Malposition of the uterus. In the past, this has been invoked as the cause of numerous conditions, including pelvic pain, back pain, abnormal uterine bleeding, infertility, and emotional difficulties. Simple malposition of the uterus without evidence of a specific disease condition that accounts for the malposition is felt to be harmless and virtually symptomless. It is essential, therefore, that individuals who have been told that a tipped uterus is the cause of their symptoms be carefully examined to attempt to find a specific organic cause for the symptoms. If in the absence of other findings a vaginal pessary relieves symptoms associated with a retro-displaced uterus and these symptoms return when the pessary is removed, then surgical suspension of the uterus is indicated. If surgery is not acceptable to the patient, the pessary may be worn intermittently. Evidence is lacking that a tipped uterus is an important cause of pelvic pain and discomfort.