Uterus FAQs
The uterus is an organ that is part of a woman’s reproductive system. It’s made of muscle fibers, similar to a calf or bicep muscle. It is hormonally affected, and when pregnant, the uterus thins significantly, grows to house the fetus, and produces the placenta.
An average, non-pregnant uterus is approximately 3 inches tall by 2 inches wide by 1 inch thick (without the presence of polyps or fibroids).
It is located in the pelvic region just behind the bladder and leans over it. The rectum is located behind the uterus.
According to a recently published study* by the Mayo Clinic, removing the uterus negatively impacts cardiovascular health. It seems there are also interactions with other systems in a woman’s body and the uterus that are not yet fully understood, and these interactions may not be related to reproduction.
*Laughlin-Tommaso SK, et al. Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study. Menopause. 2018 May;25(5):483-492. View PDF
AUB FAQs
Abnormal uterine bleeding (AUB) is menstrual bleeding of abnormal quantity, duration, or schedule. It’s a common gynecologic condition affecting 1 in 3 women during their life.* While sometimes referred to as heavy menstrual bleeding (HMB), AUB is more complex than excessive menstrual bleeding. AUB can severely impact a woman’s quality of life, and it can also affect fertility.
*Davis E, Sparzak PB. Abnormal Uterine Bleeding. 2021 Feb 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-Feb 10. PMID: 30422508. Available from here
A normal period is one that rarely interferes with your daily life. You’ll need to change pads or tampons as recommended, but you’re not bleeding through them in two hours. You can maintain your typical schedule, enjoy your favorite activities and work is rarely impacted by your period.
Your bleeding is heavy if you
- bleed through pads or tampons in two hours
- need to use both a pad and tampon regularly
- wake up to change pads or tampons during the night
- collect more than 30 mLs of blood in your menstrual cup
- bleed through your clothes
- routinely pack a just-in-case bag when you head out
- cancel plans or call in sick
- schedule your life around your period
If you are passing blood clots and soaking through your usual pads or tampons each hour for two or more hours, your bleeding is considered severe, and in some cases, this can lead to anemia. You may benefit from seeing a gynecologist who understands AUB.
Click here for more information on diagnosing AUB.
To accurately diagnose AUB, your gynecologist will want to run blood tests and conduct an imaging assessment of your uterus. An accurate procedure for diagnosing fibroids and polyps in the uterine cavity is called a “hysteroscopy”, during which polyps can be removed. If fibroids are present, your gynecologist will discuss the options for their removal.
Click here for more information on diagnosing AUB.
Hysterectomies may have long term side effects, the extent of which is not fully understood. In a recent Mayo Clinic study, women who had their uterus removed, leaving the ovaries, had a 33% increased risk of coronary artery disease. Furthermore, women under the age of 35 had a 4.6-fold increased risk of congestive heart failure.* While in some cases a hysterectomy is required, 68% of all hysterectomies are for benign reasons, for which there are other less invasive options.**
Minerva is committed to providing technologically advanced, minimally invasive treatment options that preserve the uterus, and Minerva supports continued research on uterine health.
*Laughlin-Tommaso SK, et al. Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study. Menopause. 2018 May;25(5):483-492. View PDF
Diagnosing the cause of AUB is a complex process. Causes of AUB are sorted into structural and non-structural categories:
AUB-L and AUB-P: The most common structural causes of AUB are fibroids (AUB-L) and polyps (AUB-P).
AUB-E: A thick endometrium is an example of non-structural AUB and is typically caused by hormonal fluctuations that lead to changes in the shedding and repairing of the endometrium (AUB-E).
When doctors diagnose the root cause of a patient’s AUB, they use the PALM-COIEN classification system. This method simplifies and defines the diagnosis and helps patients research their specific condition and the treatment path best suited for them
There’s limited conclusive evidence on what exactly causes some conditions that result in AUB. For instance, there is no definitive understanding of what causes fibroids and other tissue-growth conditions of the uterus. Given the severity of the symptoms associated with AUB, and its impact on fertility and overall quality of life, Minerva has committed to support future uterine health research.
Click here for more information on the causes of AUB.
