A normal uterus is the shape and size of an upside down pear, approximately three
to four inches wide and two to three inches in height. The top of the uterus is
called the fundus, from which the fallopian tubes extend out on
either side, with an ovary near the end of each fallopian tube. Below the fundus
is the body of the uterus which is made up of two layers of tissue: the endometrium
is the inside lining of the uterus; and the myometrium is the muscular
wall of the uterus. The cervix is immediately below the body of the uterus
and contains the cervical canal, which passes into the vagina. All
of these components together make up the uterus.
The ovaries and certain areas of the brain are the control center for a woman's hormonal cycle. Hormones are produced within the brain which control a female's entire reproductive cycle. These hormones also affect the level of estrogen produced within the ovaries as well as the monthly growth of the endometrium. Estrogen produced in the ovaries regulates the release of eggs during ovulation, which also affects the uterus and the vagina, and ultimately, the growth of uterine fibroid tumors. As women approach their mid-40's, the levels of these hormones can be unbalanced; leading to symptoms such as hot flashes, fatigue, mood swings, and insomnia, which normally occur during the beginning of menopause. Fluctuations of these hormones occur less frequently as a woman approaches full menopause.
Because of the delicate balance of the hormones that are released by the ovaries
and the brain, it is necessary to understand the important role the ovaries
and the uterus play in maintaining a woman's monthly cycle. It is also important
to understand what happens if the uterus and ovaries are suddenly removed to
treat the symptoms of uterine fibroids. If a woman with symptomatic uterine
fibroids is treated with a full hysterectomy (where the ovaries are removed),
this delicate balance may be disrupted, which may cause other symptoms, such
as hot-flashes, depression, mood swings, and osteoporosis. Although some patients
do maintain their ovaries, there may be other side effects with the removal
of the uterus, such as urinary incontinence, sexual dysfunction, and adhesions.
