An expanding waistline is not the same as a protruding abdomen, though they can be related. Causes can be gynecologic, gastrointestinal, tumors, extra abdominal fluid, or a lax abdominal wall.
Your uterus or ovaries are rarely the primary cause of a large abdomen. However, uterine fibroids, which are common, could lead to a protruding abdomen if they are present.
Normally, the uterus is about the size of an egg, located within the pelvis when not pregnant, and unlikely to cause an abdominal bulge. Uterine fibroids are non-cancerous muscle growths that, once detected, often continue to enlarge. Fibroids range from microscopic to large masses.
The typical uterus weighs 60-70 grams in fertile years. In rare cases, fibroid-laden uteri removed laparoscopically weigh up to 7 pounds (3,200 grams). For context, a pregnant uterus may expand up to 1,000 grams.
A non-pregnant uterus feels like a relaxed bicep, while fibroids feel dense and firm, similar to a rubber ball. Fibroid-related pressure can cause discomfort, and in some cases, significant pain. A large uterus may press on nearby organs, causing deformities or pressure symptoms.
In some cases, uterine muscle tissue may trap lining glands, a condition known as adenomyosis. This can occur alone or alongside fibroids. The largest uterus documented with only adenomyosis weighed around 475 grams.
Genetic mutations may predispose women to fibroids, and these mutations may also affect overall uterine size. While fibroids are benign, they belong to the broader category of uterine sarcomas, a rare form of cancer.
Fibroid growth patterns vary—some grow quickly, others slowly, and some may even stabilize over time. Most fibroids continue growing until menopause.
If you experience abdominal swelling, irregular bleeding, or pressure symptoms in the pelvis or bladder, consult your gynecologist. These could indicate fibroids enlarging the uterus. A simple ultrasound can usually assess fibroid size and location. A CT scan may better detect any significant pressure on nearby organs. Regular check-ins with a gynecologist are essential for monitoring and managing fibroids.
For a flatter abdomen, exercise and healthy diet can help, especially by reducing abdominal fat. In some cases, surgical options are necessary if fibroids are causing significant bloating or abdominal pressure.
