Tilted Uteruses: Everything You Ever Wanted To Know

photographed by Nicolas Bloise.
If you're someone who has a uterus, then you might feel like you have it all figured out: you know why it bleeds, how it holds a baby, and what it's there for. But unlike the labia or the clitoris, there's a lot about this hollow reproductive organ that you might not know about simply because it's located inside the body. For instance, sometimes the uterus can be tilted. Crazy, right?
About one in four people with uteruses have ones that are tilted, according to the Mayo Clinic. The clinical terms are "retroverted" or "anteverted" uteruses, and it refers to the direction that the uterus tilts, explains Fahimeh Sasan, DO, an Ob/Gyn in New York City and founding physician at Kindbody, a women's health and fertility clinic.
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In truth, there's nothing crazy about having a tilted uterus, although it might make you even more curious about the organ. Ahead, Dr. Sasan answers some common questions about this anatomical phenomenon:

Is it bad if your uterus is tilted?

Nope. Dr. Sasan says people often freak out when they're told that they have a tilted uterus. Really, this is just a term that doctors use to describe someone's uterus in clinical notes, she says. "Sometimes when you're trying to do a pap smear, you have to angle the speculum a different way so that you can see their cervix clearer," she says. Or in anticipation of certain surgeries, it'd be useful to know which direction a person's uterus bends, she says. "But outside of those very technical Ob/Gyn reasons to know whether a person's uterus is flipped forward or backward, it has no meaning," she says.

What causes a tilted uterus?

You can think of the uterus as a floppy deflated balloon, Dr. Sasan says. The uterus is connected to the muscular walls of your pelvis, which hold it in place inside your body, she says. Typically, the uterus sits vertically, but sometimes it can tilt forward or backwards, due to a number of normal anatomical reasons. For example, childbirth can loosen the ligaments that hold it in place, or scar tissue from endometriosis can impact the positioning of the uterus. Some people are also just born with a tilted uterus.
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Is it harder to get pregnant with a tilted uterus?

There used to be a fear that having a tilted uterus would make it more difficult for sperm to make its way to an egg, although research has shown that's not actually a concern. "From a perspective of getting pregnant, being pregnant, staying pregnant, fertility, and your menstrual cycle," having a tilted uterus really shouldn't affect you, Dr. Sasan says. Of course there are exceptions: If the uterus positioning is caused by another condition, such as endometriosis, that can affect someone's ability to get pregnant.

How do I know if I have a tilted uterus?

You might not know that you have a tilted uterus, because many doctors won't bother telling patients, given how benign it is, Dr. Sasan says. "I think it's something that should be reserved for medical notes," she says. Most people with tilted uteruses won't experience any kind of symptoms, although some may experience pain with penetrative sex, or dyspareunia, due to the positioning of the cervix. In that case, it's always worth it to mention painful sex to your doctor, so they can rule out more serious conditions, and help you brainstorm ways to make sex more comfortable.
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