Uterosacral Ligament

What is the uterosacral ligament?

Your uterosacral ligaments are thick, supportive bands of tissue that connect the lower part of your uterus to the base of your spine (sacrum). They’re part of a group of ligaments and muscles that support your pelvic organs. You have two of them — a left and a right.

What does the uterosacral ligament do?

Your uterosacral ligament’s main job is to hold up and support your uterus. It works with other ligaments and muscles in your pelvis to keep your uterus and nearby organs in place.

What happens to the uterosacral ligament after a hysterectomy?

After a hysterectomy, surgeons use the uterosacral ligament to support the top of your vagina. Its job shifts from supporting your uterus to preventing your vagina from dropping.

Where is the uterosacral ligament?

Your uterosacral ligament runs front to back, from the bottom of your uterus (cervix) to your spine.

How big is it?

Your uterosacral ligament is approximately 5 inches (12 to 14 cm) long, about the length of a soda can. It’s about one-quarter inch wide (0.5 cm), increasing slightly where it attaches to your cervix.

What is it made of?

Ligaments are made of connective tissue that usually consists of tough interwoven bundles of fibers. But your uterosacral ligaments are less fibrous and more like a strong membrane. They also contain some blood vessels and nerves.

What conditions and disorders affect the uterosacral ligament?

The most common problems associated with the uterosacral ligament are:

• Endometriosis: The cells that usually line your uterus grow along the ligament.
• Pelvic organ prolapse: This is when your pelvic organs drop from their typical location. It’s due to weakness of the ligament.
• Myofascial pain syndrome: Pain or tenderness in the ligament causes pain in nearby areas of your body.

What does uterosacral ligament pain feel like?

Symptoms of uterosacral ligament problems may include:

• Deep pelvic pain
• Painful intercourse
• Pain during your period
• Feelings of pressure or fullness in your pelvis

What are symptoms of uterosacral endometriosis?

With this condition, cells that typically line your uterus grow in the uterosacral ligament. This type of endometriosis is called deep infiltrating endometriosis. The cells thicken, break down and bleed each menstrual cycle. But these cells can’t escape your body. So, they lead to inflammation and scar tissue.

Most symptoms are like typical endometriosis symptoms:

• Severe pelvic pain that worsens during your period
• Pain during sex
• Painful bowel movements
• Constipation
• Infertility

How can I prevent uterosacral ligament problems?

Your uterosacral ligaments are a common location for endometriosis. There’s no prevention for endometriosis. Your best strategy is early detection. Having routine pelvic exams can help your healthcare provider catch problems early.

Your uterosacral ligaments also play an important role in supporting your pelvic organs. Keeping your pelvic floor strong is essential as you age, especially if you’ve given birth. Try Kegel exercises and activities that strengthen your core, like yoga and Pilates.

You can also improve your pelvic health with these tips:

• Avoid straining when you poop
• Maintain a weight that’s healthy for you
• Manage constipation
• Lift from your legs when carrying heavy items (not your back)