TiltedUterus

Not a medical professional, just a person with tilted uterus issues.

[tilteduterus]

[tilteduterus]

The best way to determine flexion or which way the uterus is bending is through an ultrasound. If the body of the uterus can be felt through manual exam, a medical professional might also be able to tell. The cervix angle will usually give an indication of which way the uterus will be bending, but not always. 

Anteflexion. If your uterus is anteflexed, the body will bend forwards towards the bladder.

Midposition (no flexion). Sometimes the uterus has no flexion at all. Instead of bending forward or backward, the uterus will be straight.

Retroflexion. If your uterus is retroflexed, the body will bend backwards towards the rectum.

[tilteduterus]

Uterus position pt. 2: finding the ‘version’ (tilt)

If you can reach your cervix yourself, you will most likely be able to tell the version or tilt of your cervix. You can also ask your doctor or another health professional to check for you.

Anteversion. If your cervix is anteverted, it will be angled towards the bladder and the opening of the cervix will point towards the rectum.

Midposition. If your cervix is midposed, the opening will be pointing straight downwards.

Retroversion. If your cervix is retroverted, it will be angled towards the rectum and the opening of the cervix will point towards the bladder.

The term ‘retroverted uterus’ is often used to mean that the body of the uterus also faces backwards. Usually the body of the uterus does line up with the angle of the cervix, but not always.

[tilteduterus]

Uterus Position pt. 1: finding out your cervix height

If you want to determine height, you can insert a clean finger into your vagina and try to reach your cervix. If you can reach it, some say it feels like a ball or doughnut. Depending on where you are in your menstrual cycle, it might feel hard or soft and squishy. You might also feel a small opening. If you can’t feel it, move your finger from side to side. Sometimes the cervix will be found at an angle and pulled either towards the back or front wall of the vagina.

Note the amount of your finger that was inserted until you were able to feel the tip of the cervix. You can use the “knuckle rule” as measurement, or you can place the portion of your finger that was inside next to a ruler to be more exact.

Low: The cervix can be reached with your first knuckle inserted (less than 4.5cm)

Average: The cervix can be reached with your second knuckle inserted (between 4.5-5.5 cm)

High: The cervix can be reached if your full finger is inserted or can’t be reached at all (above 5.5 cm)

Knowing the height of your cervix can allow you to track your menstrual cycle and fertility if you aren’t on hormonal birth control. If you use menstrual cups, the height is also important to know for comfortable fit and to prevent leakage. For accuracy, check multiple times during different points of your cycle to determine what’s normal for you.

[tilteduterus]

The position and tilt of the uterus is determined by angle and height in relation to the vagina, bladder and rectum.

These are the most common ways that uterus position is categorized:

Height: distance between the entrance of the vagina to the cervix tip.

Version: angle created between the vagina and the cervix.

Flexion: angle created between the cervix and the body of the uterus.

A tilt or angle described as forward facing means towards the bladder, while backward facing means towards the rectum.

[tilteduterus]

The uterus is (usually) free to move around, but held in place by pelvic floor muscles, tissues and ligaments.

Every uterus has a different size, shape, tilt and position. This can change overtime, throughout the month and even daily. 

What influences uterus position and tilt?

Genetics. Different cervix length, vagina length, uterus size and positions of surrounding organs all influence where it will be sitting.

Bodily functions. As the bladder and rectum fill and void throughout the day, the uterus will shift.

Exercises and movement. The uterus can shift temporarily depending on how the body is moving.

Hormonal changes. In a natural menstrual cycle, the uterus lowers during menstruation and rises during ovulation. Hormonal birth control and menopause can also impact uterus position.

Arousal. The uterus is pushed upwards as the vagina lengthens.

Pregnancy. A growing fetus will temporarily shift the position of the uterus, while childbirth can cause permanent changes.

The uterus position can also be influenced by underlying health conditions:

Tightness, weakening or damage to the pelvic floor. When the uterus isn’t supported properly, retroversion or pelvic organ prolapse can occur. 

Adhesions. Endometriosis, pelvic inflammatory disease or previous surgeries can cause adhesions or scar tissue which glue the uterus in place so that it becomes immobile.

Abnormally large uterus. Adenomyosis, fibroids or tumours can cause the uterus to become enlarged and may pull the uterus backwards.

[tilteduterus]

Most common:

Anteverted + anteflexed (forward facing and forward bend)

Retroverted + retroflexed (backward facing and backward bend)

Midposed with slight anteflexion or retroflexion (pointing upwards with a slight bend either forward or backward)

Least common:

Severe anteflexion or retroflexion

Anteverted + retroflexed (forward facing and backward bend)

Retroverted + anteflexed (backward facing and forward bend)

Midposed with no flexion (pointing straight up)