A woman is born with her uterus in a certain position. A uterus can be tilted forward (a.k.a. anteverted uterus) toward the bladder, or backward (a.k.a. retroverted uterus) toward the rectum. Anteverted uteruses are more common, accounting for about 2/3 of all tilted uteruses in women. A retroverted uterus is a normal variation, similar to being left-handed instead of right-handed. Sexual intercourse cannot shift the position of a woman’s uterus. Pregnancy, endometriosis, pelvic inflammatory disease (PID), fibroids, surgery, and aging, however, can change the angle of the uterus.
Some women who have a retroverted uterus can feel discomfort during sexual intercourse or vaginal penetration at times, because of pressure on the rectum and ligaments of the tailbone. For these women, they may find that some sexual positions and/or degree of thrusting are more comfortable than others. If penetration is persistently painful and/or a woman’s periods are causing severe pain, she needs to see a gynecologist or women’s health care nurse practitioner. Endometriosis and PID can be associated with a retroverted uterus; this can be confirmed with a physical exam.
Some people worry that having a retroverted uterus could cause problems with fertility. Fortunately, infertility is not connected with retroversion of the uterus. If endometriosis or PID is associated with a woman’s uterus being retroverted, however, successful conception may be more difficult. These conditions cause scar tissue to develop, hindering the egg and sperm from meeting for fertilization to occur.
No one knows what the future will bring in terms of your own uterine tilt. You and your health care provider can remain aware of your uniqueness and can monitor or watch for any changes or impact it may have.
A backward-tilted (retroverted) uterus is not as common as a forward-tilted (anteverted) one, but it is still considered normal in most cases. Approximately 1/3 of all tilted uteruses are retroverted.
For women who have a tilted uterus, sexual intercourse can sometimes be uncomfortable because of pressure on the rectum and ligaments of the coccyx bone. Changing sexual position, as you’ve mentioned, can often help relieve discomfort.
However, if pain on deep thrusting is frequently present and/or there is severe dysmenorrhea (painful menstruation), a gynecological evaluation needs to be done. That’s because a retroverted uterus can also be associated with conditions such as endometriosis and pelvic inflammatory disease (PID).