Uterus 101

an excerpt from ORCA, an illustrated, pocket-sized, collection of personal essays

Socrates said, know thyself.

So what do I know about my uterus?

Besides the basics. It’s central to the vagina, cervix, fallopian tubes, and ovaries. It sheds a lining every month that can be annoying and painful and inconvenient. It can incubate fertilized embryos that have the potential to become fetuses that can eventually become babies. And then ungrateful children and then angry teenagers and then resentful adults.

What do I actually know?

My uterus has been my ally for the majority of my life. Then she became a frenemy. A tale I told in two parts: I’m still bleedin’! and I'm still bleedin'! Sort of.

The TL;DR version is:

After months of heavy and too-frequent-to-be-normal menstruation, a pelvic sonogram revealed a polyp that was, upon closer inspection, a fibroid on my uterine lining and a gynecologist who specializes in a minimally invasive surgical procedure known as a polypectomy or myomectomy, removed it successfully.

The constant spotting and bleeding and painful cramping went away, I got on Menopausal Hormone Therapy, and 15 months later, I’m feeling almost like my 30-something-year-old uterus again only without the regular monthly menses. I’m on the road to menopause. Woohoo!

I have excellent health insurance through my husband’s union (WGA strong!) and access to the UCLA healthcare network. So I’m privileged and fortunate to get premium healthcare that does give time and resources to female health.

But that doesn’t mean I had a clue what was happening to me or that fibroids were even a possibility. And yet this a prevalent occurrence for nearly 80% of women by age 50. It doesn’t mean all women will need medical intervention, but it’s common enough that we should all know about it as something potentially coming down the pipeline in midlife. Along with peri/menopause. Like colon cancer or shingles.

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Perhaps if more women mastered their own domain, and knew the intricacies of their own uteruses, we could better advocate for ourselves and the culture of female healthcare would have no choice but to change. As it is, most of us are as dumb as a box of rocks when it comes to the uterus. Even in places where reproductive health is still taught in school, how much detail do we receive in order to truly understand how this vital part of our bodies and our identities work? And how many hours are allocated in the education of our doctors? Doctors who care declare: NOT ENOUGH! Data backs them up.

Reference books and Google searches online will deliver documentation and imagery that is both broad and detailed and none of them seem to use the exact same language in naming the various parts. They are similar, often overlapping, but no consistent messaging in what constitutes the wording and language that every institution or expert uses to educate the laywoman.

One image is labeled the body of the uterus while another utilizes the phrase uterine cavity. This is an example of saying the same thing in two different ways, but in trying to understand this area of the female human body, it would be convenient and less confusing to have an agreed upon basic terminology for us civilians.

Here is a list of the individual names for each part that makes up the whole of the uterus:

Myometrium

Endometrium

Isthmus of uterus

Round ligament of uterus

Fundus of uterus

Perimetrium

Uterine fallopian tubes

Isthmus (different area from the Isthmus of uterus), intramural portion

Ampulla

Infundibulum

Fimbriae

Broad ligament

Mesovarium

Mesosalpinx

Mesometrium

Uterosacral ligament

Uterine artery and vein

Ovary

Ovarian cortex

Ovarian medulla

Ligament of ovary

Suspensory ligament of ovary

Ovarian artery and vein

Cervical canal

Cervix

Cervical external orifice

And there’s the hormones that affect the uterus:

Estrogen (estrone, estradiol, estriol)

Progesterone

Prostaglandin

Testosterone

Pregnancy adds on more hormones:

Oxytocin

Prolactin

Relaxin

Human chorionic gonadotropin (HCG)

Human placental lactogen (hPL).

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Crap, that’s a lot of terminology. I might be missing something. I’m not a doctor. And maybe I don’t need to know this amount of detail. I’m not a doctor.

But shouldn’t some of this be part of a required curriculum for all people, not only for medical students?

