Overview
Human bodies are inherently different, and no two bodies are exactly alike. Some women are either born with a retroverted uterus or develop it later in life. A retroverted uterus, also called a tilted uterus, is a variation in the uterine position. Most of the time, it is a harmless biological variation, but in some cases, it can be linked to symptoms or fertility concerns. Through this blog, we aim to cover the causes, symptoms, and effects on fertility and pregnancy, offering comprehensive knowledge on a retroverted uterus.
Table of Contents
What is a Retroverted Uterus?
A retroverted uterus is a biological difference in women where the uterus tilts backwards towards the spine instead of forward towards the abdomen. The uterus is a pear-shaped pouch and is located in the pelvis between the bladder and rectum. The exact position can vary between individuals and change during the phases of pregnancy.
Typically, in an anteverted uterus, the curved part is towards the abdomen and the cervix is pointed towards the rectum. Here, the uterus is on top of your bladder. However, in a retroverted uterus, the opening of the cervix is towards the belly and the curved part is tilted backwards to the spine.
Most women don’t know that they have a tilted uterus, as symptoms usually go unnoticed. It is a common condition impacting around 20%-30% of women globally.
Is a Retroverted Uterus Normal?
Yes. A retroverted uterus is considered a normal anatomical variation rather than a medical condition. About 20-30% of women have a naturally backwards-tilted (rather than forwards-tilted) uterus. In most cases, it is painless, does not affect menstrual health, and does not interfere with fertility or pregnancy.
Many women are diagnosed with a retroverted uterus during a routine pelvic exam or ultrasound for some other problem. Treatment is generally not needed unless the tilted uterus is causing symptoms or is associated with another condition, such as endometriosis or pelvic adhesions.
Symptoms of Retroverted Uterus
Mostly, a retroverted uterus doesn’t have any symptoms. However, these symptoms often correlate to having a tilted uterus. They are:
Painful periods (dysmenorrhea):
Pain during menstruation is a common retroverted uterus symptom.
Pain during sex (dyspareunia):
Pain experienced during sexual encounters can also be a sign of a retroverted uterus.
Lower back or pelvic pain:
If an individual experiences pelvic pain or pain in the lower back, it can indicate that the uterus is tilted backwards.
Difficulty inserting tampons:
Tampons are harder to use for people with a retroverted uterus.
Bladder or bowel pressure:
In severe cases, people may experience pressure on the bladder or bowels, leading to an inability to hold in stool or urine as well.
Causes of Retroverted Uterus
The most common causes of a retroverted uterus are:
Normal anatomical variation:
Most people are born with a retroverted uterus, which is not caused by any health conditions. A retroverted uterus does not cause any functional problems.
Pregnancy:
Sometimes pregnancy can lead to a tilted uterus. The ligaments of the uterus are stretched or weakened during pregnancy, resulting in a retroverted uterus.
Endometriosis or pelvic adhesions:
Endometriosis causes tissues to grow outside the uterus. The tissue then gets attached to other organs and can cause the uterus to tilt backwards.
Fibroids or uterine surgery:
Uterine fibroids can cause a tilted uterus. Scar-like tissues from uterine surgeries can cause the tissue to stick to other organs internally. This can lead to a retroverted uterus, pulling your uterus backwards.
Diagnosis of Retroverted Uterus
A retroverted uterus diagnosis is primarily made by a medical practitioner performing a pelvic exam. If symptoms such as pelvic pain or painful intercourse are present, the doctor may also evaluate for underlying conditions like endometriosis, pelvic inflammatory disease, or fibroids that could be causing the uterus to tilt backwards.
During the exam, the practitioner can determine the position of the uterus depending on the opening of the cervix and where it is tilted. A more thorough examination can be done through an ultrasound scan.
In some extreme cases, a laparoscopy is performed to rule out the presence of any fibroids or endometriosis. Imaging tests help distinguish a naturally retroverted uterus from one associated with other pelvic disorders, allowing the most appropriate treatment plan to be recommended.
