A retrograde uterus tilts towards the rectum instead of between the bladder and rectum. It can cause discomfort during intercourse and menstruation, but can be corrected with surgery, a pessary, or exercises. Causes include abnormal development, adhesions, endometriosis, fibroids, or pregnancy. Infertility is rarely linked to a retrograde uterus.
If a woman has a retrograde uterus, it leans back into the body and toward the rectum instead of being positioned between the bladder and the rectum. Common causes of this condition are abnormal development of the uterus, adhesions, endometriosis, fibroid tumors, or pregnancy. Discomfort during intercourse and menstruation are the most common problems associated with a tilted uterus. When needed, a retrograde uterus can be corrected using surgery, a pessary, or sometimes through exercises.
A retrograde uterus tilts back towards the rectum instead of sitting halfway between the bladder and the rectum. As a woman’s reproductive system develops, the uterus typically moves from a retrograde to an intermediate position. In some women, this transition does not occur and the uterus remains tilted backwards.
Adhesions, endometriosis, or fibroids can also cause a retrograde uterus. Internal adhesions are scar tissue resulting from surgery. Endometriosis is an overgrowth of uterine cells outside the uterus, and fibroid tumors are benign growths. All of these conditions can bind pieces of tissue, which are normally separated, and cause the uterus to be held in a retrograde position.
Pregnancy can both heal a retrograde uterus and cause it. In some cases, the weight of the baby in late pregnancy will force the uterus to tip forward and remain in this central position after delivery. Pregnancy, in other cases, can cause the uterus to tilt backwards as the strain of the baby’s weight pulls on the uterine ligaments. When this is the situation, after delivery the uterus will either stay in the retrograde position or return to normal as the uterine ligaments heal.
Many women with a retrograde uterus don’t even know it and won’t experience any associated symptoms. In other cases, a woman may have painful intercourse and menstruation due to a tilted uterus. Other less common problems are the propensity to develop urinary tract infections and incontinence. Infertility is rarely linked to a retrograde uterus unless all other fertility problems have been ruled out.
A tilted uterus can be treated with outpatient laparoscopic surgery. Laparoscopic procedures will involve surgically tilting the uterus forward, removing adhesions, endometriosis, or fibroid tumors that are holding the uterus in the wrong position, or, in some rare cases, a hysterectomy will be performed to remove the uterus completely. For temporary relief, a pessary or small plastic support can be placed behind the uterus to tilt it forward. Some doctors recommend trying special exercises to reposition the uterus, but if these exercises work the benefit is usually temporary and the uterus usually falls back eventually.
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