"Ask Dr. Cook" is a series of questions and answers regarding endometriosis. The current subject and answer can be found on Current Ask Dr. Cook web page. The questions may represent a summary of questions I have been asked by several different patients. I hope you find this information helpful. If you have a question you would like answered, please Submit A Question.

Uterus Tipped to the Side

Question:
I have endometriosis and I am hoping that you might be able to provide me with some insight. I recently had a trans vaginal ultrasound done, the results came out with the following. My uterus,(which has always been tipped) is now not only tipped but it has moved to my left side, which is causing pain and a great deal of pelvic pressure. What causes this to happen? What, if anything can be done to move it back into place?

Answer:
In a patient with endometriosis, a uterus which is tipped to the side is often a sign of uterosacral ligament involvement with endometriosis. These ligaments (one on the right and one on the left) are low in the pelvis connecting the lower uterus to the lower back. They are also near the bowel and the top of the vagina. Because of their location, they often cause pain in the lower back, pain with deep penetration with intercourse and can cause bowel symptoms when involved with endometriosis. As these ligaments become involved with endometriosis they become scarred and shortened. If the left uterosacral ligament is involved more than the right it will tend to pull the uterus to the patients left. You may also notice leg pain, probably more on the left than the right. As the nerves coarse from the spine to the leg they pass through the pelvis. Endometriosis involving these nerves in the pelvis can result in pain radiating down the leg(s). Complete removal of the endometriosis will usually result in the uterus returning to the correct position and resolution of the associated symptoms.

Updatede October 29, 2005