People have varying features. These variances are normal and inherited. Hair color can be black, blonde, brown, or red. Eyes can be blue, brown, gray, green, or hazel. Another less obvious variation occurs among women: uterine position. When women are told that their uteruses are "tipped," they assume it is an abnormality, but that is not true. It is simply a normal variant much like eye and hair color.
Positions
An anteverted uterus is one in which the uterus is tipped forward toward the front of the abdomen. This is the most common uterine position. Anteflexion occurs when the body and fundus of the uterus flex forward at the cervix. When the uterus points upward, towards the head, it is retroverted. A retroflexed uterus flexes backward at the cervix, the lower part of the uterus, so that the body and fundus point towards the back. The uterus may also tilt more toward the right or left. Anteflexed and retroflexed uteruses will become retroverted as pregnancy progresses, and will likely return to their original position after childbirth.
Diagnostic Difficulties
Uterine position can cause some difficulties during examinations. During manual pelvic examinations performed by a family physician or gynecologist, a retroverted or retroflexed uterus may be more difficult to feel. Retroflexed uteruses can cause examination difficulties during early pregnancy. The baby's heartbeat may not be heard as early in the pregnancy as with an anteverted or retroverted uterus. Retroflexed uteruses may be difficult to image during the abdominal portion of a pelvic or early pregnancy ultrasound, whereas a retroverted uterus may be more difficult to image using transvaginal ultrasonography. These difficulties arise because portions of the uterus are farther away from the transducer, or ultrasound camera.
Pathology and Position
Pathology, or gynecological problems, can be associated with uterine position. Uterine fibroids are a common uterine pathology. The location of pain and pressure caused by fibroids can be affected by uterine position. Women with anteverted uteruses may experience more pain and pressure toward the front of the pelvis, while women with retroflexed uteruses may experience more back pain. The size and location of fibroids may also affect the position of the uterus. Endometriosis, a condition in which endometrial tissue grows outside of the uterus. The endometrium is the inner lining of the uterus that is shed during menstruation. Endometriosis can cause adhesions that may fix the uterus into a different position.
Fertility
Many women are concerned with the effects of uterine position on fertility. While uterine position may cause diagnostic difficulties during early pregnancy, uterine position in and of itself has no effect on the ability to conceive and carry a pregnancy.
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