Introduction:
Uterus is the organ where a baby can develop inside mother’s body. This organ is part of the female reproductive system and is present in the pelvic cavity. An inverted pear defines the shape of the uterus present in the pelvic cavity. Uterus is located posterior to the bladder and anterior to the rectum.
Generally, the uterus is anteverted, which means it is tilted towards the ventral side of the body. The uterus is positioned more towards the abdominal wall than the spine of the body. Hence, the uterus lies over the bladder. The lower part of the uterus is called the cervix. The opening of the cervix usually faces toward the rectum (in the case of an anteverted uterus).
Retroverted uterus is a condition where the uterus is tilted more towards the back of the body. You can either be born with a retroverted uterus, or acquire it after birth or pregnancy. This condition rarely leads to any symptoms or complications that can affect your normal lifestyle. That’s why some women never even know that they have a retroverted uterus.
What this blog contains:
After reading this blog, you will get to know all the necessary information about the retroverted uterus and how it can affect your normal lifestyle. We also discuss the symptoms you should pay attention to, especially during pregnancy. This will also help you know when you should seek your doctor and what questions you can ask.
How common retroverted uterus occurs:
Retroverted uterus is a condition that no one can prevent. It can either be present from birth or develop during a woman’s lifetime. It is a very common condition. Nearly 25% of women have a retroverted uterus, which basically means their uterus is tilted towards the spine. Some of them may experience symptoms or complications.
Anteverted uterus vs Retroverted uterus
Anteverted uterus:
- Uterus is present near the abdominal wall of the body; lies posteriorly on the bladder. This is the normal anatomical position and is present in the majority of women (75–80%).
- Cervix points posteriorly towards the rectum.
- Uterus bends forward.
- No effect on fertility.
Retroverted uterus:
- Uterus is present near the spine of the body; lies closer to the back. This condition is present in nearly 20–25% of women.
- Cervix points anteriorly towards the belly.
- Uterus bends backward.
- Usually has no effect on fertility unless it is associated with conditions like endometriosis, pelvic inflammatory disease, etc.
How retroverted uterus can affect your fertility:
As mentioned earlier, many people with a retroverted uterus don’t have any symptoms or complications; therefore, a retroverted uterus usually does not affect fertility. If you have a retroverted uterus and know about it, you can still conceive a normal pregnancy and deliver a healthy baby.
If you experience issues during pregnancy while having a retroverted uterus, it is likely due to an associated condition rather than the retroverted uterus itself. These associated conditions include:
- Uterine fibroids
- Pelvic inflammatory disease
- Endometriosis
- Ovarian masses
- Uterine prolapse
Main causes of retroverted uterus:
It is most probably a birth condition, meaning you may have a retroverted uterus from birth. However, it can also develop later in life due to several reasons, which are mentioned below:
- Pelvic scarring or adhesions:
After certain pelvic surgeries (such as a C-section), infections, or pelvic inflammatory disease (PID), bands of fibrous tissue may develop. These tissues can cause the uterus to attach to nearby organs, gently pulling it backward and resulting in a retroverted position. - Uterine fibroids:
Certain growths on the uterus can change its shape and tilt its position toward the spine of the body. - Childbirth:
After delivery, the muscles and ligaments of the pelvic floor become weak, which can lead to the uterus tilting backward. - Menopause:
After menopause, estrogen levels in the body decrease, leading to weakness of the pelvic floor. Weakened ligaments may no longer hold the uterus properly, causing it to tilt backward. - Endometriosis:
Endometrial tissue grows outside the uterus, which can cause pelvic adhesions and contribute to a retroverted uterus.
Symptoms of retroverted uterus:
Some women with a retroverted uterus don’t have any symptoms in their lifetime and can maintain a normal lifestyle without complications. However, some may experience a few symptoms, which include:
- Lower back pain
- Painful menstrual cycles
- Pain during intercourse in specific positions
- Urinary tract infections
- Difficulty with tampon insertion and removal
- Pelvic discomfort
Does retroverted uterus interfere with bowel function?
People with bowel conditions like inflammatory bowel disease, chronic constipation, or fecal incontinence may think that it is due to a retroverted uterus, but that’s not true.
A retroverted uterus has not been associated with bowel conditions according to research so far. However, it is possible that the root cause of a retroverted uterus (such as endometriosis, pelvic inflammatory disease, or uterine fibroids) could be associated with bowel issues.
