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  • Michael Frey, MD

Retroverted (Tilted) Uterus

A retroverted uterus (tilted uterus, tipped uterus) is a uterus that tilts towards the back of the body. This is in contrast to the typical uterus, which tilts slightly forward toward the front of the body.


Why causes a tilted uterus?

Some women are born with a retroverted uterus. Think of it as being reproductively left-handed. On the other hand, retroversion may be caused by conditions such as:

  • Endometriosis

  • Pelvic inflammatory disease

  • Tumors

  • Prior pelvic surgeries

  • Abortion

Symptoms

In most cases, the retroverted uterus is symptom-free. However, some women experience:

  • Painful bowel movements due to pressure from the uterus on the rectum.

  • Chronic constipation for the same reason as above.

  • Pain during sexual intercourse due to the collision of the penis with the cervix.

  • More intense menstrual symptoms.

  • Urinary incontinence.


Fertility with a retroverted uterus

The position of the uterus does not affect fertility. BUT, if the cause of the tilted uterus is endometriosis, pelvic infection, scar tissue from prior surgery or abortion, then fertility may be affected. These associated conditions can create a problem getting pregnant. But being born with a tilted uterus alone will not create problems getting pregnant.


Sex positions with a retroverted uterus

In general, you should seek a position that does not cause discomfort during intercourse and, if you are seeking pregnancy, have sex on fertile days. Control the depth of penetration. Avoid "girl on top" position if it is painful. Best positions are usually: missionary, and spooning.


Consider additional erotic activities that don’t include penetration. Penetration can be the side dish for sex while the other activities dominate. Pleasure is the goal, so creatively figuring this out is key. Manual stimulation using your hands on your partner’s external parts, like in this laying down position, is a stellar alternative to internal pounding.


Finally, another piece of advice for women seeking pregnancy is to keep their legs up for a few minutes after intercourse.


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