The vagina isnt positioned vertically within the pelvis it is angled towards the lower back. In most women, the uterus is tipped forward so that it lies over the bladder, with the top (fundus) towards the abdominal wall. Another normal variation found in some women is the upright uterus, where the fundus is straight up.
About one quarter of women have a retroverted uterus. This means the uterus is tipped backwards so that its fundus is aimed toward the rectum. While a retroverted uterus doesnt cause problems in most cases, some women experience symptoms including painful sex.
Other names for retroverted uterus include tipped uterus, retroflexed uterus and uterine retrodisplacement.
Symptoms of a retroverted uterus
Generally, a retroverted uterus does not cause any problems. If problems do occur, it will probably be because the woman has an associated disorder like endometriosis. A disorder like this could cause the following symptoms:
Painful sexual intercourse
The woman-on-top position during sex usually causes the most discomfort
Period pain (particularly if the retroversion is associated with endometriosis).
A range of causes for a retroverted uterus
Some of the causes of a retroverted uterus include:
Natural variation generally, the uterus moves into a forward tilt as the woman matures. Sometimes, this doesnt happen and the uterus remains tipped backwards.
Adhesions an adhesion is a band of scar tissue that joins two (usually) separate anatomic surfaces together. Pelvic surgery can cause adhesions to form, which can then pull the uterus into a retroverted position.
Endometriosis the endometrium is the lining of the uterus. Endometriosis is the growth of endometrial cells outside the uterus. These cells can cause retroversion by gluing the uterus to other pelvic structures.
Fibroids these small, non-cancerous lumps can make the uterus susceptible to tipping backwards.
Pregnancy the uterus is held in place by bands of connective tissue called ligaments. Pregnancy can overstretch these ligaments and allow the uterus to tip backwards. In most cases, the uterus returns to its normal forward position after childbirth, but sometimes it doesnt.