Retroverted uterus: what it is, causes and signs

About 20% of women have a retroverted uterus, i.e. the uterus tilts backwards. The retroverted uterus does not cause problems in most cases. But for some women this condition can create discomfort.

Utero retroverso: cause

The main causes of retroverted uterus,

they can be natural

Generally, as a woman ages, the uterus leans forward during normal maturation.

However sometimes this does not happen and the uterus remains tilted backwards.

may be memberships

An adhesion is a band of scar tissue that joins separate anatomical surfaces that would otherwise be separate.

Pelvic surgery can cause adhesions to form, which can then pull the uterus into a retroverted position.

it could be endometriosis

The endometrium is the inner lining of the uterus.

During endometriosis, the endometrial cells grow excessively and extend outside the uterus. This problem can cause the uterus to retrovert and “glue” it to other pelvic structures.

could be fibroids

These small, noncancerous lumps can make the uterus susceptible to tipping back.

it could be pregnancy

The uterus is held in place by bands of connective tissue called ligaments.

Pregnancy can put extra strain on these ligaments and allow the uterus to tip backwards.

In most cases, the uterus returns to its natural position after delivery, but not always.

Symptoms related to the retroverted uterus

These symptoms may consist of some sexual problems.

  • In most cases of retroverted uterus, the ovaries and fallopian tubes are also tipped back.
  • This can lead to pain during sexual intercourse

Problems associated with the retroverted uterus

-a- The retroverted uterus and pregnancy

In most cases, a retroverted uterus does not interfere with pregnancy.

After the  first trimester , the expanding uterus lifts out of the pelvis and, for the remainder of the pregnancy, assumes the typical bow position.

In a small percentage of cases, however, the growing uterus becomes “caught” on the pelvic bone (usually the sacrum).

This condition is known as an “incarcerated uterus”.

If so, symptoms usually occur between weeks  12  and  14  and can include pain and difficulty passing urine.

-b- The retroverted uterus and fertility

However, a retroverted uterus is believed to have no influence on a woman’s fertility.

Diagnosis and possible treatments

The diagnosis

A retroverted uterus is diagnosed by a routine pelvic exam. But, sometimes, a woman can discover that she has an inverted uterus during a simple Pap smear.

The treatments

If a retroverted uterus is causing problems, there are several options for treating the problem:

  • by treating the underlying condition  – such as hormone therapy for endometriosis.
  • by surgical treatment  – ​​using laparoscopic surgery techniques, the uterus can be repositioned so that it sits above the bladder.
    • This operation is relatively simple and usually successful.
    • In some cases, surgical removal of the uterus (hysterectomy) may be considered.
  • by inserting the Hodge pessary : ​​a small silicone or plastic device can be placed temporarily or permanently to help tilt the uterus forward.
  • with exercises  – if the movement of the uterus is not impeded by endometriosis or fibroids, and if the doctor can manually reposition the uterus during the pelvic exam, some specific exercises can help improve positioning.
    • However, this type of treatment doesn’t always work: in many cases, the uterus simply rolls over again.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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