What Do You Know about the Uterus?
An Introductory Guide to Demystifying the Uterus
With assistance from our Community Partners, Huggable Loveable Uterus has organized a group of scientific, health, and historical topics designed to de-mystify the uterus. Here topics are briefly summarized and links connect you to the original content on data-driven scientific research, comprehensive health information, and history critical to our collective understanding of the uterus.
The Uterus and Brain Health
Arizona State University Research Finds Link Between Removal of Uterus, Brain Function
- ASU scientists have shown that the uterus — and its removal — may have a direct impact on brain function. The team has replicated findings of hysterectomy-induced cognitive changes four times.
- A growing body of research reveals that the uterus is a powerhouse organ with connections to the immune system and heart.
- Our lack of comprehensive knowledge about the uterus is a symptom of a larger historical problem in medical science.
- According to the Centers for Disease Control and Prevention, around one quarter of all women in the U.S. have their uterus surgically removed by the age of 65 in a procedure known as a hysterectomy.
- Recent research suggests that the uterus may have a direct role in multiple brain functions.
- Results indicate a primary role for the uterus in regulating cognition, and that memory-related neural pathways may be modified following gynecological surgery.
- Premenopausal hysterectomy is associated with a greater relative risk of dementia.
- The non-pregnant uterus has traditionally been viewed as a “quiescent” and “useless” organ as an independent structure.
🔗 Source: https://www.sciencedirect.com/science/article/abs/pii/S0018506X23001095
The Uterus and Menstruation
- Earlier menstrual cycles are associated with higher risk of adverse health outcomes, such as cardiovascular disease and cancer, with disproportionate impact on already disadvantaged populations.
- Participants who enrolled in a Harvard study between November 2018 and March 2023—71,341 in total—self-reported the age at which they first began menstruating and their race and socioeconomic status.
- The average age of the first menstrual period has been decreasing among younger generations in the U.S.
- The average time it takes for the menstrual cycle to become regular is increasing, which has negative health implications.
The Uterus and the Reproductive Health of Black Women
Black Women and Uterine Cancer
- About 3% of all new cancer cases are uterine cancer, which is the most common cancer of the female reproductive system. Cases of uterine cancer have been on the rise in the United States, especially among Black women.
- A recent study has found that Black women may be at a higher risk for uterine cancer because of harmful chemicals in some hair straightening products. These chemicals affect a body’s hormones and experts consider them carcinogenic or cancer-causing.
- Black women tend to be diagnosed with later-stage, more severe forms of endometrial cancer (which is a form of uterine cancer) than white women. The same study found that Black women are more likely to have worse outcomes at each stage and type of endometrial cancer.
🔗 Source: https://www.webmd.com/uterine-cancer/black-women-and-uterine-cancer
Uterine Cancer in Black Women: Warning Signs to Act On
- About 90% of endometrial cancers announce themselves through abnormal bleeding, and there is no routine screening test for the disease. Responding fast to abnormal bleeding is how uterine cancer gets caught early.
- Black women die from uterine cancer roughly twice the rate of white women. The single most important thing you can do: treat any postmenopausal bleeding as a reason to get evaluated now, not later.
- CDC data shows 69% of white women but only 55% of Black women are diagnosed while the cancer is still localized. Part of that delay is related to how bleeding gets interpreted. Fibroids are extremely common in Black women, and abnormal bleeding often gets attributed to fibroids, which can stall the cancer workup.
- In 2026, the American College of Obstetricians and Gynecologists updated its guidance to recommend both ultrasound and biopsy for most patients with postmenopausal bleeding, rather than relying on endometrial thickness alone, because ultrasound can miss 5% to 12% of cancers and misses far more in women with fibroids.
🔗 Source: https://www.blackhealth.org/articles/endometrial-uterine-cancer-black-women/
Why Are Uterine Fibroids Particularly Common in Black Women?
- Black women develop fibroids 10 years earlier than white women do and are four to five times more likely to have one or more fibroid tumors.
- Chronic stress is a cause. While it’s not possible to prove that racism causes fibroids, there is at least preliminary evidence associating exposure to racism with increased risk of fibroids.
- Exposure to phthalates is a cause. Phthalates are chemicals found in a wide variety of products, including chemical hair straighteners. A research team at the University of Michigan Medical School analyzed levels of phthalates in 712 uterine fibroid patients and found a strong link between phthalates and uterine fibroids.
🔗 Source: https://www.webmd.com/women/uterine-fibroids/features/cm/uterine-fibroids-black-women
The Uterus and American Slavery
The Speculum: Life-Saving Tool or Torture Device?
- In 1845, Alabama-based Dr. James Marion Sims invented the speculum, the early iteration of which was a doubly bent spoon that allowed him to separate and hold apart the vaginal walls of his patients.
- During the mid-1800s, Sims ran a small private hospital, “Surgical Infirmary for Negroes,” and conducted experiments with his prototype speculums on enslaved women without the use of anesthesia. Sims noted in his memoir that he operated on one woman, named only as Anarcha, 30 times.
- Sims and his fellow slaveholders experimented on enslaved women to develop techniques that would help them continue to give birth to their then-enslaved children, and continue to work.
