Ipsum Tipsum—The Tipped Uterus

I get all kinds of letters, even from women with tipped uteruses. I suspect the reason a woman with a tipped uterus writes to me is because she doesn't feel comfortable discussing the ins and outs of intercourse with her gynecologist. So that's what I will focus on today, figuring you are comfortable discussing non-sex questions with your healthcare provider.

Some of you—okay, most of you—might be wondering what a tipped uterus is. Let's start with the following multi-choice question that is given to every first year medical student:

You can tell a woman's uterus is tipped when:

a. she has a five-dollar bill between her legs
b. she has to buy tampons for left-handed women where the string attaches on the other side
c. she says her partner's penis crashed into her uterus and flipped it upside down
d. none of the above

For most women, the answer is d.

Between 15% and 25% of women have a uterus that is tipped, retroverted or tilted to some degree. These three terms more or less mean the same thing—that the uterus points backwards and sits on the assward side of your vagina instead of on the belly-button side.

Think of the standard, factory-equipped female pelvis as having a vagina and uterus that more or less make a "p". The vagina is aligned like the straight part of the p, and the uterus sits above it like the round part of the p.

If the uterus is tipped, the arrangement becomes more like a "q", where the uterus points the opposite way.

Given how the penis slides up the straight part of your "p" or "q", intercourse positions that work well for a woman with a "p" alignment might not work as well for a woman with a "q" alignment. What you are trying to maximize is a smooth sliding path where the penis can make it all the way in without banging into your uterus. Significant factors will include the size of your boy's piston, the way it points when erect, and the intercourse position you are in. Another factor will be the way your uterus shifts when you are sexually aroused.

The uterus isn't welded into place. It can change position, especially during sex when a girl is really into it as opposed to when she's mentally making a shopping list. This means that unless you are one of those rare girls who finds a pelvic exam to be a sexual turn-on, your gynecologist isn't going to know exactly where your uterus will be pointing when the object of desire is your partner's penis instead of a speculum and gloved fingers.

Most women who have a tipped uterus didn't find out about it until they had a pelvic exam. Most would have gone through life perfectly happy without ever knowing, and most still do. As for intercourse positions, here's what three women who took our sex survey at www.goofyfootpress.com report, but keep in mind that what works for you may be very different than what works for another woman with a tipped uterus:

"My uterus is tilted. It makes doggy style intercourse painful. I prefer to be on top of my boyfriend."

"I have a very tipped uterus. Unless I'm pregnant they can't pick it up on a regular ultrasound because it leans so far backwards. Intercourse feels best with me on top or missionary. I've found that doggie style isn't very comfortable for me, nor is me being on top while facing his feet. As long as we are close to each other, belly touching belly, deep thrusting is fine. If we are separate, like if I'm laying down and he is in an upright position, deep thrusting can be uncomfortable. Where I'm at in my cycle also plays a role in how comfortable or uncomfortable things are."

"I have a tipped uterus and this may be why it hurts when my partner thrusts too deep. It may also be why I don't like to be penetrated from the rear. Being on top is the most comfortable position for me and the one that provides the highest likelihood of orgasm."

As an aside, I noticed that a lot of women with a tipped or tilted uterus refer to it as an "inverted uterus." Trust me, an inverted uterus is a very different beast—it is a rare event that happens when your uterus turns inside out after you just gave birth. Using an IUD is seldom a problem, although insertion might be a little different if you have a "retroverted uterus." If you are interested in menstrual cups during your period, some women find that The Keeper works better with a tipped uterus than Instead.

Also, the uterus can sometimes become tipped due to a problem such as endometriosis, so if you start having discomfort with intercourse, be sure to tell your doctor. As with all questions regarding matters of health, the information in a newspaper can never take the place of a hand's on exam from a
gynecologist.