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What Is an Anteflexed Uterus?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

An anteflexed uterus is a uterus that is tilted forward in the abdominal cavity. Some forward tilt is natural and can be seen in most women, but in some cases it can become extreme and may cause pelvic pain or interfere with fertility. An ultrasound can determine the exact location of the uterus and provide more information about whether it is a cause for concern. For pregnant women wondering if the “anteflexed uterus” an ultrasound technician or doctor has mentioned is something they should worry about, it is probably not an issue unless the doctor has stated otherwise.

The uterus is designed as a free-floating organ. While it does not wildly float about the abdominal cavity, it enjoys some degree of flexibility and can rotate around its attachment point at the cervix. This is advantageous, as the uterus needs to be able to move when it expands during pregnancy, and the flexibility of movement also allows it to move in response to pressures within the abdominal cavity. In a neutral position, it tends to fall slightly forward, with the fundus, the top of the uterus, pointing toward the front of the body.

The uterus normally has only a slightly forward tilt.
The uterus normally has only a slightly forward tilt.

In a severe anteflexed uterus, the organ may fall so far forward that it partially folds in on itself, forcing the fundus up against the bladder. This can lead to incontinence as well as pelvic pain. It is also difficult for a pregnancy to develop in this position, as the fetus does not have enough room to grow in the cramped conditions. This type of anteflexion is a potential issue for patients who plan on having children.

An ultrasound can determine the exact location of the uterus.
An ultrasound can determine the exact location of the uterus.

If the anteflexed uterus does cause problems, patients have several options for addressing it. The degree of flexion may be mild, and it could be possible to use massage and bodywork along with muscle exercises or pessaries to push it back into a more neutral position. For more extreme situations, a doctor may need to perform surgery. She can tighten up the ligaments and muscle attachments to pull the uterus into the middle of the pelvis. A doctor may recommend this if the position of the uterus appears to be causing fertility problems.

An anteflexed uterus may interfere with fertility.
An anteflexed uterus may interfere with fertility.

Other patients may have a retroflexed uterus, where the fundus points toward the spine. This is not necessarily a cause for concern either, as long as the degree of the tilt is not extreme. In cases where the uterus bends too far over, the treatment options are similar to those seen with an anteflexed uterus.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

Discussion Comments

anon992493

Did your doctor tell you which direction your uterus is tilted? It can be retroflexed (back tilted -towards your anus) or anteflexed (forward tilted) this will make a difference in terms of sexual positions. (mine was so back-tilted that they couldn't do normal ultrasounds with my first baby).

For an anteflexed uterus I would recommend "doggy" or "77" (like doggy but lying on your side) or even "scissor" (partners at 90 angle). For retroflexed "missionary" (knees over shoulders is best for getting deeper) or woman on top would be better.

Basically for retroflexed, you want to get the deepest penetration possible (wow I never thought I'd be typing this!). My midwife explained that things can get a bit 'squashed' for lack of technical term, if your uterus points backwards too far, what with your intestines pushing. After conception, you'll probably have a lot of cramping and back pain (retroflexive) or ligament pain and "need to pee" (anteflexive) until things straighten out.

anon305475

My husband and I have been married for seven years. We haven't ever used any form of birth control. I have never been pregnant. I am also 29 years old and now wish to have a baby.

The last time I had an extensive exam done, my doctor told me my uterus was tilted forward a little more than most women. I am not sure if my insurance would cover such extensive testing to check fertility. I can't use a calendar to predict when I ovulate because it is never the same. I can go anywhere from three to six months without having a period. Is my body just totally screwed up? Is there any hope of natural conception?

bfree

@Sierra02 - Contrary to what most women believe, there's really very little risk of infertility caused by a tilted uterus. Endometriosis or uterine and ovarian fibroids are more likely the culprit for that.

If you have a tilted uterus and become pregnant, the uterus is going to move forward naturally. It's my understanding that between the twelfth and fourteenth week of pregnancy all uteruses become anteflexed by nature.

It's usually quite common for a woman to feel more rectal or abdominal pressure prior to this forward rise of the uterus.

ladyjane

@Sierra02 - Hi. Retroflexed and anteflexed are two different positions of the uterus. A retroflexed is a backward tilted uterus, whereas the anteflexed leans forward.

I know this because mine is also tilted backward. So much so that it's almost fusing together. The cause of my retroflex is from endometriosis, (the cells from the uterus have grown in other parts of the body).

It's very painful and so serious that my doctor has ordered me to not even try to become pregnant until after I've had surgery. Otherwise it could cause a miscarriage, or a uterine rupture, or a handful of other complications during childbirth.

Your case might not be as severe as mine is. You can still get pregnant with a retroverted uterus, it's just that in my situation, my doctor advises against it.

Sierra02

I just learned a few weeks ago that my uterus is retroflexed. My doctor said that it probably occurred sometime during my last pregnancy and that I may have some difficulty becoming pregnant again.

Has anyone ever heard of this? Is it similar to an anteflexed uterus? I can't understand how this happened since I had a perfectly normal pregnancy with a healthy baby who is still healthy at four years old.

My husband and I really want to have another child but now I'm worried I won't be able to. Any information you can share or comforting words is much appreciated.

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    • The uterus normally has only a slightly forward tilt.
      By: Alila Medical Media
      The uterus normally has only a slightly forward tilt.
    • An ultrasound can determine the exact location of the uterus.
      By: poco_bw
      An ultrasound can determine the exact location of the uterus.
    • An anteflexed uterus may interfere with fertility.
      By: Igor Mojzes
      An anteflexed uterus may interfere with fertility.
    • Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.
      By: zayacsk
      Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.
    • Extreme cases of an anteflexed uterus may cause pelvic pain.
      By: ProMotion
      Extreme cases of an anteflexed uterus may cause pelvic pain.
    • A retroflexed uterus may occur as a result of fibroids.
      By: designua
      A retroflexed uterus may occur as a result of fibroids.
    • The uterus is a free-floating organ that has some flexibility, allowing it to expand during pregnancy.
      By: yarkovoy
      The uterus is a free-floating organ that has some flexibility, allowing it to expand during pregnancy.
    • An anteflexed uterus may cause pelvic pain.
      By: staras
      An anteflexed uterus may cause pelvic pain.