Located between the rectum and pelvis, the uterus is a hormone-responsive reproductive sex organ in females. The ovaries in females produce the eggs that implant itself in the uterus, so the main function of this hollow muscular organ is to nourish the developing fetus during pregnancy. It is worth mentioning that the normal position of the uterus is straight and vertical, but some women may find that they have tilted uterus, which is actually quite a common situation.

What Is Tilted Uterus?

Some women have their uterus tipped backwards, a little towards the back of the pelvis. A research has shown that about 20% of women have a tilted or retroverted uterus. There are actually many other terms used to describe tilted uterus, such as backward uterus, retroflexed uterus, tilted womb, and of course, retroverted uterus. Similarly, medical professionals use some other terms to describe the same conditions. This may include uterine retroflexion, uterine retroversion, symptomatic uterine retroversion, retroversion of the uterus, relfexion of the uterus, and uterine retrodisplacement.

Three Commonly Asked Questions About Tilted Uterus

1. Will Tilted Uterus Affect Your Sex Life?

It is obvious to feel concerned about a titled uterus, but it is not always that serious. You can still have sexual intercourse, but you may not like it in certain intercourse positions. The vagina is usually straight and at its end is the uterus, which is about the size of your fist. The round part of the uterus points forward toward your belly, which may point more towards your rear end if you have a retroverted uterus. It is for this reason only that women with a tilted uterus feel period pain in their back instead of experiencing pain in their abdomen.

Due to the shape of the uterus, women with a retroverted uterus prefer intercourse positions where they lay flat with face towards their partner. It is therefore quite obvious that a forward-facing woman-on-top position or missionary position will be more favorable if you have a tilted uterus.

2. Will Tilted Uterus Lead to Infertility?

Having sexual intercourse may cause pain, so it is obvious to feel concerned about retroverted uterus pregnancy. It may or may not lead to infertility. Your healthcare provider may consider it only if they have ruled out all other fertility problems in your case. When your doctor cannot pinpoint another issue, they may suggest you to go for a uterine suspension or ULIFT procedure to ensure your tilted uterus is not the culprit here.

3. Will Tilted Uterus Affect Pregnancy?

In some cases, pregnancy actually helps resolve the issue and brings uterus back into an "un-tilted" position. This usually happens by the weeks 10 to 12. The good news is that the position of your uterus isn't going to affect your pregnancy or delivery. In rare cases, the uterus doesn't move forward, which may lead to miscarriage. 

What Are the Symptoms of Titled Uterus?

It is obvious to worry about titled uterus and pregnancy, but it is important to first ensure you really have this problem. Paying attention to certain symptoms will help make a decision. The primary symptoms of a tilted uterus include pain during menstruation or sexual intercourse. Other symptoms include urinary tract infections, back pain during intercourse, fertility problems, minor incontinence and difficulty using tampons.

What Causes a Tilted Uterus?

Before you start looking for a solution, it is important to learn a bit about the causes of a retroverted uterus.

• Natural Change: The uterus usually moves back into its regular position as the woman matures, but sometimes, it holds its position and remains tilted.
• Adhesions: A band of scar tissue called "adhesion" connects two separate surfaces and sometimes pulls the uterus into a tilted position. Adhesions may form after pelvic surgeries.
• Endometriosis: One of the linings of the uterus is called the endometrium. Sometimes, the endometrial cells overgrow and move out of the uterus. These cells may stick to other pelvic structures, causing the uterus to tilt backwards.
• Fibroids: You may have a tilted uterus because of small, non-cancerous lumps. These lumps put pressure on the uterus and tip it back a bit.
• Pregnancy: Several connective tissues called ligaments help keep uterus in place, but these tissues may stretch excessively during pregnancy and cause a tilted uterus. If the tilt is due to pregnancy, your uterus normally returns to normal after childbirth.

How Is Tilted Uterus Diagnosed?

A routine pelvic exam will confirm if you have a retroverted uterus or not. You may also discover you have a tilted uterus during a Pap test. You may also experience pain during a sexual intercourse, which usually encourages your doctor to ask for a range of tests. This usually helps identify what's causing your uterus to tilt backward.

How Is Tilted Uterus Treated?

You don't usually need a treatment if your titled uterus isn't causing any problems. If needed, the treatment options depend on the underlying condition.

• You may have to undergo a hormone therapy if your titled uterus is due to endometriosis.
• Your doctor may suggest several exercises if they think that fibroids or endometriosis aren't hindering the movement of the uterus. These exercises may offer a temporary relief, as the uterus tend to tip back again.
• A small plastic or silicone device called pessary may also be used to bring your uterus back into its normal position. This is not the ideal solution though because it increases risk of inflammation and infection, and you and your partner may still experience pain during sexual intercourse.
• Laparoscopic surgery technique has been proved beneficial in repositioning the uterus. The surgery is quite straightforward and usually works well to correct the position of your tilted uterus. Surgical removal of the uterus is also an option in some cases.