Women’s Health | IVANA MD | Missouri City, TX
The uterus plays a central role in menstruation, fertility, and pregnancy. When its structure or function deviates from normal, it is referred to as a uterine abnormality. These conditions are more common than most women realize and can range from minor variations that cause no symptoms to significant structural differences that affect reproductive health and quality of life.
Uterine Abnormality
A uterine abnormality is any structural, functional, or anatomical irregularity of the uterus. These can be congenital, meaning present from birth due to abnormal development of the Müllerian ducts during fetal development, or acquired, meaning they develop later in life due to growths, scarring, or hormonal changes.
Types of Uterine Abnormalities
Congenital Uterine Abnormalities
Congenital uterine abnormalities occur when the Müllerian ducts, which form the uterus, fallopian tubes, and upper vagina during fetal development, do not develop or fuse properly. The most common types include:
- Septate uterus, where a fibrous band of tissue divides the uterine cavity partially or completely and is the most common congenital abnormality, accounting for up to 35 percent of cases according to research in Fertility and Sterility
- Bicornuate uterus, where the uterus has two distinct horns or cavities giving it a heart-shaped appearance
- Unicornuate uterus, where only one side of the Müllerian duct develops, resulting in a smaller, single-horned uterus
- Didelphys uterus, where the ducts fail to fuse entirely resulting in a double uterus sometimes accompanied by a double cervix
- Arcuate uterus, a mild indentation at the top of the uterine cavity considered by many to be a normal variant
Acquired Uterine Abnormalities
Acquired abnormalities develop after birth and include:
- Uterine fibroids, which are noncancerous muscular growths that can distort the shape and size of the uterus and affect up to 70 percent of women by age 50 according to the Office on Women’s Health
- Endometrial polyps, which are soft tissue growths on the inner lining of the uterus that can cause irregular bleeding and interfere with implantation
- Asherman syndrome, a condition where scar tissue or adhesions form inside the uterine cavity, often following surgery, infection, or repeated dilation and curettage procedures
- Adenomyosis, where the tissue that normally lines the uterus grows into the muscular wall, causing the uterus to enlarge and become tender
What Are the Symptoms?
Many women with uterine abnormalities have no symptoms at all and only discover the condition during a routine exam or when investigating fertility issues. When symptoms do occur they may include:
- Abnormal uterine bleeding including heavy, prolonged, or irregular periods
- Pelvic pain or pressure
- Painful periods
- Recurrent miscarriages
- Difficulty conceiving
- Preterm labor or pregnancy complications
- Pain during sex
What Does Science Say?
Research published in Human Reproduction found that congenital uterine abnormalities are present in approximately 5.5 percent of the general population but are significantly more prevalent among women with recurrent pregnancy loss, affecting up to 13 percent of that group. A study in Fertility and Sterility also found that women with a septate uterus had significantly higher rates of miscarriage and preterm birth compared to women with a normal uterine cavity, but that surgical correction of the septum substantially improved pregnancy outcomes.
How Are Uterine Abnormalities Diagnosed?
Several imaging and diagnostic tools are used to identify uterine abnormalities, including:
- Pelvic ultrasound, which is typically the first imaging tool used
- Sonohysterography, which uses saline solution and ultrasound to better visualize the uterine cavity
- Hysteroscopy, which allows direct visualization of the inside of the uterus using a small camera
- MRI, which provides the most detailed and accurate imaging of uterine structure and is considered the gold standard for diagnosing congenital abnormalities
Can Uterine Abnormalities Be Treated?
Treatment depends on the type of abnormality, the severity of symptoms, and your reproductive goals. Options include:
- Hysteroscopic surgery to remove a uterine septum, polyps, fibroids, or adhesions
- Myomectomy to remove fibroids while preserving the uterus
- Hormonal therapy to manage symptoms related to adenomyosis or fibroids
- Endometrial ablation for abnormal bleeding in women who do not wish to conceive
- Hysterectomy in severe cases where other treatments have not been effective
Many women with uterine abnormalities go on to have successful pregnancies, particularly when the condition is identified and treated early.
When to See a Doctor
You should speak with a women’s health provider if you are experiencing heavy or irregular periods, recurrent miscarriages, difficulty conceiving, chronic pelvic pain, or painful intercourse. A thorough evaluation can determine whether a uterine abnormality is contributing to your symptoms and what treatment options are available to you.
A diagnosis is not a dead end. For most uterine abnormalities, effective treatment exists and outcomes with proper care are very encouraging.
📍 Schedule your women’s health appointment with IVANA MD in Missouri City, TX.
📞 346-585-4077.
4220 Cartwright Road, Suite 201, Missouri City, Texas 77459.
References
Acién, P. (1993). Reproductive performance of women with uterine malformations. Human Reproduction, 8(1), 122–126.https://pubmed.ncbi.nlm.nih.gov/8458914/
Grimbizis, G. F., Camus, M., Tarlatzis, B. C., et al. (2001). Clinical implications of uterine malformations and hysteroscopic treatment results. Human Reproduction Update, 7(2), 161–174.https://pubmed.ncbi.nlm.nih.gov/11284660/
Office on Women’s Health. (2025). Uterine fibroids. U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/uterine-fibroids
Saravelos, S. H., Cocksedge, K. A., & Li, T. C. (2008). Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Human Reproduction Update, 14(5), 415–429. https://pubmed.ncbi.nlm.nih.gov/18539641/
