Did you know that 20% of uteri are tilted?
Recently, I came across the phrase “tilted uterus” in a story collection (this one, read it immediately). It reminded me that I’d actually seen it before, mainly in literature, but there was never any elaboration about what it actually is, or what it means. The term was usually mentioned in relation to infertility, but after an investigation, it turns out that it’s much more complicated.
If your uterus is tilted, it means that it points backwards, in the direction of your spine and rectum, instead of forwards towards your stomach. A tilted uterus might be the reason for painful sex, especially when there’s penetration from behind. “When I speak with my clients who are experiencing painful sex, asking if they have been diagnosed with a tilted uterus is one of my first questions,” said Sunny Rodgers, the owner of a tilted uterus and a Clinical Sexologist, Certified Sex Coach, and ACS Certified Sex Educator, accredited by The American College of Sexologists. “I will suggest certain sex play positions to lessen pain and discomfort if a client does have a tilted uterus.”
You might also have issues inserting tampons or menstrual cups, the perpetual existence of urinary tract infections, unpredictable periods, and incontinence. (Keep in mind that these are also symptoms of other conditions, so don’t diagnose yourself with a tilted uterus, leave that to your OB/GYN to do during a pelvic exam.) And while you might experience these symptoms, you also might not. “Some people who have tilted uteruses may have none of these symptoms and live a completely normal existence,” said Caleb Backe a Health and Wellness Expert for Maple Holistics.
You can’t develop a tilted uterus (also known as a tipped uterus, retroflexed uterus, retroverted uterus, uterine retroversion, or a backward uterus), you’re born with it, and there are studies that suggest it’s genetic.
Angel was diagnosed with a tilted uterus when she was 22. “I was told I’d have difficulty getting pregnant because of the tilt and that it was the explanation for my brutal periods. This was an older, male doctor (he’d delivered my younger brother in ’67.)” She later switched to a female doctor, who told her that her intense periods had nothing to do with the tilt – they would relieve out once she had children – but that it might mean she’d have fertility challenges. She didn’t – “I succeeded both times I tried. Periods became much more bearable after pregnancy. Normal and relatively simple births, both times. No mention of the ’tilt’ during either pregnancy or delivery.”
A tilted uterus probably won’t affect your ability to get pregnant, but it is associated with diagnoses that might, like endometriosis, pelvic inflammatory disease, and fibroids. Some folks don’t know they have a tilted uterus until they’re pregnant. You might experience pressure on your bladder during your first trimester, and the tilt might also necessitate the use of a transvaginal ultrasound instead of a regular one. Pregnancy also causes your uterus to get bigger and straighten, so it won’t be tipped anymore, although sometimes this doesn’t happen, and that increases your odds of a miscarriage. Your doctor can diagnose this and fix it, but you should alert them to the occurrence of incontinence, abdominal pain, and/or constipation.
While you likely won’t need any treatment for your tilted uterus, doctors might recommend exercises, such as kegels, to strengthen the muscles that keep it upright. There are surgeries that can be done to reposition the uterus if your symptoms are particularly intense, and a pessary can be inserted into your vagina in order to prop up your uterus.