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If a woman has a retrograde uterus, it tilts backward in the body and towards the rectum instead of being positioned between the bladder and the rectum. The common causes of this condition are abnormal development of the uterus, adhesions, endometriosis, fibroid tumors, or pregnancy. Discomfort during sexual intercourse and menstruation are the most common problems associated with a tilted uterus. When necessary, a retrograde uterus can be corrected using surgery, a pessary, or sometimes through exercises.
A retrograde uterus tilts backward towards the rectum rather than lying in the mid-position between the bladder and the rectum. As a woman’s reproductive system develops, the uterus typically moves from a retrograde position to a mid-position. In some women, this transition does not take place and the uterus remains tilted backward.
Adhesions, endometriosis, or fibroid tumors can also cause a retrograde uterus. Internal adhesions are scar tissue resulting from surgery. Endometriosis is an overgrowth of uterine cells outside the uterus and fibroid tumors are benign growths. All of these conditions can bind pieces of tissue, which are normally separated, and cause the uterus to be held in the retrograde position.
Pregnancy can both heal a retrograde uterus and cause it. In some cases, the weight of the baby in late pregnancy will force the uterus to flip forward and remain in this mid-position after delivery. Pregnancy, in other cases, can cause the uterus to tit backward as the strain of the baby’s weight pulls on the uterine ligaments. When this is the situation, after delivery the uterus will either remain in the retrograde position or return to normal as the uterine ligaments heal.
Many women with a retrograde uterus do not even know and will not experience any associated symptoms. In other cases, a woman may experience painful sexual intercourse and menstruation as a result of a tilted uterus. Other less commons problems are a propensity to develop urinary tract infections and incontinence. Infertility is rarely linked to a retrograde uterus unless all other fertility problems have been ruled out.
A tilted uterus can be treated with laparoscopic, outpatient surgery. The laparoscopic procedures will involve either surgically tilting the uterus forward, removing adhesion, endometriosis, or fibroid tumors which hold the uterus in the wrong position or, in some rare cases, a hysterectomy will be performed to completely remove the uterus. For temporary relief, a pessary or small plastic support can be placed behind the uterus to tilt it forward. A few doctors recommend trying special exercises to reposition the uterus, but if these exercises work the benefit is typically temporary and the uterus usually falls backward eventually.