Cervical screening tips if you have a tilted cervix
What's the lowdown?
A tilted cervix usually comes with a tilted uterus
25% of women will have a retroverted uterus (where the uterus is tilted backwards towards the spine)
Retroverted or tilted uteruses are not a problem in themselves but can make speculum examinations or cervical screening more difficult
Sometimes, a tilted cervix is associated with a gynaecological condition
Cervical screening is already uncomfortable, let alone when you have a tilted cervix. Hold up, what is a tilted cervix? What causes a tilted cervix?
Firstly, the cervix refers to the neck of the womb (uterus).
Uteruses are 75% anteverted – this is how the uterus usually sits in typical anatomy. When the uterus bends backwards, towards the spine, it is called retroverted. As the womb points backwards, the cervix will move further to the top of the vaginal canal, closer to your belly.
If the cervix is tilted, it is usually because your uterus is tipped backwards. Neither a tilted cervix nor a tilted uterus is a cause for concern. A tilted cervix and uterus can be a natural part of development, a variation of normal and won’t cause you any problems day to day1.
Symptoms of tilted cervix
Most women with retroverted uteruses do not know about it or experience any symptoms. Generally, they are told about their retroverted uterus during a doctor’s appointment or ultrasound scan.
It can be present from birth or develop later on in life. It can be a completely normal finding or associated with endometriosis, adenomyosis or fibroids. Sometimes during menopause, due to the weakening of pelvic ligaments, the uterus can move backwards2.
Tilted cervix smear test
A cervical screening test (sometimes called a smear, or pap smear) is a preventative test in women aged 25-64 to screen for the HPV virus. This virus is associated with cervical cancer. Typically during a cervical screen, a speculum (duck-billed shape device) is inserted into the vaginal canal to visualise the cervix. A small brush is used to collect cells from the cervix to be tested. It should not take longer than 5 minutes3.
With or without a tilted cervix, a smear test is not fun. 10/10 would not do for fun, but definitely recommend for the prevention of cervical cancer.
Some tilted cervix smear tests might be a bit more uncomfortable and sometimes it can be painful. There are some tips to make the procedure just a little more bearable:
- Give your healthcare professional a heads up so they are aware and can find a longer speculum which makes finding the cervix easier
- Try to take deep breaths, allowing your pelvic muscles to relax which makes the insertion smoother
- Let your healthcare professional know if you are in pain
- Put your hands into fists and sit on the top of them to bring the cervix forward and make it easier for the clinician to see
- Try the left lateral position if you clinician is willing to do this
Retroverted uterus treatment
There is no treatment for a retroverted uterus and that is because it does not need to be treated if it is not associated with another condition. It also has no impact on your fertility, so you have as much chance of getting pregnant as the next person. The only time you will need treatment is when it is associated with another condition.
We completely get it, smear tests are anxiety-inducing, let alone with a tilted cervix. If you would like to talk through this further, with doctors who have done a million smear tests, reach out to our medical team and tap into their top tips.
Dr Fatema Dawoodbhoy
Fatema is currently training in London as an Academic doctor, with a special interest in Obstetrics and Gynaecology. She is passionate about championing women to understand their bodies better and prioritise their health. She understands the importance of clinically accurate articles and has been writing engaging and educative medical content for 5 years.
Our medical review process
This article has been medically reviewed for factual and up to date information by a Lowdown doctor.