Tilted Uterus 101

An estimated 1 out of 5 folks with a uterus have what is known as a tilted uterus, and they might not even know it! Here’s everything you need to know about having a tilted uterus, including causes and the potential effects it can have on menstruation and conception. 

What is a tilted uterus?

A uterus can lean forward, called an anteverted uterus, or backward towards the rectum, which is known as a retroverted uterus. While a forward-leaning uterus is considered “typical,” approximately 20 percent of folks with a uterus have a retroverted tilt. Other names for a tilted uterus include a backward uterus, retroflexed uterus, and uterine retroversion. 

What causes a tilted uterus?

For most people, a tilted uterus is simply a physical variance that one is born with (other individuals may develop a tilted uterus as they grow older). While less common, a tilted uterus can also be caused by fibroids, endometriosis, pelvic inflammatory disease, pelvic surgery, and pregnancy (due to ligaments surrounding the uterus over-lengthening during the gestation period). If you’re unsure whether or not you have a tilted uterus and you’re comfortable having a pelvic exam, your physician can easily check to see how your uterus is positioned. 

Does a tilted uterus have an effect on menstruation?

The vast majority of people with a tilted uterus won’t experience any disruptions in their menstrual cycle. Despite this, there are some folks who may encounter exacerbated cramps or lower back pain before and during menstruation due to the position of their uterus. It is very common for those with a tilted uterus to have trouble using tampons or a menstrual cup. In fact, many people inadvertently discover they have a tilted uterus after repeatedly struggling to insert a tampon or menstrual cup. If these types of menstrual products are used, folks are more likely to experience leakage because of how the uterus is positioned. If this is the case, you may want to consider looking into period underwear. 

What are some other symptoms of having a tilted uterus?

There are many people who have a tilted uterus who don’t realize it; that is to say, there are plenty of folks who won’t experience any of the following symptoms. Others might encounter one or several symptoms — the presence or frequency is entirely dependent on the individual’s unique body.

Pain during penetrative vaginal sex

Having a tilted uterus can make certain penetrative sex positions uncomfortable or even painful. The positions themselves vary and are deeply personal, but certain sex postions — such as from behind, reverse cowgirl, or any position that emphasizes deep thrusting — seem to be particularly problematic. Again, this is dependent on many individual factors, so an open dialogue with your partner is the best way to enjoy pain-free and pleasurable sex.

Difficulty conceiving

It’s important to note that most people don’t have trouble conceiving due to having a tilted uterus. Complications can arise if a tilted uterus is the result of fibroids, endometriosis, or pelvic inflammatory disease. If having a tilted uterus is having a negative effect on efforts to conceive, minor surgery is sometimes recommended to remove excess scar tissue surrounding the uterus. 

Other symptoms of having a tilted uterus include:

• increased frequency of UTIs
• issues with incontinence
• lower back pain when pregnant or menstruating

On the whole, a tilted uterus is nothing to worry about! However, if suspect that you have a tilted uterus and it's affecting your ability to go about your day-to-day life, be sure to get in touch with your doctor or OB-GYN.

Ashley Linkletter is a mental health, food, and nutrition writer based in Vancouver, BC. 

Photo by Nick de Partee on Unsplash