Quick Guide: Using the Best Menstrual Cup for a Tilted Uterus
- Yes, you can use a menstrual cup with a tilted uterus. A retroverted or retroflexed uterus is common and usually doesn't stop a menstrual cup from working effectively.
- Many people with a tilted uterus also have a lower cervix, so a smaller menstrual cup with a trimmable stem, like the Ruby Cup Small, is often the most comfortable option.
- Try different folding techniques and insertion angles until the cup sits comfortably below your cervix and forms a secure seal.
- Once you've found the right position, trim the stem if needed to reduce irritation and improve comfort.
- Finding the best menstrual cup for a tilted uterus may take a little trial and error, but with the right size and placement, most people can wear one comfortably without leaks.
You may or may not know whether you have a tilted uterus, aka a retroverted uterus. Not to worry, Ruby Cup is here to help you figure out which way your uterus tilts and what is the best menstrual cup for a tilted uterus.
Keep reading to learn:
- What a tilted uterus is (and how to know if you have one).
- How to use a menstrual cup with a tilted uterus.
- Foolproof cup-folding and placement tips for maximum comfort without leaks!
- How to find the best cup for you—and the planet.
Quick Answer: Can you use a menstrual cup with a tilted uterus?
Yes, you can. A tilted uterus doesn't prevent you from using a menstrual cup successfully. Finding the right size, insertion angle, and position may take a little experimentation, but most people can wear a menstrual cup comfortably regardless of how their uterus tilts.
Menstrual cups are a safe, reusable period product suitable for people with many different body shapes and anatomies. If you have a tilted uterus, you may simply need to experiment with placement and folding techniques until you find what feels most comfortable. Ruby Cup is here to guide you through the process.
But first, what is a tilted uterus?
A tilted uterus, called a retroverted uterus for those in the medical world, is just a uterus that tilts back towards your tailbone, instead of more towards your midline or even forward towards your pelvic bone (called an anteverted uterus). It reaches back towards your spine instead of forward towards your belly.
About one out of every five people with a uterus has a tilted, tipped, or retroverted uterus. Sometimes a retroverted uterus rolls back on itself, and this is called a retroflexed uterus.
When talking about your uterus and how it sits in your body, it can be helpful to imagine that your uterus is like an upside-down pear, suspended above the bowl of your pelvic floor. That pear can tilt in different directions, like a blade of grass being blown forward or backward by the wind. The way it’s tipped or tilted impacts how high or low your cervix (the mouth of your uterus) is in your vaginal canal.
More commonly, the uterus tilts forward towards the pubic bone and away from the tailbone. This is called an anteverted uterus. Sometimes a forward-tilting uterus can fold over on itself, which is called an anteflexed uterus.
Is there a connection between having a tilted uterus and a short cervix?
Yes. Many people with a tilted uterus also have a lower cervix, although this isn't always the case. Measuring your cervix during your period is the best way to determine your cervical height and choose the right menstrual cup size. If you have both a tilted uterus and a low cervix, a menstrual cup designed for a low cervix is often a good choice.
Cervical height is the distance from the outside of your vagina (your vulva or the lips of your vagina) through your vaginal canal to your cervix. The cervix is the muscular opening to the uterus. Your cervix can feel like the tip of your nose if you are searching for it with your finger in your vagina.
But how do you measure your cervical height to know if you have a short cervix?
Ruby Cup offers an easy DIY guide to measuring your cervix and finding the right menstrual cup for a low cervix. Here’s a step-by-step guide to measuring your cervix height:
- Wash your hands.
- Insert your longest finger into your vagina. You can do this lying down or with one foot up on the edge of the bathtub or toilet rim. You can even measure during your period!
- Feel for your cervix - it will be smooth, round, and firm, almost like the tip of your nose feels.
- If your longest finger goes all the way into your vagina until you can feel your cervix, then you have a high or long cervix.
- If your longest finger only goes into the first or second knuckle before you reach your cervix, then you have a shorter or lower cervix.
Why does it matter if you have a short cervix or a tilted uterus when it comes to menstrual cups?
Because people with a lower or shorter cervix typically have better luck with smaller menstrual cups and cups with shorter or no stems. Other types of menstrual cups may work better for people with high cervixes.
Also, if you have a tilted uterus, it can be trickier to find your cervix. But finding and measuring your cervix can be helpful because:
- Knowing how high in your vaginal canal your cervix sits can help you choose the best-fitting menstrual cup.
- Your cervix moves over your menstrual cycle. Check your cervical height during or after your period to find the best fit for a menstrual cup.
- If you have a tilted uterus, your cervix may be towards the front of your vaginal canal, by your pubic bone and bladder.
How do you know if you have a tilted uterus?
You may not. Sometimes it may take healthcare professionals a little bit longer to locate your cervix during a gynecological exam. Some people with tilted uteruses can have pain during sex or more painful periods, so in seeing a healthcare provider about these concerns, you might learn that your uterus is tilted during a pelvic exam.
If your healthcare provider hasn’t said you have a tilted uterus, and you suspect you may have one, why not ask? It’s your body, why not learn all that you can about it? It can be empowering to know which way your uterus tilts, your cervical height, and what your vagina and cervix look like. If you’re up for it at your next appointment, you can ask your provider to help you see your cervix during the speculum exam with a hand-held mirror.
Having a tilted uterus rarely causes symptoms or any health problems. Research shows that having a tilted uterus does not:
- Impact your ability to have a normal, healthy pregnancy.
- Prevent you from having a normal, healthy vaginal delivery.
- Influence your postpartum recovery.
