Location
The uterus is about the size of a fist and it is located above the vagina in a woman, within the pelvic region, almost overlying the urinary bladder which is anteriorly situated. The rectum is situated behind the uterus. The main function of the uterus is to nourish the fetus while it develops. The uterus is divided into three parts – the fundus, body and cervix.
Under a normal condition, the uterus is slightly bent forward towards the urinary bladder. However, this order is not respected in about 20% to 30% of women where the reverse is the case.
Symptoms of Tilted Cervix
Some of the symptoms of tilted cervix or tipped cervix include the following:
- Painful sexual intercourse: This phenomenon known as dyspareunia, is the presence of pain during sexual intercourse. In the presence of a retroflexed uterus, the woman feels pain when the vagina is penetrated by a penis in the course of sex, especially if a lot of force is applied. However, it must be noted that tipped cervix is not the only reason for a painful sexual intercourse; there are several other reasons for its occurrence.
- Difficulty emptying the bladder: One other symptom that is present is difficulty passing urine out of the bladder.
- Painful menses: Dysmenorrhea is common in women who suffer from a tilted cervix. There is pain during the menstrual cycle which may also be accompanied by a back pain during sex.
- Painful insertion of a tampon: A tampon is a kind of plug inserted into the vagina during menstruation to help absorb the menstrual flow. With a retroflexed uterus, insertion of a tampon becomes painful to an extent.
What causes a tilted cervix?
There are several known reasons why the cervix could become tipped. Some of the causes include the following:
Childbirth
During childbirth, the ligaments supporting the cervix can be overstretched thereby making them to become weaker, especially when there is prolonged labor or Cephalopelvic Disproportion (the head of the baby is bigger than the pelvic opening). The excessive stretching could cause the cervix to change position. While the uterus naturally returns to its original position after birth, some cases of tilted cervix remain permanent.
Congenital abnormality
Naturally, the upper portion of the uterus is straight or slightly tilted towards the front. Unfortunately, some women are born with the uterus in a reverse order, pointing to the back instead. There are also some beliefs that tilted cervix is hereditary.
Endometriosis
This is a situation whereby uterine cells (endometrial lining) attach themselves to other portions outside of the uterus. During menstruation, the endometrial lining is shed but it is impossible to shed those portions that have attached themselves beyond the uterus. These linings could eventually break down, bleed and tear away thereby leading to the formation of scar tissues. The adhesions resulting from the scar tissue can pull on the cervix and make it to change its position.
Uterine fibroid
The weight exerted by a uterine fibroid can cause the cervix to become tipped.
Pelvic tumor
This can also cause some level of displacement of the cervix thereby making it to become tilted.
Treatment
The treatment of a retroverted cervix depends on the actual cause of the problem. Should there be symptoms, the doctor may decide to carry out a surgery to correct the problem. Basically, here are a few ways to correct the anomaly:
Exercise
The “Knee-chest” exercise plays a role in helping to reposition the cervix. However, if it the problem is caused by fibroids, endometriosis, or pelvic inflammatory disease, the exercise becomes useless.
Pessary
This involves placing a silicone or plastic device in the vagina to assist in repositioning the retroverted uterus. It only provides a temporary relief from the pelvic pain. Using it for a prolonged period can increase susceptibility to vaginal infections.
Surgery
This is the best way to proffer a permanent solution to the problem. It involves repositioning the tilted cervix from its backward-facing position to assume a forward-facing position or suspending the uterus over the urinary bladder. This will alleviate the pain that is associated with sexual intercourse.
The use of the UPLIFT method which is a newer and better improved method used for uterine suspension comes with more advantages as its postoperative complications are fewer than when other uterine suspension procedures are employed. It reduces the pain and makes sex more tolerable.
Does it affect pregnancy?
There have been some misconceptions regarding the ability of a tilted cervix to distort the course of pregnancy or completely prevent pregnancy from taking place. It was also thought to be one of the causes of infertility in women. The belief was that a retroflexed uterus did not allow sperm to make its way to the fallopian tubes where it is expected to fertilize the released ovum thereby leading to infertility.
However, several evidences have shown that a tipped cervix alone does not cause infertility. But if there are other problems in the reproductive tract, they can work against pregnancy or lead to complications during pregnancy. For instance, if there has been the existence of endometriosis or a pelvic inflammatory disease, there could be formation of scars and adhesive tissues which can eventually obstruct the sperm from entering the fallopian tubes and consequently there would be no pregnancy.
The only way a tilted cervix can prevent pregnancy is because of painful sexual intercourse. This would cause some women to limit sexual activity or completely avoid sex. With a reduced sexual activity, pregnancy might not take place.
When pregnancy has taken place, the uterus is no longer tilted as from the twelfth week. This makes it easy for the pregnancy to progress and for a normal labor to occur. However, if the uterus fails to correct itself, there could be a miscarriage, though this rarely happens.
Conclusion
Tilted or tipped cervix comes with an array of medical problems: Painful sexual intercourse, Difficulty emptying the bladder, Painful menses, and Painful insertion of a tampon. All these can make the life of a woman with the condition miserable.
However, the tips we have provided here are able to provide you some succor. However, whereby they fail to address your condition, see the doctor for further evaluation and management.
Remember that these tips are not intended to replace medical advice. Your doctor has the final say should you need any further management.
