Retroflexio Uteri

By | June 8, 2022

Retroflexio uteri is a backward-leaning uterus that can be either mobile or fixed. Mobile backward inclinations are often associated with pregnancy or age-physiological changes and then have no pathological value. In most cases, the phenomenon does not require any therapy.

What is retroflexion of the uterus?

The uterus is also called the uterus and is pear-shaped. In its natural anatomy, the organ is usually bent forward in the abdomen and points towards the abdominal wall. The uterus is up to ten centimeters long and five centimeters wide. A significant increase in size is possible during pregnancy. For what does bws stand for, please visit

Around ten percent of women suffer from a backward-leaning uterus. This phenomenon is called retroflexio uteri and causes the organ to point towards the sacrum. A retroflexed uterus need not be of pathologic value and may represent a non-discomfort variant of the anatomically normal position.

As soon as women with a backward-tilted uterus become pregnant, their uterus usually straightens up spontaneously. When the backward-tilted uterus is not mobile, but fixed. Retroflexion of the uterus with mobility is called Retroflexio uteri mobilis. The fixed variant is called Retroflexio uteri fixata. The latter form usually causes symptoms and is therefore considered to be pathological.


Mobile forms of uterine retroflexion can be genetic and thus present from birth. If the backward tendency is acquired rather than congenital, such changes typically correspond to a natural change after pregnancy. Age can also play a role in the mobile form of backward uterine tilt.

Age-physiological natural changes often cause the uterus to change the angle and direction of inclination. Fixed uterine inclinations backwards have other causes. This phenomenon often occurs in the context of adhesions with a neighboring organ. Endometriosis can also cause this anatomical change.

Focal areas of uterine mucosa that occur outside of the physiologically natural localization are designated as such. The endometrium is always related to the female menstrual cycle. For this reason, endometriosis is mostly a phenomenon that occurs within the framework of abnormal hormonal action of the menstrual cycle. Thus, the retroflexio uteri fixata is mostly due to hormonal causes.

Symptoms, Ailments & Signs

There is always talk of retroflexio uteri when the degree of angle between the cervix uteri and the corpus uteri increases. If this angle is enlarged from birth, it is usually a harmless position variant that does not cause any symptoms. In the rarest of cases, those affected suffer from slight pain that emanates from the sacrum.

In exceptional cases, dysmenorrhea can be due to a backward tilt of the uterus. Cramp-like pains during menstruation are known as such. If there is a connection, the present backward inclination is usually the fixed variant.

The fixed variant can also cause cohabitation pain and thus be responsible for pain during sexual intercourse in women. In extremely rare cases, infertility was observed in connection with retroflexio uteri. Also, such fertility problems are most likely to affect women with the fixed form of uterine backward tilt.

Diagnosis & course of disease

Doctors usually diagnose retroflexion of the uterus with imaging tests such as ultrasound. The increase in the angle of inclination can be seen more or less clearly on the imaging. The finding is often an incidental finding, since the backward inclination of the uterus has so far been asymptomatic.

Only in the rarest of cases do patients go to the doctor because of pain problems, who then uses imaging to research possible causes and discovers the backward inclination. Above all, asymptomatic and mobile retroflexio uteri have an extremely favorable prognosis. Fixed forms are usually associated with an unfavorable prognosis, but can usually be corrected with the current state of medicine.


There are usually no complications associated with retroflexion of the uterus. The uterus, which is angled backwards, is usually mobile and can therefore straighten up during pregnancy, so that no discomfort occurs. However, in rare individual cases, symptoms are possible, but they are almost never life-threatening. This sometimes leads to low back pain when the uterus is fixed by adhesions and constantly presses against the sacrum.

In addition, cramp-like pain often occurs during menstruation, which is referred to as a cycle anomaly. So-called cohabitation pain can also occur during sexual intercourse. Some patients even become infertile. However, these complications only occur if the uterus has grown together with the peritoneum in the rectum due to inflammatory processes or a so-called endometriosis.

