Many know what a uterus is, but the term retroverted uterus is not a familiar one. What is it anyway? Read here and find out.
Unless your doctor told you that you have one, you might not have heard of the term retroverted uterus before. And if your doctor tells you that you have it, is it something that you have to worry about?
According to obstetrician-gynecologist Kristine C. Tangco, MD, FPOGS, FPSUOG, a woman’s uterus is retroverted if it is tipped backward towards the rectum, rather than towards the belly and facing the urinary bladder, which is the regular position.
Screen grab from YouTube (Dr. Shahab Khan)
“The uterus is a pear-shaped organ in the pelvic cavity held in place by several bands of tissues called ligaments. It is usually positioned with its fundus or top part facing the urinary bladder (anteverted).
In a woman with a retroverted uterus, the fundus is tipped backwards or posteriorly. Instead of the fundus facing the urinary bladder, the uterus is tipped towards the rectum and the spine,” she explained.
While the term doesn’t sound very familiar, there are actually a lot of women who have retroverted uteruses. In fact, according to Mary Jane Minkin, M.D., an OB-GYN and clinical professor at the Yale School of Medicine, about 30 percent of women have a retroverted uterus. We can also refer to it as the following:
- tipped uterus
- retroflexed uterus
- uterine retroversion
- backward uterus
- uterine retro displacement
Curious about this condition, here are some helpful facts about having a retroverted uterus and how it can affect a woman’s life.
Retroverted uterus: meaning and relation to pregnancy
The vagina is commonly not in a vertical position in the pelvis, it angles towards the lower back. Most women have their uterus tipping forward, lying over the bladder, with the fundus or top towards the abdominal wall.
Another normal and common variation, which some women have, is the upright uterus. In this variation, the fundus is in a straight-up placement.
What is the meaning then, of a retroverted uterus? About a quarter of women have this condition. As doctors call this term, it refers to a uterus that curves in a backward placement at the cervix, instead of being in a forward position.
Furthermore, in this particular position, the fundus of the uterus is aimed toward the rectum.
In the Tagalog terminology, retroverted uterus is common to doctors referring to as baliktad na uterus o sinapupunan.
How does a retroverted uterus affect pregnancy?
Your retroverted uterus should not affect your pregnancy. You may still get pregnant and have a normal pregnancy.
If there is an instance that you are unable to get pregnant while you have a tilted uterus, it is more likely caused by another condition. Your uterus might be in a complication that affects your pregnancy.
Some of the following conditions that are related to pregnancy problems while having a retroverted uterus are the following:
In addition, there is no significant relevance between a retroverted uterus and complications occurring during labor and delivery. In fact, pregnancy may cause your uterus to change into an averted position sometime during your 2nd trimester.
Your uterus might return to its retroverted position after you give birth to your baby.
Anteverted uterus vs Retroverted uterus
A retroverted uterus is one type of a “tilted uterus”, a category in which the anteverted uterus also falls. While the retroverted uterus curves backward instead of forward, the anteverted uterus “tilts” forward instead of backward.
Like other parts of your body, your uterus may come in many shapes and sizes. An anteverted uterus should also not affect your health condition. Also, you may not even be aware that your uterus has this particular shape.
What can cause a retroverted uterus?
Some women are born with a tilted uterus, while some acquire it as they mature. It may have an underlying cause that we can often associate with pelvic scarring or adhesions such as:
-
Normal anatomic variation
Generally, the uterus moves into a forward tilt (facing the bladder) as the woman matures. But this does not happen to some women; their uteri remain tipped backward (facing the rectum and spine).
These are small, non-cancerous masses or lumps that grow in or on the uterus, making the organ susceptible to tipping backward.
Screengrab from YouTube (EndometriosisSA)
The endometrium is the lining of the uterus. Endometriosis is the growth of endometrial cells outside of the uterus. These cells can bring about retroversion by causing adhesions of the uterus to other pelvic structures.
The position the uterus settles into after a woman gives birth depends on a number of factors, including how much the ligaments have stretched during pregnancy and how much weight a woman has gained. Added weight puts pressure on the uterus and can affect its postpartum position.
Symptoms of having a retroverted uterus
Unless your doctor told you, you may be unaware that you have a tilted uterus, as most women experience no symptoms. However, these signs can be an indication that you have it:
- pain in your vagina or lower back during sexual intercourse
- pain during menstruation
- trouble inserting tampons
- increased urinary frequency or feelings of pressure in the bladder
- urinary tract infections
- mild incontinence
- protrusion of the lower abdomen
In general, a retroverted uterus does not cause problems. If problems do occur, an associated condition that a woman might have like endometriosis is the probable culprit.
Two symptoms of this would be pain and discomfort during sexual intercourse – especially when the woman is on top – and pain during menstruation.
