Retroverted Uterus

Overview

What is a retroverted uterus?

A retroverted uterus means your uterus is tilted or tipped backward so it curves toward your spine instead of forward toward your abdomen. Your uterus is the organ where a baby grows during pregnancy. It’s shaped like an upside-down pear and sits in your pelvis between your bladder and your rectum. Its exact position in your pelvis varies among people and can change, especially during pregnancy.

To get a better idea of how a retroverted uterus lies in your pelvis, think of your uterus like the letter U. In a retroverted uterus, the curved part of the U is aimed at your low back. The opening of the U is your cervix (the opening to the uterus from the vagina). If your uterus is retroverted, your cervix is aimed toward your belly. It’s more typical for the curved part of the U to be aimed toward your belly and your cervix to be pointed toward your rectum (this is called an anteverted uterus).

A retroverted uterus is also called a tipped uterus or tilted uterus. You can be born with a retroverted uterus or it can develop later in life. Some people never know they have a retroverted uterus because they don’t have symptoms. In some cases, you will have symptoms that may require treatment by your healthcare provider. This condition rarely causes health complications and is not a cause for worry.

How common is a retroverted uterus?

A retroverted uterus is fairly common. Approximately 25% of people have a uterus that tilts backward at their cervix.

What is the difference between an anteverted uterus and a retroverted uterus?

An anteverted uterus means your uterus tilts forward at your cervix and points toward your abdomen. This is the more common position of the uterus. In this position, your uterus is on top of your bladder. In a retroverted uterus, your uterus is usually pressing against your rectum.

How does a retroverted uterus affect fertility?

Your fertility shouldn’t be affected by a retroverted uterus. You can still get pregnant and have a normal pregnancy. If you’re unable to get pregnant and have a tilted uterus, it’s most likely caused by another condition of your uterus that affects fertility.

Some of the conditions associated with a retroverted uterus that contribute to fertility issues are:

Will a retroverted uterus affect my pregnancy?

Your pregnancy shouldn’t be impacted by a tilted uterus in any way. There is also no correlation between a retroverted uterus and complications during labor and delivery. In fact, pregnancy will cause your uterus to change to an anteverted position sometime before the second trimester. Your uterus may return to its retroverted position after your baby is born.

Symptoms and Causes

What are the symptoms of a retroverted uterus?

Some people don’t experience any symptoms of a retroverted uterus. For those that do have symptoms, the most common are:

What causes a retroverted uterus?

Some people are born with a retroverted uterus — it’s present at birth and not caused by any health conditions. In some cases, it happens later in life.

Some reasons you can develop a tilted uterus are:

  • Scarring or adhesions: Scar-like tissues from prior pelvic surgeries (including cesarean deliveries), pelvic inflammatory disease (PID) or other infections can cause the tissues in your uterus to stick to other organs. This can pull your uterus backward.
  • Fibroids: Uterine fibroids or other growths on your uterus can change its shape and position.
  • Endometriosis: With this condition, tissues like your uterine lining form outside your uterus. These cells can attach to other organs in your pelvis and cause your uterus to become retroverted.
  • Childbirth: Once you give birth, your pelvic floor muscles and ligaments are stretched and weaken, which can cause your uterus to tilt backward.
  • Menopause: People who are in menopause will have weakened pelvic muscles due to a decrease in the hormone estrogen. The ligaments that hold your uterus can’t support it and cause it to tip backward.

Can a retroverted uterus cause bowel problems?

There’s not enough research to directly connect bowel conditions, like irritable bowel syndrome (IBS) or chronic constipation, to a retroverted uterus. However, uterine fibroids and endometriosis, common causes of retroverted uterus, have been connected to symptoms of IBS. Having a weak pelvic floor from childbirth or menopause has also been connected to fecal incontinence. If you’re having trouble with your bowels, speak with your healthcare provider about your symptoms so they can determine the underlying cause.

Does a retroverted uterus interfere with sex?

Sometimes. One of the main symptoms of a retroverted uterus is painful intercourse. This is because your uterus is positioned differently in your body. Certain positions and deep thrusting may intensify your discomfort. Switching positions may make you feel more comfortable. Talk with your partner so that you can find a way to enjoy intercourse together.

Diagnosis and Tests

How is a retroverted uterus diagnosed?

Your healthcare provider can tell if you have a retroverted uterus by doing a pelvic exam. During this exam, your healthcare provider can feel the location of your cervix and uterus to determine which way it tilts. Sometimes an ultrasound is used to confirm a retroverted uterus and rule out more serious causes like uterine fibroids or endometriosis.

Management and Treatment

How do you treat a retroverted uterus?