In this case, the uterus is firmly fixed and can therefore no longer erect, even during pregnancy. As a rule, no therapy is necessary for retroflexio uteri. It is usually a harmless positional anomaly of a mobile uterus that occurs in about ten percent of women. To prevent any complications that may occur with an adherent and fixed uterus, the adhesions can be surgically removed. However, the adhesions often form again and again.

When should you go to the doctor?

Retroflexio uteri should always be treated by a doctor. As a rule, this disease cannot be treated by self-help means, so that the patient is always dependent on medical treatment. Self-healing does not occur either.

A doctor should be consulted if the person concerned suffers from pain in the sacrum. This pain can occur sporadically, including in the form of pain at rest. Furthermore, those affected very often suffer from pain during menstruation, which can also lead to pain during sexual intercourse. If these symptoms occur for no particular reason and do not go away on their own, they should always be examined by a doctor.

As a rule, retroflexio uteri is treated by a gynecologist or an internist. The patient’s life expectancy is not reduced by the disease. Since retroflexio uteri can also lead to infertility, psychological treatment can also be useful to counteract psychological problems. A psychologist should be consulted for this.

Treatment & Therapy

A retroflexion of the uterus only requires actual treatment in the rarest of cases. As long as there are no complaints or accompanying symptoms, a correction of the position is usually not necessary. During pregnancy, a mobile, backward-leaning uterus usually straightens up anyway. If the patient so wishes, the doctor can also treat the backward-leaning uterus manually and push the organ into the correct position with his hands.

If the manual correction of the situation is unsuccessful, further treatment may take place. This treatment corresponds to a surgical procedure in which the doctor straightens the oran. However, this step is only taken if the phenomenon causes serious symptoms or is associated with adhesions.

During surgery, the doctor separates the adhesions to help the uterus regain its original mobility. If the twisted uterus is associated with infertility, the infertility will be monitored postoperatively and should ideally be resolved by correcting the position. If it persists, there may not have been a causal relationship to retroflexion and the infertility needs further investigation and treatment after surgery


Up to 20 percent of all women are affected by retroflexio uteri. A congenital positional anomaly cannot be prevented. The acquired form in the context of age-physiological or pregnancy-associated changes can be prevented in moderation. For example, there is speculation about the extent to which regular pelvic floor exercises keep the uterus in the correct position by tightening the surrounding muscles.


There are no special follow-up and preventive care options for congenital retroflexio uteri. However, if it is a question of a situational anomaly that has developed gradually, targeted measures are available to the women concerned to improve their situation. Therapy with pelvic floor exercises is considered to be relatively promising.

This should strengthen the surrounding muscles of the uterus and thus ensure a tightening. In most cases, if the symptoms are caused by pregnancy, they will go away on their own. This could be an indication that the regular gymnastic exercises are actually helpful. Once the uterus has regained its normal position from the backward tilt, further treatment is unnecessary.

Patients have the opportunity to carry out physiotherapy at home according to the doctor’s advice. If this gymnastics does not lead to regression, there are other options available, such as the use of a pessary. For the patients who suffer from pain in connection with the malposition, there are gentle painkillers from natural medicine.

They should be taken exactly as directed by your doctor. Gentle massage units and warm baths also help to reduce the symptoms. Women should observe their bodies closely and, if in doubt, consult their doctor in order to be able to counteract any complications in good time.

You can do that yourself

The retroflexio uteri usually recedes by itself. Over the course of pregnancy, the backward tilt of the uterus resolves and does not need to be treated independently. This process can be supported by targeted pelvic floor exercises and comparable measures from the field of physiotherapy. It is best for the patient to discuss any accompanying measures with the gynecologist or a physiotherapist.

If the retroflexio uteri does not regress by itself, a pessary must be used. Surgery is required for the fixed form of retroflexio uteri. After the procedure, the patient should not exert any physical strain for a few days. The symptoms should go away on their own within a week.

In the case of pain, natural painkillers from homeopathy can be used as an alternative to the medicines prescribed by a doctor. There are, for example, preparations such as the soothing St. John’s wort and various globules. The pain can be relieved with gentle massages in the affected area, but also with warm baths. If the symptoms persist, the gynecologist must be consulted. The backward tilt of the uterus may not have completely resolved, or there may be another complication that needs to be evaluated.

Retroflexio Uteri