From Back Pain to Urinary Incontinence: Lesser-Known Symptoms of a Tilted Uterus

According to Saed News Family Service, terms like retroverted uterus, retroflexed uterus, inverted uterus, and backward-tilted uterus are used to describe an atypical positioning of the uterus within the female pelvis. In this article, we explain what a retroflexed uterus is, whether it affects pregnancy, and whether it increases the risk of miscarriage.

What Is a Retroflexed Uterus?

Normally, the uterus sits horizontally over the bladder. When it tilts backward toward the spine and rectum, it is referred to as a retroflexed or retroverted uterus. Physicians generally consider this a natural variation, with roughly one in five women experiencing it.

For most women, a retroflexed uterus does not cause health problems and often does not require treatment. However, some may experience pain during sexual intercourse or in certain positions. Importantly, this uterine position usually does not affect pregnancy or childbirth.

Signs of a Retroflexed Uterus

Many women with a retroflexed uterus show no symptoms. When symptoms do occur, they may include:

• Pain during vaginal intercourse

• Menstrual cramps or discomfort due to the uterus pressing on the rectum and spine

Less common symptoms may include:

• Lower back pain

• Increased urinary tract infections

• Urinary incontinence

• Discomfort when using tampons

• Fertility issues

How Is a Retroflexed Uterus Diagnosed?

If suspected, a physician can usually confirm the condition with a pelvic exam, abdominal ultrasound, or occasionally a recto-vaginal exam. In some cases, distinguishing a retroflexed uterus from a pelvic tumor can be challenging.

Does a Retroflexed Uterus Cause Infertility?

Pregnancy is typically possible with a retroverted uterus. Fertility may only be affected if accompanied by other conditions such as:

• Endometriosis

• Pelvic inflammatory disease (PID)

• Fibroids

Minor surgeries can often correct endometriosis or fibroids, while early-detected PID usually responds to antibiotics. Fertility treatments like IUI (intrauterine insemination) or IVF may help if these conditions affect conception.

A retroverted uterus itself generally does not hinder pregnancy, although it may press more on the bladder in the first trimester, causing urinary issues or back pain.

During early pregnancy, a transvaginal ultrasound may be required for accurate monitoring. By the 10th–12th week, the uterus usually rises out of the pelvis and straightens. Rarely, adhesions prevent this shift, leading to a condition called a “trapped uterus”, which can slightly increase miscarriage risk. Prompt diagnosis and treatment usually resolve the issue.

Does a Retroflexed Uterus Increase Miscarriage Risk?

For most women, the answer is no. Miscarriage is only a concern in rare cases of a trapped uterus, which can be treated once identified.

Pregnancy and Retroflexed Uterus

If you are pregnant with a retroflexed uterus, discuss the following with your doctor:

• Difficulty urinating

• Abdominal or rectal pain

• Constipation

• Urinary incontinence

These could indicate a trapped uterus, which can be detected during a pelvic exam or ultrasound.

In the third trimester, retroverted uterus usually poses no risk. Some women may experience increased back pain during labor. Sexual activity is generally unaffected, though certain positions may be uncomfortable. Adjusting sexual positions can reduce discomfort, and any persistent pain or bleeding should be discussed with a gynecologist.