When they interfere with your life experience. That’s the signal to consult a gynecologist to see if you have AUB, and if so, what the cause may be.
Once you know what is causing your AUB symptoms, you can make informed choices about your treatment path. This is important because not all gynecologists offer minimally invasive solutions for fibroid removal and instead offer a less effective alternative, like hormonal drug therapy. Or they go to the opposite extreme and suggest a hysterectomy.
If you are experiencing heavy periods, you have options that don’t require implants (IUDs, for example), invasive surgery or hormones. Seeing the right gynecologist is the first step. There are uterine-sparing, non-hormonal treatment options that are safe and effective and may be appropriate to treat your AUB. https://aubandme.com/locator/
Because some women experience high levels of estrogen and low levels of progesterone. This can cause the endometrium, or uterine lining, to thicken. When the endometrium sheds during menstruation, women might experience heavier blood flows and larger blood clots.
AUB Causes FAQs
Fibroids are muscular non-cancerous growths, or tumors in the walls or within the cavity of the uterus. Another medical term for fibroids is leiomyoma or "myoma". Doctors believe fibroids can interfere with implantation of the fertilized egg and the ability to carry a pregnancy to term.
No one knows, and we need more research. But existing research does point to fibroids being affected by both estrogen and progesterone (naturally occurring hormones) levels. If your female relatives have fibroids, you are likely to have them as well.
Polyps are composed of endometrial cells, whereas fibroids are composed of muscle cells. That means polyps are less dense than fibroids. They grow in the uterine cavity and can also be found in the cervix and vagina. As with fibroids, doctors believe polyps can interfere with implantation of the fertilized egg and the ability to carry a pregnancy to term.
- Irregular menstrual bleeding, or having frequent, unpredictable periods of variable length and heaviness
- Bleeding between menstrual periods
- Excessively heavy menstrual periods
- Bleeding after sex
- Vaginal bleeding after menopause
- Infertility
Fibroids can shrink and disappear. No one knows why they go through growth spurts or vanish, but doctors do know that fibroids are impacted by hormones, so their growth patterns may be hormone-related.
Yes, your doctor will want to see inside of your uterus to clearly see any pathology (fibroids, polyps) present in the uterine cavity and possibly conduct an endometrial biopsy to help determine the diagnosis before treatment. You may also receive an ultrasound or MRI, but the most consistently accurate way of identifying pathology in the uterine cavity is with a hysteroscope.
Click here for more information on diagnosing AUB.
AUB may be caused by many medical conditions. The heavy periods you are experiencing may be related to Abnormal Uterine Bleeding-Endometrial Dysfunction(AUB-E), or AUB caused by a thickening of the endometrium.
You can find more information about that here.
It is largely unknown if or how polyps contribute to infertility issues. Some physicians believe polyps interfere with fertility by preventing a fertilized egg from implanting in the uterine wall correctly, but more research needs to be conducted.
Click here for more information on how AUB affects fertility.
Yes, fibroids and polyps can also affect whether an embryo can implant properly, which is necessary for a sustained pregnancy. Fibroids can also affect the growth and positioning of the baby, which can result in a preterm delivery (<37 weeks), a breech presentation and the need for a cesarean section, and low birth weight*.
*Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix.
Blitz MJ, Rochelson B, Augustine S, Greenberg M, Sison CP, Vohra N
J Matern Fetal Neonatal Med. 2016 Nov; 29(21):3454-60.
Rarely (less than one in 1,000*) will a fibroid be cancerous. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.*
- Heavy menstrual bleeding
- Menstrual periods lasting more than 7 days
- Pelvic pressure or pain
- Feeling full or bloated
- Frequent urination
- Difficulty emptying the bladder
- Constipation
- Backache or leg pains
- Irregular menstrual bleeding, or having frequent, unpredictable periods of variable length and heaviness
Click here to learn more about fibroids.
There is no definitive data on what causes polyps to form.
Fibroids do grow overtime, and they can also shrink and go through growth spurts.
They stop growing after a woman goes through menopause.
