Most of the time, the uterus is in an anteverted position. In some cases, however, the uterus is retroverted, i.e. oriented backwards. Why is this? Is it dangerous? We explain.
Definition of retroverted uterus
A retroverted uterus is, as its name suggests, oriented backwards. This is the case for 20 to 30% of women.
In the majority of cases, the uterus is anteverted, i.e. oriented forward, towards the bladder. It is therefore an anatomical variety, not a malformation.
What is the purpose of the uterus?
As you know, the uterus is an organ that forms part of the female reproductive system. In fact, it's the place where an embryo is to be welcomed and allowed to develop.
The uterus is made up of an internal mucous membrane called the endometrium, which is under the influence of female hormones. This means that it will thicken during the menstrual cycle (in the event of an embryo being implanted), until it is eliminated at the arrival of the periods.
The uterus also houses the thick mucus plug at the entrance to the cervix. This mucus only becomes thin and permeable during ovulation.
What are the positions of the uterus?
The uterus is located in the lower abdomen, in the region of the pelvis. It has a triangular or inverted-pyramid shape. The size of a uterus (in women who have never had children) is 8cm long and 5cm wide (approx.).
In most cases, 70-80% of cases, the uterus is anteverted, i.e. it is directed forward, resting on the bladder. It sometimes even forms an alignment with the vaginal cavity. In 20-30% of women, however, the uterus is tilted backwards (resting on the rectum, which is oriented towards the spine). This is known as a retroverted uterus.
What are the particularities of a retroverted uterus?
As I said before, a retroverted uterus is not a malformation, it's simply a physical characteristic that's less common, like having minnow eyes, for example.
A retroverted uterus is by no means an exception, and does not appear to be a hereditary characteristic. Retroversion of the uterus is a physical characteristic, just like anteversion.
What are the symptoms and pain of a retroverted uterus?
A retroverted uterus presents no significant symptoms. Some women never even notice it. A retroverted uterus is often detected during a gynaecological examination. It is impossible to detect a retroverted uterus without a gynaecological check-up:- an MRI (prescribed for pathologies such as endometriosis)
- a scanner
- an ultrasound scan (very often prescribed)
- hysteroscopy (an examination of the uterine cavity and endometrium using fibre optics)
In the vast majority of cases, having a retroverted uterus will have no impact on fertility, pregnancy or women's health in general.
On the other hand, a retroverted uterus can cause certain types of pain, more or less intense depending on the woman, such as pelvic and sacro-lumbar pain during periods (dysmenorrhea or periods ). Women with a retroverted uterus may also experience pain during intercourse in certain positions, a condition known as dyspareunia. Pain does not necessarily occur at the moment of penetration, but rather in certain positions that are too deep.
A retroverted uterus can lead to other types of symptoms, such as constipation, pain during defecation, frequent urination or, on the contrary, repeated urination.
However, surgery is only considered when symptoms are too strong or disabling.
What causes a retroverted uterus?
A retroverted uterus can be caused by several factors:- congenital, i.e. present from birth
- of secondary origin, for example following childbirth with an obstetric tear or distension of the uterine ligaments.
- some women may also have a retroverted uterus due to a pelvic pathology (e.g. uterine fibroids) or an inflammatory disease such as endometriosis
What treatments are available for retroverted uterus?
In most cases, since a retroverted uterus presents no particular symptoms, women receive no treatment. However, if the pain is too severe and incapacitating, treatment may be considered.
To ensure that the pain is indeed due to the retroversion of the uterus, a "pessary test" can be carried out. How does this test work? A pessary (a flexible ring made of rubber, latex or silicone) is inserted by the practitioner into the patient's vagina. The aim is to fix or mobilize the cervix and support the uterus in an attempt to correct retroversion. It is left in place for a few days, or even weeks. If during this time the pain is relieved, then the test is positive: there is a causal link between the pain and the retroverted uterus. In this case, surgery may be considered.
How does a retroverted uterus affect the female body?
As mentioned above, a retroverted uterus generally has no impact on the female body.
Natural pregnancy and MAP
A retroverted uterus has no impact on fertility and in no way prevents a natural pregnancy. Just because a uterus is retroverted doesn't mean that sperm won't have access to the egg.
MAP techniques can also be performed without additional difficulty, whether for medically assisted procreation, IVF (in vitro fertilization), ovarian puncture or artificial insemination. Rest assured: having a retroverted uterus will in no way prevent you from having children.
On the other hand, a retroverted uterus can cause certain unpleasant or even painful sensations.
As the uterus begins to enlarge, it is possible that the angle of the cervix, when the uterus is very retroverted and inclined, may block urination. Fortunately, this is very rare.
Some health professionals also warn of an increased risk of organ descent due to pregnancy and a retroverted uterus. Today, however, it is very difficult to prove a causal link between these two phenomena.
Contraception with an IUD
A retroverted uterus does not prevent the insertion of an IUD either, although it may make it more complicated. However, if the retroversion of the IUD is due to a uterine pathology, you may not be able to use this type of contraception. In fact, certain pathologies such asendometriosis or fibroids are not compatible with the IUD, as the latter tends to increase the duration of periods and the intensity of bleeding.
As far as sanitary protection is concerned, a retroverted uterus does not prevent you from wearing a cup or a period pants.
If you experience pain or discomfort, consult your gynecologist!
Retroverted uterus FAQ
What are the consequences of a retroverted uterus?
Having a retroverted uterus has no particular consequences. For some women, however, pain may be experienced. In such cases, surgery may be considered.
How can I get pregnant with a retroverted uterus?
There's nothing more you can or can't do to get pregnant when you have a retroverted uterus! A retroverted uterus does not prevent you from having a baby. PMA can also be considered, just as much as for an anteverted uterus.
What is the normal position of the uterus?
There is no normal position for the uterus: in the majority of cases, the uterus is anteverted, and in around 20 to 30% of cases, it is retroverted. This is by no means a malformation, just a difference in anatomy.