Treatment Options for Retroverted Uterus
If the condition is asymptomatic, treatment is usually not required. A retroverted uterus treatment entails multiple pathways if the symptoms cause discomfort in an individual's life.
Pelvic Floor Exercises:
Healthcare practitioners suggest performing certain exercises to shift the uterus to a forward position. Usually, exercises are done to strengthen the pelvic muscles, which can cause the uterus to revert. Unfortunately, exercises wont suffice if the tilted uterus is caused by scarring.
Pessary:
A pessary is a small, plastic, doughnut-shaped device thats inserted into the vagina. It acts as a support structure, helping to hold things in place in the vagina. It can help prop the uterus up to an anteverted position.
Surgery:
In severe cases of adhesions or bleeding, a surgery will be prescribed by a doctor to reposition the uterus. The surgery is called a uterine suspension surgery. In the worst case, a hysterectomy will also be considered to remove the uterus completely from the body.
Treating the Underlying Condition
If the retroverted uterus is caused by things like endometriosis, pelvic adhesions, or uterine fibroids, treatment of the underlying issue may improve symptoms and, in some cases, return the uterus to its normal position. Depending on your condition, you may need medication, minimally invasive surgery, or other treatments.
Pain Control
Women with a retroverted uterus who have mild pelvic pain or painful periods can try pain medication, heat therapy, or lifestyle changes recommended by their health care provider to relieve pain. These treatments help to control symptoms, but do not change the position of the uterus.
Does a Retroverted Uterus Affect Fertility?
No, a retroverted uterus doesn’t hamper your ability to conceive or reduce your fertility potential in any way. A retroverted uterus and pregnancy will not cause any complications during labour or during any phase of pregnancy. As a matter of fact, the uterus, around the second trimester, shifts back to an anteverted position and reverts post-pregnancy.
However, if the uterus is tilted due to adhesions or fibroids, fertility may be compromised in those women. Conception is still possible through fertility treatments and surgical intervention.
Retroverted Uterus During Pregnancy
In most cases, a retroverted uterus in pregnancy does not cause any extra problems for women. As pregnancy progresses, the gravid uterus usually becomes anteverted by the end of the first trimester or early in the second trimester. This is a normal change and allows the uterus to grow normally as the baby develops.
Routine prenatal care and ultrasound examinations are usually enough. Rarely, the uterus can become stuck inside the pelvis, called an incarcerated uterus, which requires prompt medical attention, though it is not a frequent complication.
Conclusion
One in four women has a tilted uterus and, hence, it is a fairly common biological variation in women. Many women conceive naturally with a retroverted uterus. If one experiences any of the above symptoms and it disrupts their everyday life, it is highly recommended to consult a gynaecologist to be diagnosed and treated accordingly.
Frequently Asked Questions
Will a tilted uterus straighten during pregnancy?
Around the second trimester, a retroverted uterus can reposition as an anteverted uterus. Post pregnancy, it reverts to a tilted uterus, naturally.
Does a retroverted uterus cause painful periods?
Yes, a retroverted uterus can lead to painful periods. It is due to the uterine angle impeding menstrual blood flow.
What is the difference between an anteverted and retroverted uterus?
An anteverted uterus tilts forward and towards the bladder, and is the most typical position for a uterus to be in a woman’s body. A retroverted uterus, also known as a tilted uterus, occurs when the uterus is tilted backwards towards the spine.
Does a retroverted uterus affect implantation?
No, a retroverted uterus does not cause any issue in implantation. It is a common myth that having a tilted uterus can affect pregnancy. It is a fairly common anatomical position for a uterus to exist.
What are the symptoms of a retroverted uterus in early pregnancy?
Most women don’t experience any symptoms despite having a tilted uterus. Women with a retroverted uterus may experience lower back pain or pelvic pain during early pregnancy. There may be pressure on the bowels and bladder, making it harder to hold in stool or urine.