THE CERVIX AND THE UTERUS
Jutting into the vault of the vagina is the cervix, the neck part of the womb or uterus. This is a heavy, muscularorgan the size and shape of an inverted pear. In women who have not reproduced, it measures about 9 cm in length. 6 an in width at its widest part, and 4 cm from Cram to hack. It weighs about 50 g, and its walls are 1-2cm thick. In women who have reproduced, these figures increase, by about 13 cm.
The uterus is a very stout muscular organ, consisting of the cervix, or neck, which joins the larger, expanded part called the corpus, or body.
A small hole, called the external os, is located in the centre of the cervix as it lies in the vaginal canal. This joins with a tract called the cervical canal which extends upwards to join with the hollow interior of the body of the uterus at the internal os.
At the upper outer limits of the uterus are exit canals that join with the oviducts, or Fallopian tubes. These are called the cornua, or "horns', of the uterus.
The uterus tends to lie in a forward direction, usually at a 90 degree angle to the direction of the vagina. This is of importance, for in some conditions it is located in a different situation, and troublesome symptoms may arise: the best known is when it tends to flop backwards in a condition called retroversion. A major problem with this is often the inability of the woman to become pregnant The cervix is away from the pool of seminal fluid deposited by the male's penis in the upper part of the vagina in intercourse, and it is simply impossible, in many cases, for sperms to penetrate the cervical canal preparatory to a possible pregnancy occurring.
Women with this problem have often become pregnant within a few months once the retroversion has been corrected and the uterus brought back to its normal, so-called ante-verted position.
The cervix is an extremely important organ. In nulliparous women (those who have not reproduced), it tends to be elongated and cylindrical. After reproduction, it is much shorter and flatter.
But it is very susceptible to cancer. This is the spot where the world-famous 'smear test' is carried out. The doctor removes a thin smear of cells from the cervix with a simple instrument called a spatula. These are placed on to a slide with a 'smearing' motion (hence the term 'smear test), then they are stained and examined under the microscope by the pathologist for possible cancerous cells.
It is claimed that cancer may be detected in the very early stages, possibly 10-15 years before actual symptoms appear, by this simple yet extremely valuable test. The importance of all womenfrom age 20 onwards for lifehaving regular smear tests, say, every 2-3 years, cannot be overemphasized. Already, enormous numbers of lives have been saved in the few years that mass screening programmes have been carried out in doctors' surgeries, hospitals and other places.
Incidentally, the body of the uterus is also a popular spot for cancers. These are more common in women who have passed through the change of life. For this reason, any bleeding or unusual vaginal discharge in women past the menopause is considered to be cancer by doctors until proved otherwise. It is a sign for immediate examination by the doctor. Today, not tomorrow, or next week.
The uterus is the place where babies are developed. It is lined with special cells, called the endometrium. This tissue is very responsive to hormonal changes occurring during the menstrual cycle throughout the reproductive years. If pregnancy occurs, the entire organ undergoes enormous changes, and copes with the formation of a brand-new life.
On the other hand, if a pregnancy does not occur, the total lining is shed in the form of a menstrual bleed. This is not all blood, but the disintegrating lining. Once expelled, a new lining starts to build up in preparation for coping with a pregnancyor, if a pregnancy does not occur, to the next disintegration of the lining, and another menstrual bleed.
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Womens health
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ANTE-NATAL TESTS
Cervical smear Most cervical cancer can be prevented, which is why the majority of women will have a cervical smear test at the first ante-natal visit. It entails the insertion of a speculum into the vagina and an almost painless scraping of the surface of the cervix for a sample of cells which will be examined under a microscope in the laboratory. This test, looking for pre-cancerous cells, is widely advocated for all women pregnant or not, particularly if they're over thirty-five , have had more than one (male) sexual partner and if they have three or more children. There is no special reason for testing pregnant women and it is probably not an essential test, but if you are undergoing a vaginal examination anyway, there is virtue in having it done.
Chest x-ray If you have a history of chest illness you may be offered a chest x-ray to check for TB. Avoid it if you possibly can. X-rays are known to damage the foetus, particularly in the early months of pregnancy. A woman's body should be heavily screened during a chest x-ray to prevent the x-rays affecting the foetus, but despite the most careful precautions there is some evidence that some rays may still get through to the foetus.
Ultrasound A few hospital clinics like to perform an ultrasonic scan at this stage in order to confirm dates. Ultrasound - which uses high-frequency sound waves to form on a TV screen a picture of a foetus inside the womb - is now widely used in ante-natal care and is assumed to be safe even though this has never been verified. Since, theoretically at least, any possible effects of ultrasound are more likely to affect the foetus when it is tiny, it is perhaps particularly important that it should not be used unnecessarily at this stage. Women are anyway commonly well aware of the age of their pregnancy. In one survey, sociologist Ann Oakley found that over ninety per cent knew their dates exactly, and the rest knew to within a week.
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Women's Health
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