Patient's question:
I have had irregular periods since my first menstrual cycle, and I have taken many medications that haven't worked. Why is that? The doctor said my uterus is small. What factors or underlying causes could have led to this?Doctor's answer:
Hello, "small uterus" is one of the main reasons or causes for clinical infertile patients to seek medical attention. So, what is a "small uterus"? How can it be scientifically diagnosed? When the uterus is smaller than normal, it is medically referred to as "uterine hypoplasia." Such patients often experience menstrual irregularities, such as infrequent periods, amenorrhea, or oligomenorrhea. "Uterine hypoplasia" is primarily caused by endocrine dysfunction, especially ovarian dysfunction leading to insufficient secretion of estrogen and progesterone. Ovarian dysfunction not only causes uterine hypoplasia but also poses a greater disadvantage because such patients often fail to ovulate or have luteal phase defects. Therefore, infertility in women with uterine hypoplasia is caused by multiple adverse factors.Diagnosing a "small uterus" should be done using scientific methods. A diagnosis of "uterine hypoplasia" is made when the length, width, and thickness of the uterine body measured by ultrasound are respectively less than 5 cm, 4 cm, and 2 cm. A professional "vaginal ultrasound" is more accurate than a standard abdominal ultrasound. It is important to note that a diagnosis should not be made solely based on simple ultrasound measurements or even a gynecological examination. Another method for measuring uterine size is to measure its volume. If the volume is less than 5 mL, it can be diagnosed as "uterine hypoplasia." This diagnostic method involves injecting fluid into the uterine cavity, which can be somewhat painful.
The above two methods are scientific approaches to diagnosing a "small uterus." If a patient has previously been suspected or preliminarily diagnosed as having a "small uterus," they should seek confirmation at a large hospital. In clinical practice, many patients have had the label of "small uterus" removed after precise measurements. For patients already diagnosed with "uterine hypoplasia," except for a small number with congenital developmental disorders that are difficult to treat, the vast majority can achieve good treatment outcomes. Therefore, to achieve better results, it is necessary to determine whether uterine hypoplasia is due to congenital developmental abnormalities. Once this is ruled out, Western medicine can be used for treatment.
The correct treatment plan involves first identifying the factors causing uterine hypoplasia, then promoting ovulation to restore ovarian function and normal secretion of estrogen and progesterone. This, in turn, stimulates uterine growth and development, helping infertile patients conceive.