha Y, Okada M, Iraha R, et al. CT and MR imaging of gynecologic emergenciesRadioGraphics. 2017;37(5):1569-1586. doi:10.1148/rg.2017160170

  31. Cleveland Clinic. Female pain during sex (dyspareunia).

Additional Reading

By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.