Retroverted (Tilted) Uterus: Causes, Fertility & Treatment

More women than you might imagine live with retroverted uteruses. What exactly is this condition, though, and what implications does it have for your fertility?

Read on to learn more about tilted uteruses, including their causes, symptoms, and potential (albeit rare) complications.

A tilted uterus, also known as a retroverted or tipped uterus, is a uterus (womb) that tilts backward toward your spine instead of forward toward your abdomen (which is a uterus’s “usual” position).

Think of a tilted uterus as a normal anatomical variation, like being left-handed. Having one usually isn’t a cause for concern. In fact, this condition is quite common; about 1 in 5 women has a tilted uterus. 1

What causes a tilted uterus?

In many cases, people are simply born with tilted uteruses. However, you could also develop one later in life due to factors like: 1

• Scar tissue or pelvis adhesion: Scarring from conditions like endometriosis, uterus or fallopian tube infections, or pelvic surgeries (including C-sections) can pull the uterus backward.
• Weakened pelvic muscles: Pregnancy, childbirth, or menopause can weaken the ligaments that support the uterus, causing it to tilt backward.
• Tumor: If you have a tumor in your pelvic area, it can also lead to a tilted uterus.

As we mentioned earlier, having a tilted uterus in itself isn’t anything to worry about. However, the conditions that led to it may warrant medical attention. For instance, if your tilted uterus was caused by an infection, you’ll need to take care of that right away.

What are the symptoms of a tilted uterus?

Most women with tilted uteruses don’t have any symptoms at all. In fact, many aren’t even aware they have the condition until it’s discovered during a routine pelvic exam.

That said, in rare cases, if you have a tilted pelvis, you may experience: 12

• Back pain
• Painful periods
• Pain during intercourse
• Urinary issues 3
• Difficulty with tampon insertion (note that you should check with your doctor before using tampons to deal with spotting during pregnancy) 4

In particular, women with a tilted pelvis paired with endometriosis are more likely to find sex painful and have painful periods. 5

Bear in mind that the symptoms above aren’t exclusive to a tilted uterus; they can also result from entirely different medical conditions. If you’re dealing with any of them, make a doctor’s appointment to identify the exact issue and get the right treatment.

Having a tilted uterus doesn’t affect your ability to get pregnant. The position of your uterus won’t prevent sperm from reaching your egg or prevent your fertilized egg from implanting in the uterine lining. 2

However, if your tilted uterus is caused by other conditions that can, themselves, cause fertility issues, such as endometriosis, fibroids, or pelvic inflammatory disease (PID), you may have difficulty conceiving.

Will a tilted uterus affect your pregnancy once you do conceive?

By the same token, unless your tilted uterus is caused by another condition, it probably won’t affect your pregnancy.

In fact, your uterus will usually rise higher in your abdomen as your pregnancy progresses. 6 This means that it may naturally straighten itself out and move into a more upright position.

In the first trimester, before your uterus (potentially) changes position, you may find it harder to empty your bladder than those with forward-tilting uteruses. This (relatively rare) condition is an annoyance, but not a risk to the viability of your pregnancy. Try leaning backward while urinating to relieve the pressure. 78

If you have a retroverted uterus, it’s also possible you’ll start showing your pregnancy a little later than other moms-to-be (this is especially true if this is your first pregnancy). If that’s the case, don’t worry; it doesn’t suggest anything about the health or viability of your baby.

Rare pregnancy complications caused by a retroverted uterus

Less commonly, a tilted uterus may cause other complications, including:

• Difficulty visualizing during early ultrasound: In the early weeks, it can be a bit harder to visualize your baby during a transabdominal ultrasound if you have a tilted uterus. If that’s the case, your doctor may use a transvaginal ultrasound for a clearer view.
• Incarcerated uterus: In extremely rare cases (reportedly 1 in 3,000 pregnancies), a severely tilted uterus can become trapped in the pelvis. This is known as an incarcerated uterus, and it can lead to difficulty urinating and may increase the risk of miscarriage. If your doctor catches this, they might try to correct the position of your uterus. 9 (This doesn’t usually require surgery—OBs can often adjust the uterus with their hands.)

A tilted uterus won’t usually impact your labor and delivery. Contrary to what you might’ve read online, there isn’t any scientific evidence to suggest that a tilted uterus increases the risk of back labor or the need for a C-section. 5

After childbirth, your uterus may return to its tilted position, or settle into a different position entirely. This depends on factors like how much weight you gained during pregnancy and the degree to which your ligaments stretched. Regardless, your tilted pelvis is unlikely to cause any issues in the postpartum period or future pregnancies.

As you know, childbirth may weaken your pelvic muscles and lead to a tilted uterus. You can strengthen your pelvic muscles and stay healthy during pregnancy or postpartum by doing pelvic floor therapy. 5

While a tilted uterus may sound scary, most of the time, it won’t affect your chances of getting pregnant or endanger the fetus in your belly.

Think of it as an anatomical variation that makes you extra special. Still, if you feel any pain at all, see your doctor immediately to rule out the handful of underlying conditions that actually can cause problems.