What are the consequences of the uterus being sometimes anterior and sometimes posterior?

The uterus is very important to every woman. It is not only an organ but also a treasure land for nurturing life. However, in life, problems with the position of the uterus of many women will affect their fertility. For example, some women have an anterior uterus, some have a retroverted uterus, etc. What are the effects of these different positions? Next, I will introduce it to you in detail!

Excessive antevertion or retroversion of the uterus. The normal position of the uterus is anteverted, that is, the fundus of the uterus is toward the pubic bone, and an obtuse angle of 120° to 150° is formed between the cervix and the uterine body. About 80% of women have an anteverted uterus, 20% have a retroverted uterus, and less than 5% have symptoms. Retroversion and flexion of the uterus is the most common displacement, followed by antevertion and antevertion. Most people have no symptoms, but a few with retroflexion may experience back pain, anal distension, dysmenorrhea, excessive vaginal discharge, and in severe cases, infertility. Gynecological examination can confirm the diagnosis. Asymptomatic people do not need treatment and can naturally return to normal position by lying on their knees and chest every day. For those with symptoms, manual reduction can be performed and a pessary can be inserted to maintain the anteversion of the uterus. If combined with other diseases, treatment should be directed at the cause. Excessive anteflexion of the uterus is mostly a congenital disease, with a small uterine body and a slender cervix. The angle between the uterine body and the cervix is ​​less than 90°, which can occasionally cause dysmenorrhea or infertility. Treatment can be done by dilating the cervical canal with a cervical dilator and artificial cyclical therapy with female hormones.

2 Common Types

The normal position of the uterus depends on the support of the pelvic floor muscles and their fascia and the ligaments attached to the uterus (especially the cardinal ligaments). Under normal circumstances, the position of the uterus may change slightly when the body position changes, when the bladder or rectum is full. The position of the uterus may change when the tissue supporting the uterus is damaged and becomes loose, or when the pelvis is tilted, or when you sit, stand, or lie in bed for too long. Pelvic inflammatory disease, pelvic abscess, adhesions from an old ectopic pregnancy, or endometriosis can pull the uterus backward or fix it in a posterior position. There are two common types of uterine displacement:

Retroverted uterus

The most common. If the entire uterus moves toward the sacral concavity while the relationship between the uterine body and the cervix remains unchanged, it is called retroversion of the uterus; the uterine body may also be significantly retroflexed. The retroverted uterus can be divided into three degrees according to the degree of retroversion: the uterine fundus is inclined towards the sacral promontory (degree one), the uterine fundus is inclined towards the sacral concavity (degree two), and the uterine fundus is inverted into the rectouterine pouch (degree three) (Figure 2). A mildly retroverted uterus that is mobile is usually asymptomatic. Those with obvious posterior position are often accompanied by ovarian prolapse, and may experience soreness in the waist and back, a feeling of heaviness in the anus, or pain during sexual intercourse. A retroverted and retroflexed uterus can cause abnormal menstruation, dysmenorrhea, and excessive leucorrhea due to thickening of the uterine wall, or it can cause infertility by hindering the entry of sperm into the uterine cavity due to the upward external os of the cervix. Diagnosis mainly relies on bimanual or triple examination to determine the position, size, mobility of the uterus and whether there are prolapsed ovaries. An asymptomatic, mobile posterior uterus does not require treatment. Regular daily knee-chest position for a longer period of time may result in the natural repositioning of a mobile posterior uterus. For those with symptoms, manual reduction can be performed during a bimanual or triple consultation, and then a suitable pessary can be inserted to maintain the anteflexed position of the uterus. For patients with severe retroverted uterus and obvious symptoms, whose symptoms improve after manual reduction or reduction with a pessary; or for patients with infertility for which no other cause can be found except retroverted uterus, surgical treatment may be considered. If it is secondary to inflammation, tumor, endometriosis, etc., the cause should be treated first.

Excessive anteverted uterus

Most of them are congenital lesions. The uterine body is small and the cervix is ​​slender. The angle formed by the uterine body and cervix is ​​less than 90°, and the external cervical opening faces the anterior wall of the vagina. It generally does not affect health, but may cause dysmenorrhea or infertility. Treatment can be with cervical dilation to widen the cervical canal and/or artificial cyclical therapy with sex hormones.

Through the above introduction, everyone now has a clear understanding of some health knowledge about uterine health. So in life, female friends should not forget to protect their uterine health while taking care of their bodies. It is very good for both themselves and the baby.