Retroverted Uterus Care in Grand Rapids, Michigan

A retroverted uterus (also called a tipped uterus, retroflexed uterus, or uterine retrodisplacement) is a common variation in the position of the uterus. In most women, the uterus tilts forward over the bladder, with the top (fundus) pointing toward the abdominal wall. In a retroverted uterus, the uterus tilts backward so the fundus points toward the rectum.

Around one in four women have a retroverted uterus. For most, this is a normal anatomical variation and does not cause health problems or affect fertility. However, some women in Grand Rapids may notice symptoms such as painful sex or period pain, especially if another condition like endometriosis is present.

Grand Rapids residents can access diagnosis and treatment for a retroverted uterus through major local health systems, including Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health, as well as through local OB/GYN practices.

How the Uterus Is Normally Positioned

The vagina is angled slightly toward the lower back rather than straight up and down. The uterus can sit in several normal positions:

  • Anteverted uterus (most common) – the uterus tilts forward over the bladder.
  • Upright uterus – the fundus points straight up.
  • Retroverted uterus – the uterus tilts backward toward the rectum.

All of these can be normal. A retroverted uterus is simply a variation in anatomy, not a disease.

Symptoms of a Retroverted Uterus

Many women in Grand Rapids with a retroverted uterus have no symptoms and discover it only during a routine pelvic exam or Pap test. When symptoms do occur, they may include:

  • Painful sexual intercourse (dyspareunia), especially with deep penetration
  • More pain with the woman-on-top position during sex
  • Period pain (dysmenorrhea), particularly if associated with endometriosis
  • Low back or pelvic pain, especially during menstruation
  • Discomfort during pelvic exams or tampon use in some cases

Because Grand Rapids and the wider West Michigan region experience long, cold winters, women may be more aware of pelvic or low back discomfort when they are less physically active or spending more time indoors. However, the uterus position itself is not affected by the weather.

If you experience ongoing pelvic pain or painful sex, it’s important to talk with a healthcare provider—these symptoms are not always caused by a retroverted uterus and may be related to other treatable conditions.

Causes of a Retroverted Uterus

A retroverted uterus can be:

  • A natural variation
  • Acquired later in life due to other conditions

1. Natural Variation

In many girls, the uterus gradually tilts forward as they mature. In others, this shift doesn’t occur and the uterus remains tilted backward. This is simply how their anatomy developed and is usually harmless.

2. Pelvic Adhesions

An adhesion is a band of scar tissue that joins two surfaces that are normally separate. Adhesions can form after:

  • Pelvic or abdominal surgery
  • Pelvic infections
  • Severe inflammation in the pelvis

These adhesions can pull the uterus backward into a retroverted position.

3. Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often on the ovaries, fallopian tubes, or pelvic lining. These areas can:

  • Cause inflammation and pain
  • Form scar tissue and adhesions
  • “Glue” the uterus to other pelvic structures, causing it to tip backward

Endometriosis is a common cause of both pelvic pain and retroversion of the uterus. Grand Rapids women with heavy, painful periods or pain with sex should discuss endometriosis evaluation with an OB/GYN.

4. Fibroids

Uterine fibroids are non-cancerous growths in or on the uterus. Depending on their size and location, fibroids can:

  • Change the shape of the uterus
  • Make the uterus more likely to tilt backward

Fibroids are common in women of reproductive age, and can be evaluated by ultrasound at local Grand Rapids imaging centers and hospitals.

5. Pregnancy and Ligament Stretching

The uterus is held in place by ligaments—bands of connective tissue that support it in the pelvis. During pregnancy:

  • These ligaments stretch to accommodate the growing uterus
  • In some women, this stretching can allow the uterus to tip backward

Usually, the uterus returns to a forward position after childbirth. In some cases, it remains tilted backward.

