The my­ometrium: birth, fists and fi­broids

The Weekend Australian - Travel - - Health -

What is it? The mid­dle of the three lay­ers that form the wall of the uterus (womb). The my­ometrium makes up the bulk of the uterus and is made of densely packed, pow­er­ful mus­cle — pow­er­ful enough to help push a baby out. Where does the name come from? From the Greek words mys , mean­ing mus­cle, and me­tra , which means uterus. In what way does it un­dergo an amaz­ing trans­for­ma­tion? Dur­ing preg­nancy the uterus has to in­crease enor­mously in size and then, just as amaz­ingly, re­turn to its orig­i­nal state very soon af­ter the birth. This is largely thanks to the re­mark­ably adapt­able my­ometrium. Be­fore preg­nancy, the uterus is fist-shaped and al­most solid, with a tiny cav­ity of just 10ml. By the time the baby is due, the uterus has trans­formed into a thin-walled bal­loon with a ca­pac­ity that is now more than 500 times greater; and yet it is still ca­pa­ble of strong, painful con­trac­tions. How does it man­age to change so much? Rather than en­larg­ing by pro­duc­ing new mus­cle cells, the my­ometrium ex­pands dur­ing preg­nancy be­cause its cells ac­tu­ally stretch, grow­ing longer and longer, un­til they are about half a mil­lime­tre long at the time of the birth. Why may women have their my­ometrium re­moved? Fi­broids grow from cells in the my­ometrium. Th­ese very com­mon, be­nign growths of­ten don’t cause symp­toms and don’t need treat­ment. If treat­ment is needed, one method is to re­move them, ei­ther by tak­ing out the whole uterus (hys­terec­tomy) or just the fi­broid (my­omec­tomy), leav­ing the uterus in­tact.

Il­lus­tra­tion: Nathalie Gar­cia

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