ANATOMY AND FUNCTION OF THE FEMALE REPRODUCTIVE ORGANS AND HOW CANCER MAY BEGIN: UTERUS
The female reproductive organs are one of the most common sources of blame for a woman’s physical and psychological reactions to her surroundings (‘Oh she must be suffering PMT!’) Yet, what is often overlooked is that as a complex, unique set of organs in their function of reproduction, they can often give mixed messages about a woman’s health. A range of physical effects such as bloating, and aches and pains may be related to the functions of these organs, so sometimes the early warning signs of gynecological cancer are ignored or mistaken as part of the regular monthly cycle.
Uterus The uterus – sometimes referred to as ‘the womb’ is a pear-shaped organ, which sits right in the middle of the pelvis, behind the bladder and in front of the rectum. The ‘cardinal’ ligaments or ‘parametrium’ supports it. These ligaments hold the uterus in place and prevent it from slipping down into the vagina. The part of the uterus that juts into the vagina is the cervix and arising out of each top corner of the uterus are the fallopian tubes that lead to the ovaries.The bladder (which stores urine) sits above the cervix in front of the lower part of the uterus, while the rectum (which stores faeces or ‘pooh’) sits behind the cervix and vagina.The tubes, which come down from the kidneys to the bladder (ureters), run in the supporting ligaments close to the side of the uterus closely applied to the blood vessels that arise from the side-wall of the pelvis. The ureters are mobilized out during radical surgery for cancer of the cervix. They may become blocked by cancer or may leak urine into the vagina if damaged.The uterus is a tiny organ in the newborn, but as the amount of oestrogen from the ovaries begins to increase, then so does the size of the uterus, largely due to an increase in its musculature (‘the myometrium’). The muscular wall of the uterus varies in thickness, but is usually up to 15 mm deep, whereas the mucous lining of the uterus (the ‘endometrium’) is only 5-10 mm thick, depending on the stage of the menstrual cycle. Under the influence of the hormones produced by the ovaries – principally oestrogen and progesterone – the lining of the uterus fluctuates in thickness and eventually is mostly shed during each period. It rebuilds itself between each period.With menopause, when the ovaries are no longer producing these steroid hormones, such as oestrogen, a reduction in the size of the uterus occurs and the uterus becomes smaller again. The endometrium thins out and lacks activity (‘atrophic’), so that if the uterus is found to be enlarged or the lining thickened after the menopause, then cancer is suspected.*1/144/5*
