Your gynecologist told you about an "anteverted" or "retroverted" uterus after an ultrasound, and you're wondering what it really means? This medical terminology actually hides a simple anatomical reality. Anteverted uterus (tilted forward) affects 70 to 80% of women and does not cause any symptoms. Conversely, retroverted uterus (tilted backward) affects 20 to 30% of women and also remains normal in the vast majority of cases, even if it can sometimes cause pain during intercourse or menstruation. These two positions are neither diseases nor abnormalities, just natural anatomical variations. This article demystifies these terms and answers all your questions about the impact on pregnancy, fertility and sexuality.
The main thing to remember
- Anteverted uterus : most common position (70-80%), tilted forward, resting on the bladder, no symptoms
- Retroverted uterus : normal variant (20-30%), tilted backward, rests on the rectum, sometimes symptomatic
- These positions do not usually affect fertility or pregnancy
- Retroverted uterus straightens up spontaneously during pregnancy in 98% of cases
- Rare complication: uterine incarceration (1/3000 to 1/10000 pregnancies with retroverted uterus)
- Possible symptoms of retroversion: pain during intercourse, painful periods, urinary problems
- Secondary causes: endometriosis, fibroids, post-operative adhesions, menopause
Comparison Table: The 3 Uterine Positions
Anteverted Uterus: The "Standard" Position
Let's start with the most common. If you're told you have an anteverted uterus, it's simply to describe its natural anatomical position.
What Is an Anteverted Uterus?
In this configuration, the uterus is slightly tilted toward the front of the body. Its fundus (the upper part) is closer to the abdominal wall, while the cervix points toward the sacrum (the bone at the base of the spine).
Simplified Anatomy
- The uterus is located in the pelvis, between the bladder (at the front) and the rectum (at the back)
- In its anteverted position, it rests lightly on the bladder
- It is not truly vertical, but leaning forward about 90 degrees from the vagina
- This tilt is maintained by several ligaments that suspend the uterus in the pelvis
Anteverted and Anteflexed Uterus: What’s the Difference?
You may have heard your doctor refer to an "anteverted" and "anteflexed" uterus. These two terms describe two different aspects of uterine position.
The most common combination is "anteverted anteflexed," meaning the uterus tilts AND bends forward. This is the classic position found in 70 to 80% of women.
Anteverted Uterus: Is It Normal?
Absolutely. An anteverted uterus is not only normal, it's the most common position. The term "anteverted" usually only appears in your medical records to describe the anatomy on an ultrasound, not because there's anything abnormal.
Why some women discover their uterine position
Most women don't know whether their uterus is anteverted or retroverted, and this is completely normal. This information usually appears in the following contexts:
- During an early pregnancy ultrasound
- Before inserting an IUD (to adapt the technique)
- During a fertility assessment
- During an investigation for pelvic pain
Symptoms of an Anteverted Uterus: There Are None
This is the most important point to understand. An anteverted uterus causes no particular symptoms. No pain, no discomfort, no impact on sexuality or fertility.
If you have gynecological symptoms (pain, abnormal bleeding, difficulty conceiving), they are not caused by the anteverted position of your uterus. Another explanation must be sought.
Very rare exception: extremely anteverted uterus
In very rare cases, a uterus that tilts excessively forward can press heavily on the bladder during pregnancy and cause temporary urinary retention in the first trimester. This affects less than 0,1% of pregnant women and usually resolves spontaneously.
Retroverted Uterus: The Variant That May Raise Questions
Now let's move on to the retroverted uterus, which is of much greater concern because it can sometimes be associated with symptoms.
What Is a Retroverted Uterus?
In this configuration, the uterus is tilted toward the back of the body rather than the front. The fundus of the uterus is closer to the spine, and the organ rests on the rectum rather than the bladder. The cervix points forward, toward the pubis.
Frequency of retroverted uterus
- Affects 20 to 30% of women according to studies
- About 1 in 4 or 5 women have a retroverted uterus
- It is neither a disease nor an anomaly, just an anatomical variation
- Most affected women have no symptoms
Retroverted Uterus: Causes and Origins
There are two types of uterine retroversion depending on their origin.
Primary (congenital) retroversion
In the majority of cases, a retroverted uterus is present from birth. It is simply the way the uterus developed in the mother's uterus, with no identified pathological cause. This form is hereditary in some families, although the genetic link is not clearly established.
