In some people, the womb or uterus is tipped backward, pointing toward the lower back. This is known as a retroverted, tilted, or tipped uterus.
Usually, the uterus sits upright, in a vertical or up-and-down position. A tilted uterus is quite common, with one woman out of every five having a tilted uterus.
The uterus is a hollow, pear-shaped organ that sits in the lower part of a person’s pelvis. It is where a fetus grows during pregnancy.
A person can have a tilted uterus for several different reasons:
- Weakening of the pelvic muscles: After menopause or childbirth, the ligaments supporting the uterus can become lax or weakened. As a result, the uterus falls in a backward or tipped position.
- Enlarged uterus: An enlarged uterus due to pregnancy, fibroids, or a tumor can also cause the uterus to become tilted.
- Scarring or adhesions in the pelvis: The uterus or pelvis may be scarred by conditions, including endometriosis, infection, or previous surgery. This scar tissue can pull the uterus backward and cause it to be tipped.
- Genetics: Some people are born with a uterus in a tilted or tipped position.
Anteversion of the uterus means that the uterus is tilted towards the front of the abdomen. This is a normal position and typically does not have an impact on a person’s ability to get pregnant.
Retroversion of the uterus means that the uterus is tipped backward. This can sometimes cause problems for people who are pregnant.
Many people are concerned that having a tipped uterus will impact their ability to get pregnant. The position of the uterus does not usually affect fertility, however. Doctors may consider it if a person is having difficulties becoming pregnant, but only after other causes of infertility are ruled out.
Having a tilted uterus should not affect a person’s ability to have a healthy pregnancy. In fact, being pregnant may cause the growing uterus to tip backward. In most cases, there is no impact on labor or delivery.
Painful sex can be a problem for a person with a tilted uterus. Doctors are unsure what causes this discomfort, though there are several theories:
- A tilted uterus can cause the cervix to sit differently in the vagina. The pain may be caused by the way the penis bumps against the cervix during intercourse.
- The ligaments supporting the uterus may be stretched and moved in a different direction than the uterus. This can cause pain or discomfort during sex.
- Another theory is that a tilted uterus causes venous congestion in the pelvis, meaning the veins in the reproductive organs dilate and fill with blood.
Sometimes, simply changing positions can make painful sex less troublesome. It is important for people to communicate to their partner what is comfortable and what is not.
Some signs are typical in people with a tilted uterus, including:
- pain during sex
- menstrual pain or cramping
- back pain during intercourse
- minor urinary incontinence
- recurrent urinary tract infections
- discomfort when wearing tampons
It’s very common for a person to have no symptoms. A person may not realize that they have a tipped uterus.
A tipped uterus can be easily detected during a routine pelvic exam. A doctor will insert two fingers into the vagina to feel and push against the cervix slightly.
Next, the other hand is placed on top of the abdomen and pushes it in gently to capture the uterus between the two hands. This allows the doctor to feel the uterus to determine its shape, size, and position and to feel for abnormal growths.
People who are having pain during sex or other symptoms of a tipped uterus should consult with their doctor, if possible. These symptoms can be a sign of other, more serious conditions and the doctor can do diagnostic tests to distinguish this condition from something more serious.
A tipped uterus, by itself, is not typically considered a problem that needs treatment. Treatment will usually focus on the root cause of a tipped uterus such as fibroids or lack of support.
There are a few treatment options that can help to correct the root causes of a tilted uterus.
If a person has severe symptoms that interfere with their life or ability to get pregnant, these options may be used.
- Pessary: A pessary is a device that a doctor places in the vagina. It helps to support the vaginal walls, uterus, and other pelvic structures and can help to reposition the uterus. A pessary is a temporary fix, as the uterus will revert to its original position if it is removed.
- Surgery: For some people, surgery can reposition the uterus. Uterine suspension surgery is an outpatient procedure done with or without the use of a mesh or sling. Lasting results and improvement of pain during sex are usually achieved from surgery.
- “Knee-chest” position: Though not a permanent solution, bringing the knees to the chest while lying down can help to move the uterus temporarily into a more comfortable position.
The outlook for someone with a tilted or tipped uterus is good. Though some people experience discomfort related to the position of the uterus, serious health problems are not usual.
It is always important for people to talk to a doctor about pain during sex or other symptoms, even if they suspect that a tilted uterus is causing the discomfort.