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Enlarged uterus secondary to use of oral contraceptive pills

Case contributed by Dalia Ibrahim
Diagnosis probable

Presentation

Pelvic pain. History of oral contraceptive pills use. Ultrasound revealed diffusely enlarged uterus and suspected adenomyosis. MRI is needed for better characterization.

Patient Data

Age: 25 years
Gender: Female

Diffusely-enlarged uterus showing swollen globular myometrium with high signal intensity and thinned atrophic endometrium. Preserved zonal anatomy excludes neoplastic lesion and narrow junctional zone excludes adenomyosis.

Prominent follicles in both ovaries. 

Case Discussion

Estrogen-progesterone combination (oral contraceptive pill) administration can result in uterine changes in the form of swollen and globular myometrium with high signal intensity and atrophic endometrium. Those changes are more pronounced in women taking higher concentrations of hormones.

Differential diagnosis of an enlarged uterus

Uterine enlargement can occur in a number of situations.These include:

Special thanks to Professor Soha Talaat and Dr. Mohamed Talaat ali, Kasr Al Ainy school of medicine, Egypt.

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