Backward Uterus – Does Tilted Uterus Affects Pregnancy?
Sometimes you never know you have a medical condition and after conception, you come to know that you are suffering from something unusual. In this case, you are bound to feel down. One such case is tilted or backward uterus and whether it will affect pregnancy or not.
What is a tilted uterus?
Uterus or womb is a hollow and pear-shaped organ in which the fetus develops. Normally, the uterus sits horizontally over the bladder but some women have tilted or backward uterus. This type of uterus is tilted backwards towards the spine and rectum or say back of the pelvis. Usually, doctors consider this variation a normal thing as it occurs in approximately 1 in 5 women.
Tilted or backward uterus is also known by different names. These include:
- Tipped uterus
- Retroverted uterus
- Inverted uterus
- Uterine retroversion
- Retroflexed uterus
- Tilted womb
- Malposition of the uterus
- Uterine retro displacement
What causes uterus to tilt?
There could be various reasons for tilted uterus. Some of them are related to scars and adhesion.
- Pelvic Inflammatory disease
- Pelvic surgery
- Uterine fibroids
- History of pregnancy and childbirth
Symptoms of tilted uterus
Many women with tipped or tilted uterus do not experience any symptoms, means they are unaware of the condition. But some women who experience symptoms may feel:
- Pain in the vagina or lower back during sex
- Pain during menstruation
- Pressure on the bladder or increased frequency of urination
- Urinary tract infections
- Mild incontinence
- Difficulty inserting tampons during menstruation
- Protrusion or bulging of the lower abdomen
Does titled uterus affect fertility?
The above causes would obviously point towards a question that does retroverted uterus affect fertility? A tilted or tipped uterus typically doesn’t affect a woman’s ability to become pregnant again. This condition can sometimes be related to other diagnoses which may affect the potential to conceive. These are:
- Pelvic inflammatory disease (PID)
- Ovarian cysts
- Abnormality in uterus
While endometriosis and fibroids can be treatable through minor surgical procedures, pelvic inflammatory disease can be treated with antibiotics.
Does tilted uterus affect pregnancy?
Many women with retroverted uterus would think that does this condition have an impact in pregnancy? Well, a tilted uterus might create pressure on the bladder in the first trimester. This can result in urinary incontinence and back pain for women.
It is also difficult to see the uterus through ultrasound until and unless it begins to expand with pregnancy. In this case, the doctor would need transvaginal ultrasound to check the progression of your pregnancy. In most of the cases, a tilted uterus will resume the normal position at some point of pregnancy. But in some rare cases, a tilted uterus might get trapped in the pelvis, resulting in a condition called as incarcerated uterus.
This incarcerated uterus may lead to miscarriage in the second trimester or may result in other complications such as preterm delivery, uterine rupture or intrauterine growth restriction. The cases of incarcerated uterus are extremely rare, occurring in about 1 in 3,000 pregnancies.
If incarcerated uterus is detected early via ultrasound or MRI test, the chances of miscarriage can be eliminated. If you are pregnant and experiencing below signs, talk to your doctor immediately.
- Inability to urinate
- Pain in the stomach or close to rectum
However, the third trimester is unlikely to be affected at all.
Can I have sex with a tilted uterus?
A tilted uterus shouldn’t affect your sex life. However, in some cases, you might feel pain during intercourse. This discomfort might be more when you are in a certain sex position. Changing the sex position might reduce this uneasiness. If every other sexual position causes you discomfort, talk to your doctor.
Diagnosis of tilted or retroverted uterus
Tilted uterus can be diagnosed during a routine pelvic examination. For women with symptoms, they should talk to the doctor and brief her about the concerns. Other women with tilted uterus and with no signs of discomfort, they would be diagnosed when they get pregnant. This is because their doctor will be diagnosing the condition during routine ultrasound test.
How tilted uterus is treated?
For asymptomatic women, they won’t be requiring any treatment. For women with symptoms, they would be suggested following techniques:
Some things can be naturally fixed through physical activity. Many a time, the doctor might be able to manually manipulate the uterus and place it on the correct position. This can be achieved by certain types of exercises that focus on pelvic floor muscles, ligaments and tendons which support the uterus. Some of them are mentioned below:
- Knee chest – For this exercise, you must be lying on your back. Both of your knees should be bent with feet on the floor. Now slowly elevate one knee at a time towards your chest by gently pulling it with both the hands. Stay in this position for 20 seconds and release. Repeat the step with your other knee.
- Pelvic contractions – This exercise targets the pelvic floor muscles. Lay on your back with the arms at sides in a comfortable position. Now inhale as you lift your hips off the floor. Hold and release as you exhale. Repeat these steps 10-15 times.
These exercises will not benefit if your uterus is tilted due to endometriosis, pelvic infection or fibroid tumors.
A pessary is a plastic or silicone device that is placed in the vagina to reposition the tilted uterus. It is generally a temporary solution and if left for long-term, it can lead to infection.
In some other cases, surgical procedures might be required to relocate the tilted uterus. They are:
- Uterine suspension - This surgery can be performed laparoscopically, abdominally or vaginally.
- Uplift procedure - This laparoscopic procedure is a newer and improved method of repositioning tilted uterus. This method can be performed in mere 10 minutes.
If you experience symptoms of tilted uterus, get it fixed before you get pregnant. Talk to your gynecologist today.
1. Retroversion of the uterus(2016, May 16) read more
2. Suzuki S., et al.(2009, July).Recurrence of urinary retention secondary to retroverted gravid uterus read more
3. Gerscovich Eugenio O. and Maslen Lorelei (2009). The Retroverted Incarcerated Uterus in Pregnancy read more
4. Retroverted uterus. (2012) read more