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How do I use a menstrual cup with a tilted uterus?

Do you have a “tilted” uterus? If so, you may find that it takes a little practice to get a menstrual cup to work for you. But don’t worry! This doesn’t mean that you can’t use a menstrual cup. You absolutely can! It just may take a little extra effort to find the right cup for your body and to learn how to position it correctly. We’re here to help!

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What is a tilted uterus?

According to Better Health Channel, about 25% of women have a tilted or “retroverted” uterus, so you’re in good company!

tilted uterus menstrual cup

In most women, the uterus is tipped slightly forward so that it points toward the stomach. When most people use the term “tilted uterus,” they are referring to a retroverted uterus, where the uterus is tipped slightly backward, so that it’s aimed towards the rectum.

As you can see from the image below, there are actually several different ways the uterus can be positioned in the body:

  • Normal uterus position: tipped slightly forward
  • Retroverted / tilted uterus: tipped slightly backwards
  • Retrocessed uterus: the uterus is tilted forward, with the cervical opening pointed toward the back
  • Retroflexed uterus: The uterus is tipped backward and folded toward the back.
How to use a menstrual cup with a tilted uterus

In many cases, a tilted uterus doesn’t cause any problems, and women may not even be aware that their uterus is tilted. For others, a tilted uterus may cause symptoms such as painful sex, painful menstruation, and irregular menstruation.

What causes a tilted uterus?

Many women are simply born with a tilted uterus. In rare cases, a tilted uterus may be caused by an infection, such as pelvic inflammatory disease, or other conditions such as endometriosis.

What is a tilted cervix?

The cervix is the base of the uterus, so if the uterus is tilted, the position of the cervix will also change. With a retroverted uterus, the cervical opening may be pointed more towards the front. The cervix may also sit slightly lower or higher than normal.

If you’re using a menstrual cup with a tilted uterus, the position of your cervix may require you to position your cup differently. You may need to wear your cup lower in the vagina. You may also need to experiment with different methods of folding or insertion.

How do you know if your uterus is tilted?

It’s possible to have a tilted uterus and not even know it! Many women become aware of their tilted uterus when they’re pregnant, for example during an ultrasound appointment. Some women say they didn’t even know they had a tilted uterus until they were pregnant with their third child! Others say they didn’t find out about their tilted uterus until they asked their gynecologist directly, even though it had been written on their medical chart for years.

If you suspect your uterus is tilted or your cervix is otherwise in an unusual position, ask your doctor at your next appointment. If you have a tilted uterus, it’s possible that your doctor has noticed, but didn’t mention it if you weren’t experiencing any symptoms.

Learn more about common side effects of a tilted uterus.

If you’re curious about the position of your cervix, you may be able to determine that on your own. Check out our blog post about how to measure your cervix. In addition to determining how high or low your cervix is, try to feel for the opening. Does it feel like your cervix is pointed forwards or backwards? If so, it may affect how your need to wear your menstrual cup.

What is the best menstrual cup for a tilted uterus?

We designed our Pixie Cup Slim especially for women with a tilted uterus. It is more of a slim shape than the Classic Pixie Cup and is made with a softer material, which many people find more comfortable when wearing it lower in the vaginal canal.

You may also want to give our Pixie Disc a try! A disc is inserted higher in the vaginal canal and does not create a seal, but instead collects flow from directly under the cervix. 

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Can a tilted uterus cause problems with using a menstrual cup?

The answer to this question completely depends on your body and how your period cup fits you! Some women who have a tilted uterus find they have difficulty getting their menstrual cup to pop open or seal properly, but many women have no issues at all.

If you have a retroverted uterus or tilted cervix, try these tips for inserting your menstrual cup.

Insert your cup a little lower

If your uterus, and therefore your cervix, is tilted, your cup should still be able to seal properly below the cervix in your vaginal canal and catch your flow with no problems. This is why we often recommend a smaller cup, such as our Pixie Cup Slim, for women with a tilted uterus.

Trim the stem

Because your cup needs to sit a little lower in your vaginal canal, you might need to trim the stem of your cup. Just remove and sanitize your cup, grab a pair of scissors, and trim away! If needed, you can file any sharp corners with a disposable nail file to get rid of rough edges.

Check the position

If your cervix is at an angle, and your cup doesn’t line up properly with the opening, it could cause leaks. This is why being familiar with the position of your cervix can help you make sure you have a proper fit, and why inserting your cup lower in the vaginal canal often helps. The important thing is to get your cup to sit beneath the cervix, rather than right up against it.

menstrual cup leaking

Try a different fold

Some menstrual cup users find that the way they fold their cup affects the fit and the seal. See our blog post on different folding techniques and try experimenting with different ways of inserting your cup.

