Most of the time, the uterus is in an anteverted position. However, in some cases, the uterus may be retroverted, i.e., oriented backwards. How can this be explained? Is it dangerous? We explain.
Definition of the retroverted uterus
A retroverted uterus is, as its name indicates, oriented towards the back. This is the case for 20 to 30% of women.
In the majority of cases, the uterus is anteverted, meaning that it is oriented forward, towards the bladder. It is therefore an anatomical variety, not a malformation.
What is the purpose of the uterus?
The uterus is, as you know, an organ that is part of the female reproductive system. It is in fact the place where an embryo can be placed and develop.
The uterus is composed 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 case an embryo is implanted), until it is eliminated at the arrival of the period.
The uterus also houses the thick mucus plug at the entrance to the cervix. This mucus becomes thin and permeable only at the time of ovulation.
What are the positions of the uterus?
The uterus is located in the lower abdomen, in the pelvic region. Its shape is triangular, or an inverted pyramid. The size of a uterus (in women who have never had children) is about 8cm long and 5cm wide.
The uterus is in most cases, 70 to 80% of the cases, oriented in an anteverted way, that is to say that it is directed towards the front while resting on the bladder. It sometimes even forms an alignment with the vaginal cavity. However, in 20 to 30% of women, the uterus is tilted backwards (resting on the rectum oriented towards the spine). This is called a retroverted uterus.
What are the particularities of the retroverted uterus?
As said before, a retroverted uterus is not a malformation, it is simply a physical characteristic, less common, such as the fact of having minnow eyes.
The 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, as is anteversion.
What are the symptoms and pains of a retroverted uterus?
A retroverted uterus has no significant symptoms. Some women may never notice it. Often a retroverted uterus will be detected during a gynecological examination. It is impossible to notice it outside of a gynecological check-up as :
- an MRI (especially prescribed in the case of pathologies such as endometriosis)
- a CT scan
- an ultrasound (very often prescribed)
- a hysteroscopy (an examination that allows the uterine cavity and the endometrium to be examined using fiber optics)
In the vast majority of cases, having a retroverted uterus will not have any impact on fertility, pregnancy and generally on women's health.
However, a retroverted uterus can cause some pain, more or less intense depending on the woman, such as pelvic and sacro-lumbar pain during menstruation (dysmenorrhea or painful periods). Women with a retroverted uterus may also experience pain during sexual intercourse in certain positions, which is called dyspareunia. The pain does not necessarily occur during penetration, but rather in certain positions that are too deep.
A retroverted uterus can cause other types of symptoms such as constipation, pain during defecation, frequent urination or, on the contrary, repeated urination.
However, surgery is only considered when the symptoms are too strong or disabling.
What are the causes of retroverted uterus?
A retroverted uterus can be caused by several factors:
- of congenital origin, i.e. present since birth
- of secondary origin, for example following a delivery where there was an obstetrical tear or a distension of the ligaments of the uterus.
- Some women may also have a retroverted uterus due to a pelvic pathology (e.g., a uterine fibroid) or an inflammatory disease such as endometriosis
What are the treatments for retroverted uterus?
In most cases, since a retroverted uterus does not present any particular symptoms, women do not receive treatment. However, if they experience severe and disabling pain, treatment may be considered.
To make sure that the pain is caused by the retroversion of the uterus, it is possible to perform a "pessary test". 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 purpose is to fix or mobilize the cervix and support the uterus to try to correct the 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, a surgical operation can be considered.
How does the retroverted uterus impact the female body?
As mentioned earlier, a retroverted uterus does not usually have an 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 does not mean that sperm will not have access to the egg.
MAP techniques can also be carried out without any additional difficulty, whether it be for medically assisted reproduction, 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.
Indeed, when the uterus starts to grow, it is possible that the angle of the cervix, when the uterus is very retroverted and tilted, blocks 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. But it is very complicated to prove the 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, it is possible that this type of contraception will be prohibited. Indeed, 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 the use of a cup or menstrual panties.
In case of pain or discomfort, consult your gynecologist!
FAQ about a retroverted uterus
What are the consequences of a retroverted uterus?
Having a retroverted uterus has no particular consequences. For some women, pain can be felt. In this case, a surgical intervention can be considered.
How to get pregnant with a retroverted uterus?
There is nothing more to do or not to do to get pregnant when you have a retroverted uterus! A retroverted uterus does not prevent you from having a baby. MAP can also be considered, as much as for an anteverted uterus.
What is the normal position of the uterus?
There is no normal position of the uterus, the uterus is anteverted in the majority of cases, and it is retroverted in about 20 to 30% of cases, this is absolutely not a malformation, but just a difference of anatomy.