Occasionally fibroids can be discovered during a routine pelvic exam. But in order to definitively diagnose fibroids or polyps, you’ll need to undergo a hysteroscopy, ultrasound or MRI. A Symphion hysteroscopy will enable your physician to clearly see inside your uterus and quickly and safely remove fibroids and polyps in one treatment.
Click here to learn more about Symphion.
Often women in the same family experience fibroids and polyps, but there is no data that indicates fibroids and polyps are hereditary.
All gynecologists are trained to remove fibroids. Some gynecologists specialize in minimally invasive treatments for fibroid removal.
Fibroids can affect the number of sperm that can enter the uterus and inhibit their movement or the transport of a fertilized egg in the uterus. Fibroids can block the fallopian tubes, and they can alter the lining of the uterine cavity, affecting the fertilized egg's ability to implant in the lining. Fibroids can also affect blood flow to the uterine cavity, decreasing the ability of the fertilized egg's to implant to the uterine wall or develop properly.
Click here for more information on how AUB affects fertility.
Download this AUB physician discussion guide. You’ll have everything you need in one place to have an informative conversation about AUB, and you’ll be prepared with questions to ask your healthcare team.
AUB Treatments FAQs
You have the final say in what device is used during a treatment for you. But not all physicians offer all available devices, so you may not be informed of all available treatment options at one medical practice.
After receiving a diagnosis, ask your physician about the available treatment options and which they offer. You may find that you need to get a second opinion from a physician who offers a variety of treatment options. Visit our physician locator to find a gynecologist near you that offers Minerva treatment options.
Symphion is a system used by physicians to perform diagnostic hysteroscopies, and to remove uterine tissue like polyps (polypectomy) and fibroids (myomectomy). The uterus is accessed via the vagina and cervix. This eliminates the need for incisions or the removal of the uterus (hysterectomy).
Some women have mild cramping. Rarely do women need anything but over the counter pain medicine. Most women are back to normal activities within a few days.
Minerva ES is a device that physicians use to perform an endometrial ablation. Endometrial ablation is a method of removing the endometrial layer of tissue in the uterine cavity to treat AUB.
Every woman is different, but at 1 year post-Minerva ES, 72%* of women had their period completely eliminated.
In the first year after Minerva ES treatment, many women experience a few cycles, but they are typically light enough to be handled with liners and last only a few days.
93%* of women who had the Minerva treatment had their periods reduced to a bleeding level of normal or less at 1 year.
At 1 year post-treatment with the NovaSure procedure, periods were completely eliminated in just 36%** of women.
After Minerva ES, most women resume normal activities within a day or two. You may experience some cramping, mild pain or nausea. You may also experience some discharge for a few days to a few weeks. Your gynecologist will review this with you so that you know what to expect. Be certain to follow the guidance of your gynecologist for all post-treatment care plans.
**NovaSure Advanced Impedance Controlled Endometrial Ablation System. Instructions For Use and Controller Operator’s Manual. Available at: https://www.hologic.com. Accessed February 04, 2019. (Not based on a head-to-head study).
**NovaSure Advanced Impedance Controlled Endometrial Ablation System. Instructions For Use and Controller Operator’s Manual. Available at: https://www.hologic.com. Accessed February 04, 2019. (Not based on a head-to-head study).
With all surgical procedures, including endometrial ablation, serious injury or death can occur.
The following adverse events could occur or have been reported in association with the use of other endometrial ablation systems and may occur with the Minerva System:
- Post-ablation tubal sterilization syndrome (PATSS)
- Thermal injury to adjacent tissue, including bowel, bladder, cervix, vagina, vulva and/or perineum
- Perforation of the uterine wall
- Hemorrhage
- Hematometra
- Difficulty with defecation or micturition
- Uterine necrosis
- Air or gas embolism
- Infection or sepsis
- Complications leading to serious injury or death
Every woman is different, but most women experience fewer and lighter cycles after Genesys HTA. Periods are often light enough for just liners and last only a few days.
After Genesys HTA, most women resume normal activities within a day or two. You may experience some cramping, mild pain, or nausea. You may also experience some discharge for a few days to a few weeks. Your gynecologist will walk you through what to expect. Be certain to follow the guidance of your gynecologist for all post-treatment care plans.