Secondary (acquired) retroversion
Sometimes a uterus that was initially anteverted tilts backward later in life. The most common causes are:
- Endometriosis : Adhesions caused by this disease can pull the uterus backward
- Uterine fibroids : Especially posterior fibroids that push the uterus backward
- Post-operative adhesions : After pelvic surgery (cesarean section, myomectomy, appendectomy)
- Pelvienne Infections : Pelvic inflammatory disease can create adhesions
- Delivery : Ligament stretching may not return to normal after delivery
- Menopause : The drop in estrogen weakens the ligaments supporting the uterus
Retroverted Uterus: Possible Symptoms
Unlike an anteverted uterus, a retroverted position can sometimes cause symptoms, although the majority of affected women do not have any.
⚠️ Important to understand
If you have a retroverted uterus AND significant symptoms, the cause is rarely the position itself. Often, it is the underlying pathology (endometriosis, fibroids, adhesions) that causes both the retroversion and the symptoms. Treating this pathology usually resolves both problems.
Retroverted Uterus & Pregnancy: What You Need to Know
This is probably the question that most worries women with a retroverted uterus. Rest assured, the news is very good.
Retroverted Uterus Does Not Prevent Pregnancy
Several recent scientific studies have confirmed that a retroverted uterus does not directly affect fertility. A 2024 study of 621 nulliparous women showed that women with a retroverted uterus had a slightly higher incidence of IVF (12,3% vs. 6,8%), but not because of the position itself.
Why some studies show a link between retroversion and IVF
It is not the position of the uterus that reduces fertility, but the pathologies that CAUSE secondary retroversion (endometriosis, adhesions, fibroids). These conditions, however, affect fertility. A retroverted uterus is therefore a marker, not a cause.
Development of a retroverted uterus during pregnancy
In the vast majority of cases (98%), the retroverted uterus straightens spontaneously between the 10th and 14th week of pregnancy. As the uterus grows, it naturally moves out of the pelvis and tilts forward.
Timeline of uterine straightening
- Weeks 1-10 : The uterus remains retroverted, nestled in the hollow of the sacrum
- Weeks 10-14 : The uterus begins to grow and move out of the pelvis, gradually tilting forward
- Weeks 14-40 : The uterus is in an anteverted position, the pregnancy is proceeding normally
- After childbirth : The uterus can return to its initial retroverted position or remain anteverted
Retroverted Uterus and Big Belly: A Myth
Contrary to popular belief, a retroverted uterus does not cause the belly to "stick out" more during pregnancy. Once the uterus has straightened (around 12-14 weeks), the shape of the belly is identical to that of a woman with an anteverted uterus.
Some women think they have a bigger belly because of their retroverted uterus, but the taille of the belly actually depends on factors like the taille of the baby, the volume of amniotic fluid, the tone of the abdominal muscles and personal morphology.
The Rare Complication: Uterine Incarceration
In very rare cases (estimated at between 1/3000 and 1/10000 pregnancies), the retroverted uterus fails to straighten and remains stuck behind the pubis during its growth. This situation is called "uterine incarceration" or "incarcerated gravid uterus."
Symptoms of uterine incarceration (12-14 weeks)
- Acute urinary retention : Total or partial inability to urinate
- Severe pelvic pain persistent
- Lower back pain severe
- Constipation important
- Vaginal bleeding sometimes associated
If you experience these symptoms between 12 and 14 weeks of pregnancy with a known retroverted uterus, seek emergency medical attention.
Treatment of incarceration generally consists of manual repositioning of the uterus by the gynecologist (a painless maneuver under anesthesia), combined with temporary bladder catheterization. In the vast majority of cases, once upright, the uterus remains in an anteverted position and the pregnancy continues normally.
Risk of Miscarriage: The Scientific Data
A landmark 1976 study (Jordan et al.) suggested a slightly increased risk of first-trimester bleeding and miscarriage in women with a retroverted uterus. However, more recent research (2024) found no significant difference in miscarriage rates between women with anteverted and retroverted uteri.
A 2024 study found that women with a retroverted uterus had 4 times more bleeding in the first trimester, but the miscarriage rate was the same. This bleeding is therefore likely benign and related to the gradual repositioning of the uterus.
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Retroverted Uterus and Pain During Intercourse
Dyspareunia (pain during intercourse) is one of the most common symptoms associated with a retroverted uterus, but it does not affect all women.
Why a Retroverted Uterus Can Cause Pain
In a retroverted uterus, the fundus of the uterus and ovaries are positioned further back, closer to the posterior wall of the vagina. During penetration, especially deep penetration, the penis can hit these sensitive structures.
Possible types of pain
- Collision dyspareunia : Sharp pain during deep penetration, as if something was "bumped"
- Persistent dull pain after intercourse, in the lower abdomen or lower back
- Uterine cramps triggered by penis movements
- Ovarian pain if the ovaries are hit during penetration
Sex Positions to Avoid with a Retroverted Uterus
Certain positions promote deep penetration and increase the risk of hitting the retroverted uterus. If you experience pain, try to avoid these positions:
Solutions to Reduce Pain
If you have a retroverted uterus and intercourse is painful, there are several solutions available before considering medical treatment.
