Impact of Tilted Uterus on Pregnancy and Sex | Causes, Symptoms and Treatment of Tilted Uterus

Some people have their uterus tip pointing towards the lower back and it is known as retroverted, tilted, or tipped uterus. This can also lead to difficulty in getting pregnant. The normal position of the uterus is sitting upright in a vertical or up-and-down position and is tilted towards the front of the abdomen. This is called the anteverted position and does not affect a person’s ability to get pregnant. A tilted uterus is a common condition and one in every five women have it.⁽¹⁾

People with a tilted uterus are concerned whether or not they would have difficulty conceiving. The position of the uterus is generally not a cause of infertility but can be considered one when all the other causes are ruled out.

A tilted uterus may not affect a person’s ability to have a healthy pregnancy. Sometimes during pregnancy, the uterus may tip backward. But the tilted uterus may not impact the labor or delivery.

A person with a tilted uterus may have pain during sex. Why this happens is not sure, but there are several theories supporting it.

• When the uterus is tilted the cervix sits in the vagina differently and the pain may be due to bumping of the penis against the cervix during intercourse.
• The ligament of the uterus may be stretched and moved in a different direction, causing pain and discomfort.
• Tilted uterus may cause venous congestion in the pelvis, which may be due to filling up the dilated veins with blood.
• Sometimes the person may be comforted by changing position during sex. Communicating with the partner about the discomfort may be helpful in getting to the answer.

The uterus is a hollow pear-shaped organ present in the pelvis and a place where the fetus grows. A female can have a tilted uterus due to the following reasons.

• Weakening of Pelvic Muscles: After childbirth or menopause the ligaments supporting the uterus become lax or weakened and fall backward or in a tipped position.
• Enlarged Uterus: An enlarged uterus during pregnancy, due to tumor, and fibroids can get tilted.
• Scarring or Adhesions in the Pelvis: Conditions such as endometriosis, infection, or previous surgery can scar the uterus or pelvis. The scar tissue may pull the uterus backward and cause a tilted pelvis.
• Genetics: Some females are born with the uterus tilted or tipped backward.

People with a tilted uterus may observe the following signs and symptoms:

• Painful sex
• Back pain during sexual intercourse
• Menstrual pain and cramping
• Pain while wearing tampons
• Mild urinary incontinence

Some people experience no symptoms and do not even realize that the uterus is tilted.

A tilted uterus can be easily detected when a gynecologist does a pelvic examination. It involves putting 2 fingers in the vagina to feel and push against the cervix slightly. The other hand is placed on the top of the abdomen and pushed gently to capture the uterus between the hands. This is done to feel the uterus and to determine its shape, size, and position.

If females have extreme pain during sex or other symptoms, a doctor can be consulted. It can be either just due to a tilted uterus or something serious that would be needed to be treated.

A tilted uterus is not a problem and no treatment is needed. Treatment may be needed if the cause includes fibroids, lack of support and extreme discomfort. There are a few treatments that can be done to treat the cause of the tilted uterus. For those experiencing symptoms, the doctor may recommend surgery. The surgical procedure involves repositioning the uterus from backward-facing to forward-facing. A procedure known as the uplift procedure is a newer and improved method and involves fewer postoperative complications.⁽²⁾

Pessary is another option that can be used in the treatment. A pessary is a device that is placed in the vagina to support vaginal walls, uterus, and other pelvic structures. It can also help in repositioning the uterus. It is a temporary fix as the uterus goes back to its previous tilted position as it is removed.

The knee-chest position, though temporary but is another solution that moves the uterus temporarily into a comfortable position.

Some people experience discomfort with a tilted uterus while a few do not. It is not a serious condition unless the cause is serious. Still, it is good to consult a doctor for any discomfort, to look for a cause and an appropriate solution.