A Text-book of Diseases of Women

by Charles B. Penrose

III. Cervico-corporeal anteflexion, when the cervix and body of the uterus are both bent forward upon each other ([Fig. 82]).

Anteflexion of the uterus is a disease of single and sterile married women. It is very rarely found in women who have borne children. The disease is congenital or is caused by imperfect development during childhood.

Fig. 81.—Cervical anteflexion.

Fig. 82.—Cervico-corporeal anteflexion.

The fetal condition of a large cervix and a small, sharply-flexed body may persist. The posterior wall of the uterus may develop while the development of the anterior wall is arrested, and thus the uterus would be flexed forward. A mark of such arrest of development is sometimes seen in the atrophied or undeveloped anterior lip of the cervix. Anteflexion is usually accompanied by a small, undeveloped condition of the whole of the uterus, and often by poorly developed vagina, tubes, and ovaries.

It is probable that improper dress and hygiene during the period of puberty have much to do with the development of anteflexion. The early menstrual history sometimes points to poor development of the sexual organs. The menses often make their appearance much later than usual—sometimes when a girl is nineteen or twenty years of age—and when established, the function is often irregular, the bleeding recurring at long intervals.

The most prominent symptom of anteflexion of the uterus is dysmenorrhea, or painful menstruation. The dysmenorrhea is characteristic: violent pains in the center of the lower abdomen, extending down the thighs, occur for several hours before the bleeding begins. In the later years of the disease the pain extends to the whole of the pelvis and the back. The pain is caused, in all probability, by the accumulation of blood behind the obstruction in the cervical canal. When the blood begins to escape freely, the pain is relieved, and may be absent during the remainder of the menstrual period. The blood is often clotted during the first part of the flow. Nausea and vomiting may be present during the height of the pain.

The menstrual period may be followed by several days of great physical weakness and debility.