Does retroverted uterus interfere with sex?
Generally, people don’t even know they have a retroverted uterus, and most can have a normal lifestyle. This condition usually does not interfere with sexual intercourse.
However, sometimes you may feel intense pain during certain positions, so it is advisable to avoid those positions. In a retroverted uterus, the uterus is positioned deeper in the pelvic cavity, so deep thrusting can cause discomfort during intercourse in some specific positions.
If you experience pain during intercourse every time, with or without bleeding, you should consult your healthcare provider to address this problem.
How retroverted uterus affects pregnancy:
Usually, this condition does not have any impact on pregnancy or the developing baby. However, due to the deep position of the uterus in the pelvic cavity, it can be harder to check the progress of the developing baby by a standard ultrasound. Therefore, doctors may prefer a transvaginal ultrasound to monitor progress.
During pregnancy, the size of the uterus increases because of the developing baby. By the end of the first trimester, the uterus expands out of the pelvic cavity and is no longer tilted backward.
Prevention:
You cannot really prevent a retroverted uterus, as it usually occurs due to underlying medical conditions or natural anatomical differences beyond your control.
However, you can reduce the risk of developing conditions like pelvic inflammatory disease and uterine fibroids, which can lead to a retroverted uterus. In some cases, it is simply present from birth.
Diagnosis:
If you consult your healthcare provider with symptoms mentioned above, your doctor can determine your condition by performing a pelvic examination. During this examination, the doctor can feel the position of the uterus and cervix to know exactly how your uterus is tilted.
Sometimes, the doctor may also recommend an ultrasound, as it helps diagnose other conditions that may be associated with a retroverted uterus, such as endometriosis, pelvic inflammatory disease, ovarian masses, etc.
Treatment or management:
These are the following options that your doctor may recommend:
Treat the root cause:
If a retroverted uterus develops due to an infection, treating the infection can help prevent further complications.
Pessary:
A pessary is a small, soft, ring-shaped device made of plastic or silicone that is placed inside the vagina to provide support. It helps lift and hold the uterus in a forward (anteverted) position. However, it may cause issues like irritation or infection if used for long periods, so doctors usually suggest it as a temporary option.
Exercise:
In some cases, your healthcare provider may be able to gently move your uterus into a more upright position. When this is possible, doing specific exercises that strengthen the ligaments and pelvic muscles supporting the uterus can be helpful.
Kegel exercises are a good example. Other beneficial moves include:
- Knee-to-chest stretch: Lie on your back with your knees bent and feet flat on the floor. Bring one knee up toward your chest, holding it gently with both hands for about 20 seconds. Lower it back down and repeat with the other leg.
- Pelvic lifts: These strengthen your pelvic floor muscles. Lie on your back with your arms at your sides. Inhale and slowly lift your hips upward, hold for a few seconds, then exhale and lower them back down. Repeat 10–15 times.
Surgery:
In some cases, your doctor may suggest a surgical procedure to move the uterus into a forward position. This operation, known as uterine suspension or uterine repositioning, can help correct the tilt and ease discomfort. For severe or complicated cases, a hysterectomy (surgical removal of the uterus) might be considered as a last resort.
When to seek a doctor:
If you experience any of the following symptoms, especially during pregnancy, let your doctor know. Symptoms you shouldn’t ignore include:
- Consistent inability to urinate
- Chronic constipation
- Pain near the rectum or stomach
- Incontinence
- Other symptoms such as painful menstruation, painful intercourse, etc., as mentioned above
If you feel that you are suffering from any of these symptoms, don’t delay in seeking help from your doctor.
Complications of retroverted uterus:
In general, there are no major complications associated with a retroverted uterus. However, very rarely, you may experience an incarcerated uterus. In this condition, during pregnancy, the uterus can become trapped in the pelvic cavity as it expands. This can increase the risk of miscarriage by the end of the first trimester. This also answers a common question: “Does a retroverted uterus cause miscarriage?”
Note from Femwise:
A retroverted uterus is often detected during a routine pelvic examination. While it typically doesn’t lead to major health concerns, you should consult your doctor if you experience pain or discomfort. They can suggest appropriate treatment options to ease your symptoms and check for any underlying medical issues.