Remember that the cervix and uterine position can change after vaginal childbirth, so if you’ve found the best menstrual cup for a retroverted uterus and plan to wear one postpartum, you may want to ask your provider about whether or not childbirth changed your uterus’s position in your pelvis. Sometimes people have heavier flow after childbirth, so you may need to try a larger capacity menstrual cup.
Your uterus may also change due to scarring from endometriosis, fibroids, and pelvic inflammatory disease. Most important for you to know about having a retroverted or tilted uterus is that there’s nothing abnormal about having a retroverted or retroflexed uterus. There’s no reason to feel embarrassed or worried. Many, many people live their whole lives without knowing that they are packing a tilted uterus.
For more help choosing the right menstrual cup for you, check out our beginner's guide.
What to look for in a menstrual cup if you have a tilted uterus
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Smaller cup.
If you also have a low cervix, a smaller menstrual cup may sit more comfortably and be easier to insert and remove. That's why many menstrual cup brands, including Ruby Cup, offer different sizes to suit different anatomies.
Not sure which size is right for you? Check out our menstrual cup size guide or take our quick quiz to find your best fit in just a couple of minutes.
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Soft to medium firmness
A cup made from soft, medical-grade silicone is easier to fold and can make insertion more comfortable, especially while you're learning what angle and position work best for your body. At the same time, the cup should be firm enough to open properly and create a secure seal. Ruby Cup is designed to provide that balance.
The best folds to try are the Punch-down fold, C-fold, and 7-fold, all demonstrated in our how-to-use Ruby Cup guide.
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Shorter stem.
A trimmable stem lets you customise the fit once you've found the most comfortable position for your cup.
If your cervix sits lower in your vaginal canal, a longer stem may:
- Feel noticeable or uncomfortable at the vaginal opening.
- Cause irritation during everyday activities.
Many menstrual cups, including Ruby Cup, have a stem that you can trim gradually until it feels comfortable while still leaving enough length to help with removal.
How to use a menstrual cup with a tilted uterus
We’re going to dive into more detail here about how to use a menstrual cup with a tilted uterus. Regardless of which way your uterus tilts or your cervical height, learning how to use a menstrual cup without leakage or discomfort takes practice.
Knowing where your menstrual cup should sit is something you may need to experiment with to find the best fit. Here’s our step-by-step guide for finding a menstrual cup for a retroverted uterus:
1- Try using a smaller cup
If you also have a low cervix, a smaller menstrual cup may be more comfortable and easier to wear. While a tilted uterus doesn't always mean you have a low cervix, the two can occur together, so choosing the right size can make a big difference.
If you're unsure which size is right for you, you may need to experiment. That's why Ruby Cup offers the Ruby Cup Duo, which includes both a Small and a Medium cup for lighter and heavier flow days.
2- Try different folds
There are several different ways to fold your menstrual cup before inserting it into your vaginal canal. Check out Ruby Cup’s how to use a menstrual cup guide to become a master of menstrual cup folding. The fold that we recommend for beginners is the punch-down fold.
Saying that, try all the different folding methods and find the technique that works best for you and your body.
3- Let your cup open before pushing it higher
Wearing your cup too close to your cervix can cause it to suction onto the cervix instead of your vaginal walls, which can be uncomfortable or painful. Wearing it too low can cause leaks or make it feel noticeable at the opening. The fix for both: let the cup open early and low in your vaginal canal, then slide it up only until it sits comfortably below your cervix.
Try applying some water-based lubricant around the rim of your cup to make insertion easier. Use a water-based lubricant that will not break down the silicone of your menstrual cup. This method is great for discovering what height is most comfortable for you.
If you have a tilted uterus, you may bump against your cervix while positioning the cup — pinch the base to break the suction and slide it down. And remember, menstrual cups don't need to be worn as high as tampons if you're used to wearing tampons.
4- Trim the stem
Once you’ve found the ideal location in your vagina for your menstrual cup to call home, you can trim the stem with scissors if it is bothering you or is uncomfortably long.
It’s ok if you trim off more than you need, but keep in mind that the shorter the stem, the harder it may be to remove your menstrual cup.
Why choose Ruby Cup for a tilted uterus
Finding the right menstrual cup is about choosing one that fits your anatomy as well as your flow. If you have a tilted uterus—especially if you also have a low cervix—you may find that a smaller cup with a trimmable stem is more comfortable and easier to position correctly.
Ruby Cup is designed with these needs in mind. It features:
- A small cup option that's often more comfortable for people with a lower cervix.
- Soft, medical-grade silicone that folds easily for comfortable insertion while still opening reliably to create a secure seal.
- A trimmable stem so you can customise the fit if your cervix sits lower in the vaginal canal.
- Air holes around the rim to help create a secure seal while making removal easier.
Whether you're new to menstrual cups or switching because of comfort or leaks, Ruby Cup is designed to provide a comfortable fit that adapts to your body.
Beyond comfort and performance, choosing Ruby Cup also supports menstrual equity. Through our Buy One Give One programme, every cup purchased helps provide a menstrual cup and menstrual health education to someone who otherwise wouldn't have access to reusable period care.
Period poverty is a huge issue, with many people not having access to safe period products. Ruby Cup not only donates menstrual cups but also provides educational workshops to fight stigma and teach about reproductive health.
Your body is unique, as are your intimate parts. We at Ruby Cup encourage you to use your menstrual cup journey as a way to learn more about your body, including which way your uterus tilts. Reach out to your healthcare provider with any questions and even use Ruby Cup as your go-to resource. We cover everything about your whole menstrual journey, from beginner-cup-users to, well, tilted uterus and advanced folding techniques!