Institutions of learning believe it’s imperative that we know about things like when the pyramids in Egypt were built or what year the Magna Carta was signed or the event that marked the beginning of the American Civil War or slavery. Unless of course those institutions and their school boards have been intimidated and threatened by groups like Moms for Liberty and Proud Boys¹ Because ‘murica! Are we great yet?

While I’m not the most astute vessel of the history of the world, I understand its importance and the value in how it shapes a human’s way of thinking. Why isn’t one’s own anatomy equally as important? We only get to live in one body, in one lifetime. Even if one believes in reincarnation, full sentience is in the present.

I don’t remember every date and event from Persian or Japanese history, for example, but when the scholars, our experts, discuss the past and hold it up as context to current events, it’s familiar. People’s ideas about what is agreed upon truth is changing, unfortunately, but there’s still a broad enough knowledge base that allows for many events to not be completely unknown. Many humans have heard of Mahatma Gandhi. The Aztecs. The Dallas Cowboys. This could be their year to go all the way? Haha, just kidding.

And yet, female bodies are unknown. To both the women who inhabit them and the people who don’t.

According to the Centers for Disease Control and Prevention (CDC), after Caesarean section (1.1 million annually), the second most common surgical procedure for women in the United States is the hysterectomy (600,000 annually.) And yet over 50% of women who undergo hysterectomies, don’t know exactly what’s being removed, there is no straightforward consensus amongst the doctors who perform the surgery on what all should or shouldn’t be removed, and anywhere from 40% to 90% of women might not actually need a hysterectomy and could be better treated with less invasive procedures.²³ You know, to preserve hormones that effect women’s bones and mental health and cardiovascular health and everything else in the female body that makes a uterus essential for more than just baby-making.

More troubling is when the people who don’t have a woman’s body, men, and don’t know a woman’s body, men, get to make decisions about a woman’s body. Come on, men, stay out of my uterus and stay in your in your own member-hood!

I get that what makes the uterus of greater importance is that it’s the most significant body part required for the continuation of the human species. Which is why women should have the knowledge of what all those parts are doing and how they change over time, whether or not they are growing fetuses inside them.

And if men are going to have sex with and impregnate women, they should be required to know the nuts and bolts of the organic factory that’s getting infections or building their babies.

If a man can learn every fucking inch of a car engine and not recoil from black, greasy motor oil, why can’t he learn about a woman’s central body cavity and not fear menstrual blood?

My uterus is pushing me to learn more about her every day. She’ll be ready for her own TED talk soon.

I want her to explain to the male-majority legislatures why she has the right to freedom and choice and bodily autonomy. Her basic human rights. And then silence those men once and for all.

I want her to take younger uteruses under her fallopian tubes and encourage them to speak out and demand more comprehensive education and awareness.

I want her to support younger uteruses so if/when they encounter a doctor who wants to remove them, that they are comfortable pushing back, armed with questions and concerns about the necessity of this surgery, that they are empowered to get up off that examination table and walk out of that office if that doctor isn’t listening, and that they know they can get second and third opinions.

I want her to remind younger uteruses that it’s okay to prioritize themselves.

I know, these are #loftyuterusgoals. But my uterus was made to grow life, so she inherently carries hope. She can dream for a better future for her kinswomen.

Until then, maybe she can reassure my husband that my occasional mood swings are reasonable and rational. He just needs to keep feeding me buttery cheeses or truffle French fries and feeding her some good cock. All goddesses require their oblations.

1. “SPLC Adds ‘Moms for Liberty’ to Its List of Extremist Groups,” NPR, June 7, 2023, https://www.npr.org/2023/06/07/1180486760/splc-moms-for-liberty-extremist-group.

2. “The ‘Madness’ of Unnecessary Hysterectomy Has to Stop,” Lown Institute, April 12, 2019, https://lowninstitute.org/guest-post-the-madness-of-unnecessary-hysterectomy-has-to-stop/.

3. “Why Are So Many Women Still Getting Hysterectomies?,” Women’s Health, February 1, 2021, https://www.womenshealthmag.com/health/a34574411/hysterectomy-side-effects/