Give it time

If you experience leaks at first, keep trying your cup at different angles and positions. Even if it doesn’t work quite right at first, most people are able to adjust and use a menstrual cup easily after some practice.

If you’re still unsure…

Ask us! In our years of experience in the menstrual cup industry, we’ve learned lots of tricks, and we’ve been able to help hundreds of women like yourself find the right fit. Often, menstrual cup leaks or discomfort are the result of improper positioning, not the fault of the cup itself.

We love talking about menstrual cups, so contact us if you have any questions!

Our guarantee

Your happiness is our priority. We offer a 100% satisfaction guarantee, and if you aren’t completely happy with your cup, we will give you a full refund. We’ll also work with you to help you find something that works for your body — even if it’s another company’s product! We understand that every body is different, and sometimes another product will work better for you.

Even if you request a refund, you can keep your Pixie Cup! Menstrual cups are completely sanitary once they’re cleaned (we recommend our menstrual cup steamer), but we understand you may not feel comfortable giving it to someone else if it’s been used. But don’t just throw it out!

Our bodies are always changing. Store your cup away, and you may find that it fits better after a few years. It’s especially common for our bodies to change after giving birth. In fact, if you have a tilted uterus now and you have children later, your uterus could straighten out after going through a few pregnancies! So just because your cup doesn’t fit quite right now, that doesn’t mean it might not work for you later. (Plus, you’ll have a backup if you lose your cup or if your dog eats it — which has happened!)

So go ahead, give Pixie Cup a try! You have nothing to lose! Order now and receive free shipping on orders of $25 or more!

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PLEASE NOTE: This blog post is not intended as a substitute for the medical advice of your doctor. You should regularly consult a physician in matters relating to your health and particularly with respect to anything related to menstruation. If you have any concerns about using a Pixie Cup, consult your doctor before use. If you have any gynecological conditions, please talk to your physician before using any menstrual cup.

This content was originally written on March 4, 2019, and has been updated for freshness, accuracy, and comprehensiveness.

Hannah L.

If you’ve read the Pixie Cup blog, emails, updates or… well, anything lately, Hannah probably wrote them. She's a business owner, self-made writer and marketing expert. Experience in Mailchimp, ConvertKit, SnapChat, Pinterest and SMS Marketing.

13 thoughts on “How do I use a menstrual cup with a tilted uterus?”

  1. Hi!

    I wanted to make note that this article was about titled cervixes but the last picture of the correct ways to insert the cup were all pictures of a normal cervix. Are there any pictures a tilted cervix with the cup inserted?

    Reply
    • Hi Rakiya, yes, the largest photo in the post is a picture of menstrual cups inserted with different cervix heights and positions. All showing that it will work, it just may need help finding the right style or how to insert your cup! Please let us know if you have more questions – we’re so happy to help!
      Tilted Cervix

      Reply
  2. Hi! So my cervix is pointed really far to the right, is that still a tilted cervix?

    Anyway, when I try to insert the menstrual cup it doesn’t unfold and stays flat no matter how much I twist/ try to reposition it. When I think I’ve done it right, it rides up so far that it doesn’t even cover the cervix and I leak. Do you know what I’m doing wrong?

    Reply
    • Hi Poppy! I’m so sorry it’s not working out for you quite yet! Cups are definitely a learning curve, but you’ve got this! Someone from our customer service team will reach out ASAP.

      Reply
      • I bought the XL pixie cup because I was having trouble with regular sized cups. After still having leaks and placement issues and reading this I think it’s probably because of my tilted uterus! I wish I had ordered the disc…

        Reply
        • Hi Lisa! We offer a 100% Happiness Guarantee – so we’ll send you a disc to try! I will have our Customer Service team email you.

          Best,
          Kayla

          Reply
  3. Hi thanks for this info. I have a slight tilted cervix but don’t seem to have any leaking problems with the cup. Question: is it normal that as I insert, the cup suddenly disappears? It’s like it gets swallowed up. While it’s comfortable tucked away, when the time for removal comes it really hurts as it comes back out, like it was too far up. Any tips? Really appreciate the help!

    Reply
    • Hi Anna! Prior to removal, find the stem. If you’re able to slide one finger up the side of the cup, this will help break the seal and continue pressing to collapse the cup. This should make it smaller and easier to remove.

      Reply

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