Have a Tipped or Tilted Uterus? | 5 Causes And Treatments

If you’ve ever heard the term, or you’ve been told you have a tipped or tilted uterus, you might be wondering what that means for you and whether it can affect your baby during pregnancy or birth.

It’s common to have questions about what impact a tilted uterus might have on your everyday life.

Have you ever wondered about the exact position of the uterus in the body? Well, we’re about to take a ‘deep dive’ inside the pelvis to find out.

What is the uterus, or womb?

The uterus, or womb, is one of the female reproductive organs that sits inside the female pelvis. It’s hollow and shaped like an upside down pear. The womb is the home to the developing fetus and supports its growth and development during pregnancy. Outside of pregnancy, the uterus is also responsible for menstruation.

Related reading: What Your Uterus Does During Labour

What is a tipped or tilted uterus?

The term ’tilted uterus’ describes how the uterus sits within the pelvis. Its normal anatomical position is between the urinary bladder, anteriorly, and the rectum, posteriorly. Its exact position varies from person to person and can change during pregnancy.

A tilted uterus, also called a ‘tipped uterus’ is typically considered a normal anatomical variation; it refers to the uterus being tilted slightly backwards towards the spine. This rarely causes serious health problems.

Anteverted vs retroverted uterus

The terms ‘anteverted’ and ‘retroverted’ describe the direction in which the uterus tilts.

• ‘Anteverted uterus’ means the uterus tips forward at the cervix, towards the abdomen
• ‘Retroverted uterus’ means the uterus is tipped backward at the cervix, towards the spine.

Is a tipped or tilted uterus rare?

Having a tilted or retroverted uterus is considered a normal variation of the uterine position and rarely causes serious health conditions. The retroverted position is fairly common, with around 25% of women experiencing it.

For most women (75%), the uterus tips forward from the cervix (anteverted) in a forward position above the bladder.

What does a tipped or tilted uterus look like?

You can see that, in its usual forward position, the womb lies horizontally over the bladder. If you have a tilted or retroverted uterus, it will be positioned tilting backwards towards the spine; this can put pressure on the rectum.

It can be seen during an ultrasound examination.

Related reading: What Can I Expect At My First Trimester Pregnancy Ultrasound?

How can you tell if you have a tilted uterus?

Some women will never know they have a tilted uterus, as they don’t experience any symptoms.

A tilted uterus can be diagnosed during a physical examination or a pap test. A pelvic exam is performed by inserting two fingers into the vagina to feel the cervix and the direction the uterus is tilting.

If you’ve been experiencing pain or discomfort, your doctor might suggest an ultrasound to rule out any other medical condition, such as abnormal growths or uterine fibroids. During the ultrasound, your doctor will look at the other pelvic structures, such as the ovaries, fallopian tubes and other organs, to make sure they all look as they should.

What causes a tipped or tilted uterus?

Some women are born with the condition but there might be other reasons why the uterus tips backwards, including:

1. Scarring from previous surgeries, such as a caesarean section
2. Pelvic inflammatory disease (PID), endometriosis or pelvic infections. Adhesions, which can cause tissue and other pelvic organs to stick to each other, can pull the uterus backwards.
3. Fibroids, which can enlarge the womb, changing its shape and position
4. Pregnancy and childbirth. The uterus will naturally change its position during pregnancy to accommodate the growing baby
5. Menopause, which can cause the ligaments holding the uterus in place to become weak, due to decreasing levels of oestrogen.

It’s possible to develop a tilted uterus at different stages in life, due to any of the above conditions.

To learn more about endometriosis, read our article Endometriosis Stages | 4 Critical Stages.

Find out more about PID in our article Pelvic Inflammatory Disease | 6 Symptoms To Look For.

Tipped or tilted uterus symptoms

Many women will experience painful sexual intercourse or pain with their periods.

The following symptoms are common with a tipped uterus:

1. Menstrual pain. You might experience painful periods or have difficultly using or inserting tampons
2. Painful intimacy. A tipped uterus can often affect a woman sexually. When the uterus tilts backward it’s common to experience discomfort during intimacy. Talk this through with your partner to find positions that are comfortable for both of you.

Painful periods can be caused by different things. If you’re experiencing this, it’s a good idea to speak to your doctor, to find out whether there’s an underlying cause.

If you want to read more about good positions for pregnancy, read our article Pregnancy Sex Positions – 7 Ideas For Pregnant Couples.

Can a tipped or tilted uterus go back to normal?

It’s possible for a retroverted uterus to return to its normal position; however it depends on the cause. If the uterus is being pulled backwards due to scar tissue or adhesions, it is unlikely to return to normal without pelvic surgery.

Treatment for a tipped or tilted uterus

A tipped uterus doesn’t always require treatment. Many people will live with the condition without even knowing they have it. If symptoms are mild or don’t cause discomfort that interrupts your lifestyle, then treatment is probably not needed.

What is the best option for one woman, might not be right for another. Treatment will depend on the severity of your symptoms and/or the cause. If you have a retroverted uterus, your doctor might suggest a number of treatment options:

1. Treat the underlying cause. Depending on the reason, the uterine position might be altered once the underlying cause is corrected. For example, if endometriosis or fibroids are causing the uterus to tilt backward, removing the fibroids might return the uterus to its normal position
2. Pelvic floor exercises. Pelvic exercises might help support the uterus more effectively. Exercising the pelvic muscles regularly can help in some cases
3. Pessary. A doctor might place a special plastic device inside the uterus, through the vagina. This can act as a support structure to hold it in place, pulling it into a more anterior position. There are some risks with this type of treatment, including infection and inflammation; therefore, it might not be appropriate for everyone. It might sometimes be used as a short term solution
4. Surgery. Uterine suspension surgery can be used as a permanent solution to a retroverted uterus. This surgery manually repositions the uterus. A hysterectomy might be considered for some people. Surgical options might be more appropriate for those with severe cases.

Can a woman with a tipped or tilted uterus have a baby?

A tilted uterus will not prevent a woman from becoming pregnant or having a normal pregnancy. Neither is the condition associated with any pregnancy or labor health risks.

If you’re having difficulties getting pregnant or you have experienced a miscarriage, it’s very unlikely to as a result of this condition. It’s more likely to be caused by underlying fertility problems. Speak to your health care provider if you’re concerned.

Pregnancy will normally correct a retroverted uterus as, after the first trimester, the growing uterus will shift out of the pelvis, naturally pulling the womb forward. After pregnancy, the womb might remain in the anteverted position or could fall back to a posterior position.

In rare cases, a pregnancy condition known as uterine incarceration can develop. Incarcerated uterus happens when the uterus doesn’t move to the anteverted position. The uterus cannot fully expand as the baby develops and becomes trapped within the pelvis. This condition is serious but also rare. Research suggests it occurs in only 0.3% of pregnancies.

Does a tipped or tilted uterus cause miscarriage?

There’s no evidence to suggest that a tilted uterus causes any increase in the risk of miscarriage. If you’ve experienced multiple miscarriages, it might be a good idea to speak with your doctor to find out whether there is a reason or cause.

There can be any number of causes for painful intimacy, discomfort during periods or fertility problems. Therefore, if you have symptoms that are causing you concern, it’s always better to seek medical advice and discuss the best course of action or treatment for you.