Retroverted uterus and sex
According to Dr. Yvonne Fulbright, author of Sultry Sex Talk to Seduce Any Lover, having a tilted uterus may affect the sensations that you feel during sex.
The uterus (retroverted or not) is a very flexible organ so sex should rarely cause pain. But for sexual positions that allow deeper penetration such as a woman on top, a person with a tilted uterus may feel a little discomfort.
The uterus is located fairly low in the pelvis, along with the ovaries. So during vigorous sex or sex with deep thrusting or penetration, the head of the penis may put some force against the walls of the vagina, bumping into the uterus or ovaries. This can cause pain or bruise in some women.
However, it should not cause any bleeding or extreme pain, which can discourage you from having sex. If you have a retroverted uterus and can feel any discomfort while having sexual intercourse, just change positions.
A woman on top or cowgirl position is good because you can control your partner’s thrusting. Fulbright also suggests trying a modified version of missionary with your legs straight and closer together, so that your guy is less likely to go deep and irritate your uterus while thrusting,
Retroverted uterus and fertility or pregnancy
One of the most questions that OB-Gynecologists get from women who just learned about their retroverted uterus is, “Will I be able to get pregnant?”
But according to Dr. Tangco, having a tilted uterus does not lessen a woman’s chances of conceiving, nor does it affect pregnancy.
“Having a retroverted uterus has no bearing on a woman’s reproductive career. It is not associated with problems in conception or a woman’s fertility,” said the doctor.
On the whole, it doesn’t affect pregnancy. As the baby grows in the first trimester, the uterus expands in the pelvic cavity, and by 12 to 13 weeks of pregnancy, the uterus grows up and out of the pelvis and into the abdomen to accommodate the growing baby.
While it doesn’t have any effect on your chances of getting pregnant and the safety of your baby, it can affect the symptoms that you are experiencing, especially during the first trimester.
During your first weeks of pregnancy, the uterus may be difficult to see during an abdominal ultrasound, which is why most doctors go with a transvaginal ultrasound instead.
According to Healthline, a retroverted uterus might put more pressure on the bladder during the first trimester, which can lead to increased incontinence, difficulty urinating, or back pain for some women.
Incarcerated uterus
As mentioned, the uterus usually expands and straightens towards the end of the first trimester. However, if for some reason this does not happen, there is an increased risk of miscarriage. This is what doctors refer to as an incarcerated uterus.
The incarcerated uterus is a very rare obstetrical complication wherein the pregnant and growing uterus remains persistently in a retroverted position. As a result, it becomes wedged into the pelvic cavity. This condition may be improvable by hospitalization, insertion of a urinary catheter to empty the bladder, and a series of exercises such as pelvic rocking to help free the uterus.
So if you’re pregnant, it’s best to inform your doctor right away if you’re experiencing the following symptoms:
- a consistent inability to urinate
- pain in your stomach or near your rectum
- constipation
- incontinence
Is there a treatment for retroverted uterus?
In most cases where a woman with a retroverted uterus is asymptomatic, there is no need for treatment. However, if you’re experiencing symptoms and you are worried about it, here are some treatment options that you can discuss with your doctor.
- Medical or surgical treatment of the underlying condition/s (endometriosis, pelvic inflammatory disease, adhesions, and myomas).
- If the above-mentioned conditions do not hinder the movement of the uterus, and if the doctor can manually reposition the uterus during a pelvic examination, some exercises and stretches may help.
- Pessary – this is a small silicone or plastic device that a doctor may place temporarily or permanently inside the vagina. It helps prop the uterus into a forward lean. But because a pessary is a foreign object, it has disadvantages, warns Dr. Tangco. It can trigger pelvic infection and inflammation, make sexual intercourse painful for the woman, and cause discomfort as well for her partner.
Exercise for Retroverted Uterus: A treatment
In some cases, doctors may not be able to manipulate your uterus position into an upright position. If that is the situation, certain types of exercises can help strengthen the ligaments and tendons holding the uterus in an upright position. These exercises are also beneficial to you.
Kegels exercise is one example. Other exercises may include:
- Knee to chest stretches. You may lie on your back with your knees bent and your feet on the floor. Then, gradually raise one knee at a time up to your chest. While your knee is on your chest, slowly pull it with both hands. Do this position for a length of 20 seconds. Release. Then, your other knee will be next.
- Pelvic contractions. These exercises work in strengthening your pelvic floor muscles. To do this, lie on your back with your arms on both sides in a relaxing position. Then, inhale as you raise your bottom off the floor. Hold in this position when inhaling, and release as you exhale. Do this 10-15 times.
However, this exercise will not work if your uterus is stuck in place because of scarring or adhesions.
If you have any questions about your uterus or reproductive health, don’t hesitate to consult your OB-GYN.
Additional information by Nathanielle Torre
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