Retroverted Uterus and Sexual Pain

In most cases of retroverted uterus, the ovaries and fallopian tubes also tilt backward. During intercourse, especially with deep penetration:

  • The head of the penis can “collide” with these structures
  • This is called collision dyspareunia

Positions That May Cause More Pain

The woman-on-top position often causes the most discomfort for women with a retroverted uterus, especially with vigorous thrusting. This position can:

  • Increase the chance of striking the cervix, uterus, or ovaries
  • Strain or, in rare cases, injure the supporting ligaments

Positions That May Be More Comfortable

Many women find less pain with:

  • Side-lying positions (spooning)
  • Partner-behind positions with shallower penetration
  • Adjusting angle and depth of penetration

If painful sex is affecting your quality of life or relationships, a Grand Rapids OB/GYN, pelvic floor physical therapist, or sexual health counselor can help you explore options for pain relief and more comfortable intimacy.

Does a Retroverted Uterus Affect Fertility?

Current evidence suggests that a retroverted uterus by itself does not reduce fertility. Most women with a tilted uterus:

  • Conceive naturally
  • Have normal pregnancies and deliveries

Fertility problems are more likely to be related to:

  • Endometriosis
  • Fibroids
  • Ovulation issues
  • Sperm factors
  • Tubal problems

If you are trying to conceive in Grand Rapids and have concerns about a retroverted uterus, a fertility evaluation through local clinics or hospital-based reproductive endocrinology services can identify any underlying issues.

Retroverted Uterus and Pregnancy

In most pregnancies:

  • The uterus expands and rises out of the pelvis by the end of the first trimester (around 12–14 weeks)
  • As it grows, it usually assumes a typical forward-tilted position, even if it started retroverted

Incarcerated Uterus (Rare Complication)

In a small number of cases, the growing uterus can become “snagged” under the pelvic bone (usually the sacrum). This is called an incarcerated uterus. It is rare but serious and requires prompt medical attention.

Symptoms typically appear between 12 and 14 weeks of pregnancy and may include:

  • Increasing pelvic or lower abdominal pain
  • Difficulty or inability to pass urine
  • A feeling of pelvic pressure

Any pregnant person in Grand Rapids who suddenly cannot urinate or has severe pelvic pain should seek urgent care at a local emergency department (for example, Spectrum Health or Trinity Health Grand Rapids) or contact their obstetric provider immediately.

Diagnosis of a Retroverted Uterus in Grand Rapids

A retroverted uterus is often discovered during:

  • A routine pelvic exam
  • A Pap smear
  • A pelvic ultrasound ordered for pain, bleeding, or fertility evaluation

Your Grand Rapids healthcare provider (family doctor, nurse practitioner, or OB/GYN) may:

  1. Take a detailed history

    • Menstrual symptoms
    • Pain with sex
    • Past surgeries or infections
    • Fertility concerns

  2. Perform a pelvic exam

    • Assess the position and mobility of the uterus
    • Check for tenderness or masses

  3. Order imaging or tests, such as:

    • Pelvic ultrasound (transabdominal or transvaginal)
    • MRI in complex cases
    • Tests for suspected endometriosis or fibroids

Local imaging can be done in hospital systems like Spectrum Health, Metro Health, or outpatient imaging centers across the Grand Rapids area.

Treatment Options for a Retroverted Uterus

Most women with a retroverted uterus do not need treatment if they have no symptoms. When treatment is needed, it usually focuses on:

  • Relieving pain
  • Treating underlying conditions (such as endometriosis or fibroids)
  • Improving quality of life and sexual comfort

1. Treating the Underlying Condition

If your retroverted uterus is linked to another condition, your provider may recommend:

  • Hormone therapy for endometriosis, such as:

    • Birth control pills
    • Progestin-only methods
    • GnRH analogs (medications that reduce estrogen levels)

  • Fibroid management, which may include:

    • Medications to control bleeding and pain
    • Minimally invasive procedures (e.g., uterine artery embolization, myomectomy)

Addressing these conditions often reduces pelvic pain and discomfort during sex, even if the uterus remains tilted.

2. Manual Repositioning

In some cases, if the uterus is mobile and not fixed by adhesions or fibroids, a doctor may:

  • Gently reposition the uterus to a forward tilt during a pelvic exam

This may provide temporary relief. However, the uterus often tips backward again over time.

