Many know what a uterus is, but the term retroverted uterus is not a familiar one. What is it anyway? Read here and find out.
Unless your doctor told you that you have one, you might not have heard of the term retroverted uterus before. And if your doctor tells you that you have it, is it something that you have to worry about?
What Is a Retroverted Uterus?
According to obstetrician-gynaecologist Kristine C. Tangco, MD, a woman's uterus is retroverted if it is tipped backwards towards the rectum, rather than towards the belly and facing the urinary bladder, which is the regular position.
“The uterus is a pear-shaped organ in the pelvic cavity held in place by several bands of tissues called ligaments. It is usually positioned with its fundus or top part facing the urinary bladder (anteverted). In a woman with a retroverted uterus, the fundus is tipped backwards or posteriorly. Instead of the fundus facing the urinary bladder, the uterus is tipped towards the rectum and the spine,” she explained.
While the term doesn't sound very familiar, there are actually a lot of women who have retroverted uteruses. In fact, according to Mary Jane Minkin, M.D., an OB-GYN and clinical professor at the Yale School of Medicine, about 30 per cent of women have a retroverted uterus. It may also be referred to as the following:
- tipped uterus
- retroflexed uterus
- uterine retroversion
- backward uterus
- uterine retro displacement
Curious about this condition? Here are some helpful facts about having a retroverted uterus and how it can affect a woman's life.
What Can Cause a Retroverted Uterus?
Some women are born with a tilted uterus, while some acquire it as they mature. It may have an underlying cause that is often associated with pelvic scarring or adhesions such as:
-
Normal anatomic variation
Generally, the uterus moves into a forward tilt (facing the bladder) as the woman matures. But this does not happen to some women; their uteri remain tipped backwards (facing the rectum and spine).
-
Myomas or Fibroids
These are small, non-cancerous masses or lumps that grow in or on the uterus, making the organ susceptible to tipping backwards.
-
Endometriosis
The endometrium is the lining of the uterus. Endometriosis is the growth of endometrial cells outside of the uterus. These cells can bring about retroversion by causing adhesions of the uterus to other pelvic structures.
- Pregnancy and childbirth
The position the uterus settles into after a woman gives birth depends on a number of factors, including how much the ligaments have stretched during pregnancy and how much weight a woman has gained. Added weight puts pressure on the uterus and can affect its postpartum position.
Symptoms of Having a Retroverted Uterus
Unless your doctor told you, you may be unaware that you have a tilted uterus, as most women experience no symptoms. However, these signs can be an indication that you have it:
- pain in your vagina or lower back during sexual intercourse
- pain during menstruation
- trouble inserting tampons
- increased urinary frequency or feelings of pressure in the bladder
- urinary tract infections
- mild incontinence
- protrusion of the lower abdomen
In general, a retroverted uterus does not cause problems. If problems do occur, an associated condition that a woman might have like endometriosis is the probable culprit. Two symptoms of this would be pain and discomfort during sexual intercourse - especially when the woman is on top - and pain during menstruation.
Retroverted Uterus and Sex
According to Dr Yvonne Fulbright, author of Sultry Sex Talk to Seduce Any Lover, having a tilted uterus may affect the sensations that you feel during sex.
The uterus (retroverted or not) is a very flexible organ so sex should rarely cause pain. But for sexual positions that allow deeper penetration such as a woman on top, a person with a tilted uterus may feel a little discomfort.
The uterus is located fairly low in the pelvis, along with the ovaries. So during vigorous sex or sex with deep thrusting or penetration, the head of the penis may put some force against the walls of the vagina, bumping into the uterus or ovaries. This can cause pain or bruise in some women.
However, it should not cause any bleeding or extreme pain, which can discourage you from having sex. If you have a retroverted uterus and can feel any discomfort while having sexual intercourse, just change positions.
A woman on top or cowgirl position is good because you can control your partner's thrusting. Fulbright also suggests trying a modified version of missionary with your legs straight and closer together, so that your guy is less likely to go deep and irritate your uterus while thrusting.
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Retroverted Uterus and Fertility or Pregnancy
One of the most common questions that OB-Gynaecologists get from women who just learned about their retroverted uterus is, "Will I be able to get pregnant?" But according to Dr Tangco, having a tilted uterus does not lessen a woman’s chances of conceiving, nor does it affect pregnancy.“Having a retroverted uterus has no bearing on a woman's reproductive career. It is not associated with problems in conception or a woman's fertility,” said the doctor.
On the whole, it doesn’t affect pregnancy. As the baby grows in the first trimester, the uterus expands in the pelvic cavity, and by 12 to 13 weeks of pregnancy, the uterus grows up and out of the pelvis and into the abdomen to accommodate the growing baby.
While it doesn't have any effect on your chances of getting pregnant and the safety of your baby, it can affect the symptoms that you are experiencing, especially during the first trimester.
During your first weeks of pregnancy, the uterus may be difficult to see during an abdominal ultrasound, which is why most doctors go with a transvaginal ultrasound instead.
According to Healthline, a retroverted uterus might put more pressure on the bladder during the first trimester, which can lead to increased incontinence, difficulty urinating or back pain for some women.
Incarcerated uterus
As mentioned, the uterus usually expands and straightens towards the end of the first trimester. However, if for some reason this does not happen, there is an increased risk of miscarriage. This is referred to as an incarcerated uterus.
An incarcerated uterus is a very rare obstetrical complication wherein the pregnant and growing uterus remains persistently in a retroverted position. As a result, it becomes wedged into the pelvic cavity. This condition can be improved by hospitalisation, insertion of a urinary catheter to empty the bladder, and a series of exercises such as pelvic rocking to help free the uterus.
So if you're pregnant, it's best to inform your doctor right away if you’re experiencing the following symptoms:
- a consistent inability to urinate
- pain in your stomach or near your rectum
- constipation
- incontinence
Can a Retroverted Uterus Be Treated?
In most cases where a woman with a retroverted uterus is asymptomatic, treatment is not needed. However, if you're experiencing symptoms and you're worried about it, here are some treatment options that you can discuss with your doctor.
- Medical or surgical treatment of the underlying condition/s (endometriosis, pelvic inflammatory disease, adhesions and myomas).
- If the movement of the uterus is not hindered by the above-mentioned conditions, and if the doctor can manually reposition the uterus during a pelvic examination, some exercises and stretches may help.
- Pessary - this is a small silicone or plastic device that can be placed temporarily or permanently inside the vagina. It helps prop the uterus into a forward lean. But because a pessary is a foreign object, it has disadvantages, warns Dr Tangco. It can trigger pelvic infection and inflammation, make sexual intercourse painful for the woman, and cause discomfort as well for her partner.
If you have any questions about your uterus or reproductive health, don't hesitate to consult your gynaecologist.
Republished with permission from theAsianparent Philippines.
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