Your physician will send the removed polyp tissue to be examined by a pathology lab. You will go about your day as normal, but may experience some spotting. Any cramping may be treated with over-the-counter pain medicine.
Minerva treatments for AUB are covered by most insurance providers. Talk to your physician about specific insurance options and offerings.
You have the final say in what device is used during a treatment for you. But not all physicians offer all available devices, so you may not be informed of all available treatment options at one medical practice.
After receiving a diagnosis, ask your physician about the available treatment options and which they offer. You may find that you need to get a second opinion from a physician who offers a variety of treatment options. Visit our physician locator to find a gynecologist near you that offers Minerva treatment options.
Symphion is a system used by physicians to perform diagnostic hysteroscopies, and to remove uterine tissue like polyps (polypectomy) and fibroids (myomectomy). The uterus is accessed via the vagina and cervix. This eliminates the need for incisions or the removal of the uterus (hysterectomy).
Some women have mild cramping. Rarely do women need anything but over the counter pain medicine. Most women are back to normal activities within a few days.
Minerva ES is a device that physicians use to perform an endometrial ablation. Endometrial ablation is a method of removing the endometrial layer of tissue in the uterine cavity to treat AUB.
Every woman is different, but at 1 year post-Minerva ES, 72%* of women had their period completely eliminated.
In the first year after Minerva ES treatment, many women experience a few cycles, but they are typically light enough to be handled with liners and last only a few days.
93%* of women who had the Minerva treatment had their periods reduced to a bleeding level of normal or less at 1 year.
At 1 year post-treatment with the NovaSure procedure, periods were completely eliminated in just 36%** of women.
After Minerva ES, most women resume normal activities within a day or two. You may experience some cramping, mild pain or nausea. You may also experience some discharge for a few days to a few weeks. Your gynecologist will review this with you so that you know what to expect. Be certain to follow the guidance of your gynecologist for all post-treatment care plans.
**NovaSure Advanced Impedance Controlled Endometrial Ablation System. Instructions For Use and Controller Operator’s Manual. Available at: https://www.hologic.com. Accessed February 04, 2019. (Not based on a head-to-head study).
**NovaSure Advanced Impedance Controlled Endometrial Ablation System. Instructions For Use and Controller Operator’s Manual. Available at: https://www.hologic.com. Accessed February 04, 2019. (Not based on a head-to-head study).
With all surgical procedures, including endometrial ablation, serious injury or death can occur.
The following adverse events could occur or have been reported in association with the use of other endometrial ablation systems and may occur with the Minerva System:
- Post-ablation tubal sterilization syndrome (PATSS)
- Thermal injury to adjacent tissue, including bowel, bladder, cervix, vagina, vulva and/or perineum
- Perforation of the uterine wall
- Hemorrhage
- Hematometra
- Difficulty with defecation or micturition
- Uterine necrosis
- Air or gas embolism
- Infection or sepsis
- Complications leading to serious injury or death
Every woman is different, but most women experience fewer and lighter cycles after Genesys HTA. Periods are often light enough for just liners and last only a few days.
After Genesys HTA, most women resume normal activities within a day or two. You may experience some cramping, mild pain, or nausea. You may also experience some discharge for a few days to a few weeks. Your gynecologist will walk you through what to expect. Be certain to follow the guidance of your gynecologist for all post-treatment care plans.
Your physician will send the removed polyp tissue to be examined by a pathology lab. You will go about your day as normal, but may experience some spotting. Any cramping may be treated with over-the-counter pain medicine.
Minerva treatments for AUB are covered by most insurance providers. Talk to your physician about specific insurance options and offerings.
Minerva Surgical does not provide medical diagnosis, treatment or engage in the practice of medicine. There are potential risks with any medical procedure. These procedures may not be appropriate for all patients, and all patients may not benefit. For information about risks, visit minervasurgical.com/safety . Rx Only.
Minerva The Uterine Health Company, Minerva ES, Symphion and Genesys HTA are registered trademarks of Minerva Surgical, Inc.
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