3. Pelvic Exercises

Some providers may suggest pelvic exercises, such as:

  • Pelvic rocking
  • Certain core and pelvic floor strengthening routines

These exercises aim to strengthen supportive muscles and may help the uterus stay in a more comfortable position for some women.

However, the medical community is divided on whether pelvic exercises offer a long-term solution for a retroverted uterus. They are generally safe and may improve pelvic health overall, but they may not permanently change uterine position.

4. Pessary Use

A pessary is a device inserted into the vagina to support pelvic organs and, in some cases, help keep the uterus tilted forward. While pessaries can help some women:

  • They may increase the risk of vaginal infections and inflammation if not properly managed
  • They can cause discomfort for both the woman and her partner during sex
  • They require regular follow-up and cleaning

Because of these drawbacks, pessaries are not commonly used solely for a retroverted uterus in modern practice, but they may be considered in specific situations.

5. Surgery (Uterine Suspension)

For women with significant symptoms that do not improve with conservative measures, surgical repositioning of the uterus may be an option. Using laparoscopic (“keyhole”) surgery:

  • The surgeon repositions the uterus so it sits over the bladder
  • The uterus is then secured in a forward position

This procedure is:

  • Relatively straightforward for experienced surgeons
  • Usually successful in reducing symptoms related to uterine position

In rare, complex cases or when other serious conditions are present, a hysterectomy (surgical removal of the uterus) may be considered. This is generally reserved for women who:

  • Have completed childbearing
  • Have severe symptoms
  • Have other uterine disease (such as large fibroids or severe endometriosis)

Surgical care is available through major Grand Rapids hospitals and specialty gynecologic surgeons.

Treatment of Incarcerated Uterus

Treatment for an incarcerated uterus during pregnancy is urgent and typically involves:

  • Hospitalization for close monitoring
  • Insertion of a urinary catheter to relieve bladder pressure and empty the bladder
  • A series of positioning techniques and exercises, such as pelvic rocking, to help free the uterus from behind the pelvic bone
  • In some cases, manual repositioning under anesthesia or surgical intervention

This condition is rare but serious. Pregnant individuals in Grand Rapids should seek immediate medical attention if they experience severe pelvic pain or trouble urinating in the late first or early second trimester.

When to See a Doctor in Grand Rapids

You should consider seeing a healthcare provider if you:

  • Have painful sex, especially deep pain during intercourse
  • Experience severe or worsening period pain
  • Have chronic pelvic or low back pain
  • Notice difficulty urinating, especially during pregnancy
  • Are having trouble conceiving and are concerned about uterine position

Local Resources and Providers

Grand Rapids residents can seek help from:

  • Your primary care provider or GP
  • OB/GYN specialists at:
    • Spectrum Health
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Mercy Health physician groups
  • Reproductive endocrinologists and fertility clinics for conception concerns
  • Kent County Health Department and Grand Rapids Public Health for referrals and general women’s health resources
  • Pelvic floor physical therapists for pelvic pain and sexual discomfort

If you need confidential sexual health support, you can also look for local ���sexual health clinic Grand Rapids” or “women’s health clinic Grand Rapids” to find nearby services.

Key Points to Remember

  • A retroverted uterus is a common anatomical variation; about one quarter of women have it.
  • Most women have no symptoms, and a retroverted uterus usually does not affect fertility or pregnancy.
  • When problems occur, they are often due to associated conditions such as endometriosis, adhesions, or fibroids.
  • Painful sex—especially in the woman-on-top position—and period pain can be linked to a retroverted uterus, but should always be evaluated to rule out other causes.
  • Treatment in Grand Rapids focuses on treating underlying conditions, managing pain, and, in selected cases, repositioning the uterus with manual techniques, pessaries, or surgery.
  • Pregnant women with sudden pelvic pain or difficulty urinating between 12 and 14 weeks should seek urgent evaluation to rule out an incarcerated uterus.

If you live in the Grand Rapids, MI area and are worried about a retroverted uterus or pelvic pain, schedule an appointment with a local OB/GYN or women’s health provider to discuss your symptoms, get an accurate diagnosis, and review personalized treatment options.