- Experiment with different positions to find those that limit deep penetration
- Contact your partner on what triggers the pain to adapt the movements
- Prioritize good lubrication to reduce friction
- Explore other forms of sexuality (oral sex, caresses, toys) that do not cause pain
- Consult a physiotherapist specializing in perineal rehabilitation : pelvic floor exercises can sometimes help
- If the pain persists, consult to check that there is no associated pathology (endometriosis, adhesions)
Diagnosis: How Do You Know If Your Uterus Is Anteverted or Retroverted?
The position of the uterus is easily determined during a gynecological examination or ultrasound.
Clinical Examination
During vaginal examination combined with abdominal palpation, the gynecologist or midwife can feel the position of the uterus. An anteverted uterus is easily palpated anteriorly, while a retroverted uterus is palpated through the posterior vaginal wall, near the pouch of Douglas.
Pelvic Ultrasound
Transvaginal or abdominal ultrasound directly visualizes the position of the uterus and allows for diagnosis confirmation. It is the gold standard examination for assessing uterine version and flexion, as well as for screening for possible associated pathologies (fibroids, endometriosis, adhesions).
Retroverted Uterus Treatment: When Is It Necessary?
In the vast majority of cases, a retroverted uterus does not require any treatment. Intervention is only required if the symptoms are truly disabling and significantly impact quality of life.
Conservative Treatments
perineal rehabilitation
Pelvic floor strengthening exercises can help slightly reposition the uterus. This approach works especially well if the retroversion is due to postpartum ligament laxity.
Vaginal pessary
A pessary is a silicone device placed in the vagina to hold the uterus in an anteverted position. It is a temporary or long-term solution for women who cannot or do not want to undergo surgery. The main disadvantage is the risk of infection and the need to remove it regularly for cleaning.
Treatment of the underlying pathology
If the retroversion is secondary to endometriosis, fibroids, or adhesions, treating these conditions can resolve both the retroversion and the symptoms.
Surgical Treatment
Surgery is rarely necessary and reserved for cases where symptoms are severe and have not responded to other treatments.
Uterine Suspension (UPLIFT)
This laparoscopic procedure (minimally invasive surgery) involves shortening the ligaments that support the uterus to reposition it in anteversion. The success rate is good, but there is a risk of recurrence and postoperative complications (adhesions, pelvic pain).
Frequently Asked Questions About the Uterine Position
Uterine Position: A Normal Variation of the Female Body
Whether your uterus is anteverted or retroverted, it is a normal anatomical variation, not an abnormality that needs to be corrected. An anteverted uterus never causes symptoms. A retroverted uterus can sometimes cause pain during intercourse or menstruation, but the majority of affected women live very well with this peculiarity. Either position generally does not affect fertility or the course of pregnancy.
If you have troublesome symptoms (severe pain, difficulty conceiving, recurring urinary problems), they are rarely caused by the uterine position itself, but rather by an underlying pathology such as endometriosis or fibroids. In this case, a complete gynecological evaluation can identify and treat the true cause. Your body is not defective because your uterus is in one position rather than another. It is simply your anatomy, unique and normal.
Sources & Scientific References
This article is based on scientific studies published on PubMed and international medical recommendations.
Studies on retroverted uterus and pregnancy
- Weekes A, Atlay R, Brown V, Jordan E, Murray S. (1976). The retroverted gravid uterus and its effect on the outcome of pregnancy. British Medical Journal. PMID: 1252851
- Garretto D, et al. (2024). Retroverted uterus in the first trimester and associated pregnancy outcomes. American Journal of Perinatology. PMID: 39631743
- Shaul C, et al. (2024). The impact of uterine position on conception modes and perinatal outcomes in nulliparous patients. American Journal of Obstetrics & Gynecology. DOI: 10.1016/j.ajog.2024.11.009
Studies on uterine incarceration
- Dierickx I, et al. (2019). Incarcerated gravid uterus: A rare but potentially devastating obstetric complication. Radiology Case Reports. PMC8924533
General medical resources
- Cleveland Clinic. Retroverted (Tilted) Uterus: Causes, Symptoms & Fertility. Cleveland Clinic
- RMA Network. (2025). Tilted or Retroverted Uterus: Impact on Pregnancy. RMA Network
- CCRM Fertility. (2025). Retroverted Uterus and Fertility: Causes, Symptoms and Treatment Options. CCRM
Note: PMIDs and links provide direct access to original scientific publications.
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If you experience severe pelvic pain, difficulty conceiving, or any concerning symptoms, consult a gynecologist or midwife.
1 comment
My cervix is anteverted and I cannot conceive. What should I do?