Your healthcare provider may recommend the following treatment options:

  • Treating the underlying condition: If you have an underlying cause of a retroverted uterus, treating that condition could help improve your symptoms.
  • Exercises: Some healthcare providers have experience manually shifting the uterus into a forward position. If this happens, performing exercises to strengthen your pelvic muscles can help keep your uterus in that position. Ask your healthcare provider if performing exercises like Kegels can help you improve your condition. To do Kegel exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Exercises won’t help if your retroverted uterus is caused by scarring and it may move back to its retroverted position.
  • Pessary: A pessary is a small, plastic donut-shaped device that’s inserted into your vagina. It acts as a support structure, helping to hold things in place in your vagina. It can help prop your uterus up to an anteverted position. There are some risks to pessaries, like infection and inflammation, so healthcare providers may recommend it as a short-term solution.
  • Surgery: Your healthcare provider can surgically reposition your uterus to a forward-facing position. This surgery is called uterine suspension or uterine repositioning. This can permanently fix a tilted uterus and provide pain relief. In severe cases, a hysterectomy (removal of your uterus entirely) can be considered.

Prevention

How can I prevent health risks from a retroverted uterus?

There’s nothing you can do to prevent a retroverted uterus. Most of the time it is beyond your control because it is caused by a medical condition that can’t be prevented.

If your retroverted uterus is caused by pelvic inflammatory disease (PID) you can reduce your risk of PID by practicing safe sex. Wearing condoms and limiting your sexual partners can help reduce your risk of sexually transmitted infections (STIs), which can lead to PID.

Outlook / Prognosis

Are there any health risks from having a retroverted uterus?

Uterine incarceration is a rare, but serious, condition caused by a retroverted uterus. This is a condition during pregnancy where a retroverted uterus doesn’t shift to the anteverted position. During the second trimester of pregnancy, your uterus should tilt forward, which allows it to fully expand. If it doesn’t change to the anteverted position, your uterus can become trapped within your pelvis. This only happens in about .3% of pregnancies.

Living With

When should I see my healthcare provider?

If you have a retroverted uterus, contact your healthcare provider if your pain and discomfort become unbearable. Painful sex and painful menstruation are the two most common reasons you might see your healthcare provider for a retroverted uterus. Your healthcare provider will want to rule out any health conditions that are causing your symptoms.

What questions should I ask my doctor about my retroverted uterus?

It’s common to have questions about a retroverted uterus. Some questions to ask your healthcare provider are:

  • Does this increase my risk for any diseases?
  • Can I still get pregnant?
  • Is my fertility affected?
  • What treatment can relieve me of my symptoms?
  • Will the pain or discomfort go away?
  • Are there any other problems associated with a tilted uterus?

Frequently Asked Questions

Can a retroverted uterus cause a miscarriage?

A retroverted uterus can’t cause a miscarriage. If you have a tilted uterus and experience a miscarriage, it’s likely caused by another factor like a chromosomal abnormality or an underlying uterine condition. In rare cases, uterine incarceration can cause a miscarriage.

A note from Cleveland Clinic

A retroverted uterus can be diagnosed during a pelvic exam. It usually doesn’t cause any serious health problems, but if you’re experiencing discomfort or pain, talk to your healthcare provider about your symptoms. They can recommend a treatment to relieve your pain and rule out a more serious condition.

Last reviewed by a Cleveland Clinic medical professional on 07/06/2022.

References

  • American Pregnancy Association. Tilted uterus. (http://americanpregnancy.org/womens-health/tipped-uterus/) Accessed 7/6/2022.
  • International Society for Sexual Medicine. What is a tilted uterus how might it affect a woman sexually? (https://www.issm.info/sexual-health-qa/what-is-a-tilted-uterus-how-might-it-affect-a-woman-sexually/) Accessed 7/6/2022.
  • McEvoy A, Tetrokalashvili M. 2020. Anatomy, abdomen and pelvis, female pelvic cavity. (https://www.ncbi.nlm.nih.gov/books/NBK538435/) StatPearls. Accessed 7/6/2022.
  • Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Female genitalia. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 9th ed. St Louis, MO: Elsevier; 2019:Chap 19.
  • Sweigart AN, Matteucci MJ. Fever, sacral pain, and pregnancy: an incarcerated uterus. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672273/) West J Emerg Med. 2008;9(4):232-234. Accessed 7/6/2022.
  • Slama R, Barry M, McManus K, Latham D, Berniard M. Uterine Incarceration: Rare Cause of Urinary Retention in Healthy Pregnant Patients. (https://pubmed.ncbi.nlm.nih.gov/26587114/) West J Emerg Med. 2015;16(5):790-792. doi:10.5811/westjem.2015.7.27185. Accessed 7/6/2022.
  • U.S. National Library of Medicine. Retroversion of the uterus. (https://medlineplus.gov/ency/article/001506.htm) Accessed 7/6/2022.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy