Everything You’ve Wanted To Know About Your Uterus

The uterus is an incredible organ that serves an important role in our reproductive health. It has also often been the subject of misinformation. In ancient times, scientists believed the uterus could wander throughout the body causing illness, and that it had to be lured back into place. While we’ve come a long way since then in understanding the female body, there’s always more to learn! In this edition of “What’s Up, Down There,” we’ll uncover everything you should know from the basic anatomy of the uterus to possible variations in shape and position that could affect your health.

What Is the Uterus?

The uterus is a muscular organ situated in the female pelvis that carries and nourishes a developing fetus during pregnancy. It is shaped like an upside-down pear and is approximately 3 inches long, 2 inches wide, and 1 inch thick. During pregnancy, it can grow from the size of a small grapefruit to the size of a watermelon. Yes, it’s super stretchy!

The uterus is made up of three layers:

The inner layer, called the endometrium, is where a fertilized egg implants and grows.
The middle layer, called the myometrium, is made up of muscle tissue that helps to contract during childbirth.
The outer layer, called the perimetrium (or serosa), is a thin layer of tissue that surrounds the uterus.

The uterus is attached to the cervix, which is the narrow neck of the uterus that opens into the vagina. The cervix is responsible for controlling the outflow of menstrual blood and the passage of a baby during childbirth.

Possible Uterus Positions

A typical uterus is slanted slightly forward towards the abdomen (known as an anteverted position). In certain cases, the uterus can be tilted backward toward your spine (also known as a retroverted position). This is known as a “tilted” or “tipped” uterus and affects approximately 25% of women.

Women who have a tilted uterus may be born this way or may have developed a tilted uterus after surgery like a C-section. Often, women with a tilted uterus won’t have obvious symptoms. A tilted uterus may be detected by your healthcare provider during a pelvic exam. If you experience symptoms, the most common are pain during intercourse or trouble when inserting a tampon. It’s important to note that this isn’t cause for alarm. You may simply need to adjust positions and learn to work with your body.

Those with a tilted uterus often wonder if it will affect their chances of conceiving. Good news! In most cases, a tilted uterus will not impede your chances of conceiving.

Overall, a slight variation in the tilt of your uterus is nothing to be concerned about. However, if you’re experiencing painful, heavy periods, painful bowel movements, and abdominal bloating it’s worth discussing with your provider. This could be a sign of a condition known as endometriosis. Many women with endometriosis may have a tilted uterus.

Different Uterus Shapes

A difference in uterine shape is known as a uterine anomaly. Most often, women won’t know they have a uterine anomaly until trying to conceive. Certain shapes can impact your chances of conceiving or carrying a pregnancy to term. Here’s a few of the most well-known uterine anomalies:

Unicornuate uterus: This condition occurs when only half of the uterus forms. The uterus is typically smaller in shape and only has one fallopian tube. Having a unicornuate uterus can increase your risk for preterm birth and miscarriage.
Bicornuate uterus: A bicornuate uterus has an indentation at the top, giving it a heart-shaped appearance with two separate uterine cavities. Those with a bicornuate uterus typically won’t have trouble conceiving. However, it can make labor more difficult as a baby may not have enough room to position head-down in birthing position. Therefore, those with a bicornuate uterus are at increased risk for a C-section delivery.
Septate uterus: This is a condition where the uterus is divided by a septum or wall, similar to what we have in our nose. Those with a septate uterus may experience difficulty conceiving and are at higher risk for having a miscarriage. There is also an increased risk of needing a C-section delivery.
Arcuate uterus: An arcuate uterus has only a minor irregularity with a slight dip at the top. Having an arcuate uterus does not affect your ability to conceive and should not impact your pregnancy and delivery.

The only way to know if you have a uterine anomaly is through a 3D ultrasound and MRI. If detected, your doctor can help you understand your options and develop a plan for achieving pregnancy, if that is your goal. It’s important to know there are options! In working with your Axia Women’s Health provider, you can determine the best course of action for you.

The uterus is a complex organ that plays an important role in our reproductive health. There are many different variations in uterine shape and position, some of which can impact our ability to conceive and carry a pregnancy to term. As always, it’s important to keep up with regular gynecologic exams and raise any concerns with your provider to stay on top of your health!