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Birth Control/Cervix position - is it normal?

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Question
Hello Dr.

I'm a 29yo female, trying to conceive for 1 year, had 2 chemical pregnancies so far.

Lately I've checked my cervix and for the past month I can feel it very far towards the back and very low, around where the tailbone is. So it's very low but far away, my finger can barely reach it - but it also feels like the vagina goes almost horizontally towards the back. When I insert my finger it goes up like a hill towards the back then down again and the cervix is very low at the end of it, around 7-8cm from the vagina.

It feels firm and round, facing towards the back/tailbone.

Is that a normal position? It used to be towards the back but higher up, like 2-3 cm higher than now. The vagina has the same length though.

I haven' felt it this low and far back before. I am not pregnant (ovulated 5-6 days ago).

Last transvaginal ultrasound was 2 months ago - normal, with a small amount of free fluid in Douglas pouch (16mm). Vaginal discharge & PAP smear tests normal.

I've also had some pains in the lower abdomen when having sex and when having bowel movements in the morning. When I lean forward when having sex from behind it's better.

Can the pain with sex be related to IBS (that I have)?

Can fluid in Douglas pouch lower the cervix? I'm afraid I might have some undiagnosed peritoneal cancer or something. Can this lower the cervix like that or am I exaggerating?

Thank you so much.

Answer
Most likely the position of your cervix is normal, although it would require a pelvic exam to know for sure.  The position of the uterus (forward, backward, etc.) can change over time, and it usually has no significance.

The pain with sex might be related to IBS, but that would be unusual.  It's often difficult to figure out the reason for pain with sex.  Endometriosis is another cause for pain with sex and bowel movements, but that requires a laparoscopy to diagnose.

Some fluid in the pouch of Douglas is normal, and won't affect the position of the cervix.  Undiagnosed peritoneal cancer would be very unusual.  Cancer would be a very unlikely cause of a low cervix.

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Norman Solberg

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