Q: Hi Dr. Please ma’am, I was told a woman with retroverted uterus cannot conceive. Please ma’am, how true is it?

A: Normally, a uterus tilts forwards at the cervix towards the stomach. In some women, however, the uterus tilts backwards inside the pelvis towards the spine. This is called a retroverted or tilted uterus. Many women with this condition are born with it but some women may develop it after birth as a result of:

• Pregnancy: During pregnancy, the ligaments holding the uterus in place become weak and so after pregnancy, some women now find their uteri tilted.

• Prior surgery, infections and disease conditions like endometriosis may lead to a tilted uterus. In these cases, conception may be difficult but not impossible. Patients here may benefit from seeing a fertility doctor.

For more on endometriosis and pelvic inflammatory disease, please click on these links:

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• Menopause: Estrogen deficiency in menopause also leads to weakened ligaments such that the uterus now becomes tilted.

A retroverted uterus is usually an incidental finding as most women experience no symptoms. The women with symptoms usually complain of pain during menstruation and pain during sexual intercourse. Other symptoms include lower back pain, incontinence, difficulty with passing stool or urine.

Treatment for this include:

Kegel exercises: The exercise mimics the movements we make when we want to stop the flow of urine. Try holding this for about 10 seconds and then doing about 10 repetitions per set. Try about 4 to 6 sets per day and increase this as you feel ready.

Knee to chest exercise: Lie flat on your back and place both feet on the floor with both knees bent. With your left foot still flat on the floor, bring your right knee to your chest. Hold this position for about 15 to 30 seconds and then return your leg to the floor. Do about 10 reps of this exercise on each leg 3 times a day. This can help return a tilted uterus to a forward position.

Vaginal pessaries (plastic devices) which help to hold the uterus in position.

Surgery can also help to shorten (tighten) the weakened ligaments and thus return the uterus to its rightful position.

Now, does a retroverted uterus stop one from getting pregnant? No. The sperm can swim just as easily here as they do in other uteri/wombs. However, given that some of the causes of retroverted uterus like endometriosis are associated with difficulty to conceive, then retroverted uterus may be associated with infertility even though it doesn’t cause it.

I hope this helps you. If you have more questions, please seek out a good gynaecologist and let him/her help you.

Have a good night, everyone 😀

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