What is a tilted uterus or a so-called retroverted uterus?

An explanation of your uterus

The uterus is an important organ at the bottom of your abdomen. It’s shaped like a pear that’s upside down in your lower belly. It’s usually 8 cm in length, but during pregnancy it can grow up to your rib cage.

In order to stay firmly inside of your lower abdomen, the uterus is attached to various bands that are connected to your abdominal wall.

What’s the deal with its positioning?

The uterus can be tilted forwards or backwards. If the doctor tells you that you have a tilted uterus, this usually means that it’s tilted backwards. In medical terms, it’s called ‘retroverted’, which happens way less often than a forward tilt. A forward tilt is called an anteverted uterus (‘ante’ means ‘angled forward’, and ‘verted’ means ‘twist or tilted’).

You should imagine the uterus as a pear, of which the stem is angled downward toward your vagina, and with its thickest point angled up. There is also a bend in the uterus. The thickest part, the uppermost part, can be bent forward to your navel, or bent backwards toward your back. So whether the top is bent forward or backward is what determines if your uterus is tilted or not.

How often does a tilted uterus occur?

In essence, all uteri are tilted, either forward or backward. A tilted uterus isn’t a bad thing. It’s just a fact about how it’s positioned. They’re usually tilted forward, and about 10% of women+ have one that’s tilted back. You can compare it to being left- or right-handed. More people are right-handed, but it’s not a bad thing to be left-handed.

Is a tilted uterus a problem?

You can sometimes have more pain in your back or pelvis if your uterus is tilted backward, or you can experience more pain during sex since the penis will be able to reach your cervix easier. But some people enjoy this sensation! You might sometimes feel a bit of pain or a pressing feeling in your lower abdomen, suffer from constipation, or more pain during your menstruation. This could be due to you having adhesions due to endometriosis or an inflammation you once had in the pelvis (PID).

Does a tilted uterus make you less fertile?

You don’t have to be concerned about your fertility. A uterus that’s tilted backward doesn’t have an influence on this. It could be the case that it’s tilted back due to an underlying condition such as endometriosis, which could be the reason you’re having a harder time getting pregnant.

Getting an IUD with a tilted uterus

If you have a tilted uterus, it can make things a bit more complicated for your doctor. For example when inserting an IUD. Since most uteri are tilted forward, that’s what the doctors are used to. However, it’s not the case that it’s impossible to have an IUD inserted in a uterus that’s tilted backward! Just like with lefties, it’s less common: it’s not a bad thing, but it can make some things a bit more complicated. Once the doctor has felt that it’s tilted backward, they’ll be able to take it into account when placing the IUD. If the GP struggles to insert it, you can go to a gynecologist. They’ll be able to use an ultrasound to see exactly how the uterus is positioned. They’ll be experienced enough to not see your tilted uterus as a hurdle for placing the IUD!

So, if you have a tilted uterus, no worries! In most cases, it won’t have an effect on your day-to-day life!