Women's Health

A tilted uterus , also called a retroverted uterus , simply means the uterus tilts backward toward the spine instead of forward toward the bladder. It's a normal variation of anatomy, not a disease or defect. You may also hear it described as "tipped" or "backward."

About 20 to 30 percent of women have a tilted uterus. For most, it's simply the natural shape they were born with. In some women, the uterus tilts forward later in life, especially after pregnancy.

Many women have no symptoms at all. When symptoms do appear, they can include:

• Lower back pain during your period
• Pain during sex, especially with deep penetration
• Mild urinary frequency or urgency
• Discomfort when using tampons or menstrual cups

Yes. A tilted uterus generally does not affect fertility. The angle of the uterus does not stop sperm from reaching the egg or prevent implantation. Most women with a tilted uterus conceive naturally without any special treatment.

If deep penetration is uncomfortable, positions that let you control depth and angle can help:

• On top , you control the depth and pace
• Spooning or side-lying , often allows shallower penetration
• Using pillows under your hips or knees for support
• Plenty of lubrication and going slowly

Communicate with your partner and go at your own pace.

See a provider if pain during sex is severe, your periods are increasingly painful, you have pain outside your period, or you have trouble conceiving after 12 months (6 months if you're over 35). These can be signs of endometriosis, fibroids, pelvic inflammatory disease, or other conditions that deserve care.

• Myth: A tilted uterus causes infertility. Fact: It usually does not affect fertility.
• Myth: It always causes painful sex. Fact: Many women have no symptoms at all.
• Myth: It requires surgery to fix. Fact: Most women never need treatment; pelvic floor therapy or simple exercises can help if symptoms are bothersome.
• Myth: It prevents a healthy pregnancy. Fact: Most women with a tilted uterus carry pregnancies normally.