Round ligament: what is it and why it hurts?

February 28, 2024

In today’s article, we will discuss a topic of great interest to many women: the round ligament. A fundamental element of the female anatomy that often goes unnoticed until pain or problems related to its function occur. Let’s discover together the details of this important structure.

What is the round ligament?

The round ligament is an important anatomical structure in the female body. It is a fibromuscular cord that originates on the sides of the uterus and extends through the inguinal canal to the labia majora in the external genital area. Its main role is to keep the uterus in an anteverted position, that is, slightly tilted forward, a condition considered normal in most women.

During pregnancy, the round ligament gains considerable importance. As the months progress and the size of the uterus increases, this ligament stretches and adapts to support the uterus itself. Sometimes, the rapid increase in volume and weight can cause a tight or painful sensation known as “round ligament pain,” a common and generally unceremonious phenomenon that occurs during pregnancy.

Where does the round ligament hurt?

Round ligament pain is a symptom often reported by pregnant women, particularly during the second trimester of pregnancy. This pain manifests as discomfort or a pulling sensation, usually located in the lower abdomen or groin areas. The discomfort may be accentuated by sudden movements, changes in position, sneezing, or coughing and usually disappears with rest or a change of position.

Although round ligament pain is commonly associated with pregnancy, it can also be felt outside of this context with special stresses or specific conditions involving the female reproductive system. However, it is important to consult a physician for a proper diagnosis, as pelvic pain can be a symptom of several conditions, like polycystic ovary.

What are the uterus sacral ligaments used for?

The uterus sacral ligaments are another group of important ligaments located in the female pelvis. They originate at the back of the uterus, near the neck of the organ, and extend toward the sacrum, a part of the spine. Their main task is to support the uterus and keep it aligned with the rest of the genital apparatus. They are key structures in maintaining the stability and correct position of the pelvic organs.

In some situations, such as in the presence of endometriosis or other pathological conditions, the uterus sacral ligaments may be affected by inflammatory processes or scar tissue formation, causing pain and discomfort. In addition, their role is crucial during pregnancy and childbirth, as they must adapt to changes in the expanding uterus, maintaining its correct position.

What are the ligaments of the uterus?

The uterus is supported and maintained in position by a complex network of ligaments that includes, in addition to the aforementioned round ligament and the uterus sacral ligaments, the cardinal ligaments, and the broad ligaments. The latter extend from the sides of the uterus to the lateral walls of the pelvis and help support the blood vessels, fallopian tubes, and ovaries.

The cardinal ligaments, also known as the Mackenrodt’s ligaments, are considered the main supporting ligaments of the uterus. They are located at the base of the broad ligament and extend toward the connective tissue of the pelvis. All of these ligaments work together to ensure that the uterus remains in place and to provide support during movement and the various stages of a woman’s reproductive life.

How long does it take for a ligament to heal?

The healing of a ligament can vary significantly depending on the extent and severity of the injury. For mild strains, recovery can take a few weeks, while for more serious injuries or ruptures, the healing process can extend for months. It is critical that a professional would evaluate each injury. Treatment may include rest, physical therapy, orthopedic support, and, in some cases, surgery.

Rehabilitation plays a crucial role in ligament recovery. Through targeted exercises and therapies such as physical therapy, work is done to restore the strength and flexibility of damaged ligaments, as well as to prevent future injuries. Patience and strictly following the advice of professionals are essential for optimal healing.

Where does the round ligament of the uterus end?

Starting from the horns of the uterus, the round ligament travels a path through the inguinal canal to finally reach the labia majora region. The end of its path is located in the very area of the subcutaneous tissue of the labia majora, where it branches off and loses its compact structure. This final location allows the round ligament to exercise its function of supporting and maintaining the uterus in an anteverted position.

Recall that despite its small size compared to other ligaments in the body, the round ligament plays a critically important role in female reproductive health. Therefore, any unusual signs or pain you experience in this area should be evaluated by a trained physician.

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SOURCES

Chaudhry SR, Chaudhry K. Anatomy, Abdomen and Pelvis: Uterus Round Ligament. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499970/

About the Author

Severino Cirillo

Health, Wellness and Education Expert. With a degree in Community Health, he is the CEO of Informed Parent and is responsible for validating the blog's scientific information and coordinating the editorial team of experts, consisting of gynecologists, midwives, psychotherapists, and others in pregnancy, perinatal, and parenting wellness and health.