🔗 Source: https://www.pbs.org/wgbh/americanexperience/features/cancer-detectives-brief-history-speculum/ 🔗 Source: https://amwa-doc.org/anarcha-lucy-and-betsey-the-women-who-built-gynecology-without-consent/ 🔗 Source: https://www.anarchalucybetsey.org/
The Uterus and Medical Racism
Role of Bleeding Recognition and Evaluation in Black-White Disparities in Endometrial Cancer
- Advanced stage endometrial cancer at diagnosis is an independent, unexplained contributor to racial disparity in endometrial cancer. Researchers sought to investigate whether, prior to diagnosis, provider recognition of the cardinal symptom of endometrial cancer, postmenopausal bleeding, differs by patient race.
- 4,354 White and 537 Black women diagnosed with endometrial cancer were included in this study. Compared to White women, Black women were less likely to have guideline-concordant care for postmenopausal bleeding and appropriate diagnostic evaluation (70% vs 79%).
- Older Black women with endometrial cancer are at highest risk for the most aggressive histology types, yet they are less likely to get guideline-concordant evaluation of vaginal bleeding from their doctors.
🔗 Source: https://www.ajog.org/article/S0002-9378(18)30832-9/abstract
Clinicians’ Perspectives on Racism and Black Women’s Maternal Health
- The objective of this University of California study was to explore clinician perceptions of how racism affects Black women’s pregnancy experiences, perinatal care, and birth outcomes.
- Perinatal care clinicians who serve racially diverse women were interviewed in early 2019. Three themes emerged: provision of inequitable care; surveillance of Black women and families; and structural care issues rooted in the history of medical racial experimentation.
- Black women are three to four times more likely to experience complications during pregnancy and childbirth and die from these complications compared with white women.
- Infants born to Black women are two times more likely to be born premature (<37 weeks of gestation) compared with infants born to white women.
🔗 Source: https://escholarship.org/uc/item/2306471s
The Uterus and Transgender Maternity
“I Don’t Know if I’m a Dad, I Don’t Know if I’m a Mom, I Think I’m Both”
- Many transgender and gender-expansive, nonbinary people assigned female at birth retain the capacity for pregnancy and want to become parents, through pregnancy or otherwise.
- A national survey of US adults found that 12% of transgender people assigned female at birth had experienced a pregnancy and 11% wanted to become pregnant in the future.
- While many transgender people desire pregnancy and parenthood, qualitative research suggests that they face barriers to achieving this goal, including access to healthcare, financial constraints, and social-emotional support.
🔗 Source: https://uterusart.org/wp-content/uploads/2026/09/i_dont_know_if_im_a_dad_masterson.pdf
The Uterus, PCOS and PMOS
Periods, Polycystic Ovarian Syndrome, and Heart Health
- Menstrual cycles are different among individuals and can change month to month. Small changes in a person’s period are normal — for example, being shorter or longer in length, or having heavier or lighter bleeding. Menstrual cycles change for many reasons, including stress, medication, and age. Periods are largely considered a window into overall health.
- This Harvard study’s Medical History survey provides data from 37,000 participants on questions about gynecological conditions, family medical history, and heart health. Approximately 30,000 participants also completed the Reproductive History survey and answered questions about their menstrual cycle over time.
- Long menstrual cycles and heavy periods can be symptoms of a condition called polycystic ovarian syndrome, or PCOS. Fluid-filled sacs called follicles develop on the ovary during a normal menstrual cycle and can develop into cysts. Too many follicles or cysts on a person’s ovaries can interfere with normal ovulation, resulting in a cascade of reproductive health issues.
- While PCOS is characterized as a condition impacting periods and menstruation, it is also closely linked to heart and circulatory health. PCOS may increase the risk of diabetes, high blood pressure, high cholesterol, obesity, and cardiovascular disease.
- For too long, the PCOS name reduced a complex, long-term hormonal or endocrine disorder to a misunderstanding about “cysts” and a focus on ovaries. This contributed to missed diagnoses and inadequate treatment.
- PMOS is characterized by fluctuations in hormones, with impacts on weight, metabolic and mental health, skin, and the reproductive system.
- “This shift will reframe the conversation and demand that it is taken as seriously as the long-term, complex health condition it is.”
🔗 Source: https://www.endocrine.org/news-and-advocacy/news-room/2026/pcos-name-change
PCOS Is Renamed PMOS: What You Need to Know
- This condition has multidimensional implications, according to Dr. Pal, who explains that the condition is linked to a range of effects, including menstrual and ovulatory dysfunction, psychological burden and metabolic havoc, and long-term health risks such as diabetes and cardiovascular disease. One reason for the switch in terminology is to move away from classifying it as a reproductive disorder.
- The original name, PCOS, focuses attention on cysts in the ovaries. The condition actually involves multiple systems across the body. It may present with symptoms such as irregular periods, elevated androgen (male hormone) levels, and fertility difficulty, but also insulin resistance, increased long-term risk of type 2 diabetes, and abnormal cholesterol levels.
🔗 Source: https://www.yalemedicine.org/news/pcos-is-renamed-pmos-what-you-need-to-know
- The term PCOS is inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma, while curtailing research and policy framing.
- Preferred terms were polyendocrine, metabolic, and ovarian, reflecting the condition’s multisystem pathophysiology, and “polyendocrine metabolic ovarian syndrome” was the consensus new name. Accuracy was improved by omitting cysts and by capturing endocrine, metabolic, and ovarian dysfunction.
