There is a lot to love about being a woman. The softness, the nurturing, the beauty. But there’s also the mystique. There is a depth to women that many people, will never fully understand. That’s reflected in women’s characters, essence, but also in their physical anatomy. 

With all of women’s reproductive organs tucked away inside of their bodies, it can sometimes be difficult to know all that’s happening and whether everything is functioning as it should. Until you go to the doctor it’s a bit of a guessing game. But more often than not, your body is offering you clues that something might be amiss as is often the case when dealing with a retroverted or tilted uterus.

Amiss doesn’t necessarily mean wrong or a serious issue. In fact, The Cleveland Clinic estimates that 1 in 5 women have a tilted uterus. Still, the more you know your body, the more comfortably you can live. To learn more about this issue, 21Ninety spoke to obstetrician-gynecologist Dr. Brandye Wilson-Manigat to get her insight on what it means to have this specific anatomical variation.

A retroverted uterus is one that is tilted back toward your spine instead of forward toward your abdomen, according to The Cleveland Clinic. You can either be born with a tilted uterus or it can develop over time due to scarring from pelvic surgeries like c-sections. Your uterus can shift positions due to fibroids. Natural everyday occurrences like childbirth and menopause can cause a tilted uterus as well. 

In Dr. Brandye’s experience, women don’t usually realize their uterus is any different.

“A bunch of the times, it’s an incidental finding,” she said. They’re coming in for abnormal bleeding or a cyst on their ovary. And it’s like, ‘Oh hey, your uterus is tilted toward the back instead of towards the front.’ My spiel is usually ‘That’s pretty common. It’s not anything to worry about.’”

Titled uterus and fertility

Most of the time, a tilted uterus does not impact fertility.

“Generally, the penis so close to the cervix, the sperm swim and do what they’ve got to do,” Dr. Brandye explains. “[A retroverted uterus] doesn’t cause any issues with getting pregnant or cause you to have infertility.”

Pain could be a pregnancy complications as a result of a tilted uterus but that is in extreme cases.

“There was some older data that showed sometimes when women are pregnant with a severely retroverted uterus that the uterus could get stuck against the sacrum in the back and cause a lot of pain,” Dr. Brandye said. “And so one of the ways to fix that was to put in a pessary to lift the uterus out of the pelvis. But that’s old school. And in my 15 years of practice, I have not come across anyone who’s had an entrapped uterus or anything like that. So in general, no, there’s not a danger to having a retroverted uterus.”

There are times when this positioning can cause discomfort. If you can relate to any of these symptoms, you should speak to a medical professional. But until you can get an appointment, check out these suggestions.

Painful sex 

One of the most common signs of a tilted uterus is pain during penetrative sex. When your uterus tilts backward, the chance that the tip of penis is colliding with your uterus and other reproductive structures is increased.

What to do

Dr. Brandye suggests switching up your positions.

“The missionary position is prone to things hitting that part of the uterus so maybe trying cowgirl or reverse cowgirl. Even doggy style where they enter from behind—especially if you have your head down and you behind in the air [can make sex more pleasurable],” she said.

Tampons Are A Headache

Tampons can be tricky your first-go-around. But once you understand the lay of the land, they are supposed to be relatively simple and certainly painless. That’s not always the case with a titled uterus. 

What to do

If your uterus tilts back, you may have to position your body differently to properly insert the tampon. Furthermore, leaks are more likely when your uterus is tilted. Instead of squatting of standing over the toilet to insert, try to lift one leg up on the side of the tub or even angle your body backward for more ease.

Period Cramps in Your Lower Back 

A 2013 study found that people with tilted uteri experienced more pain during menstrual cycles than those without. Scientists believe the tilted position can prevent blood from flowing from the uterus to the cervix. The body had to contract harder to release the blood, resulting in more pain according to ToplineMD. 

But Dr. Brandye says more patient information like ultrasound findings may prove that this theory is no longer applicable.

“Old studies found that more women who had endometriosis had more retroverted uteri. But I don’t think that’s panning out with the more ultrasounds that we’re doing,” she said.

What to do

The traditional methods are best here: pain medication, heating pad or hot water bottle can help. Using peppermint, something as simple as a candy cane in your tea can help manage cramps. It’s not an instant relief but once it hits, the difference is night and day. Massage with essential oils may also be helpful.

Ultimately, Dr. Brandye advises women to accept their body.

“Love your uterus,” she says. “Whichever way it’s tilted, it’s you.”