The cervix is part of the female reproductive system. It is the lowest part of a woman’s uterus and is often referred to as the neck of the womb, joining it to the top of the vagina. Any condition which can affect the cervix has possible implications for a woman’s fertility. In America, it is estimated that between 10 to 15% of couples are infertile (meaning that they have tried unsuccessfully to conceive a child for two or more years). A third of infertility problems are related to the male reproductive system and a third to the female system. The remaining third are cases where there is no clear underlying cause for infertility. Many cases of infertility will resolve naturally, but others cannot be treated successfully or will require medical assistance before a conception can take place.
In this article, we will look at a condition affecting the neck of the womb and explain what causes stenosis of the cervix.
Cervical Stenosis And Infertility
Cervical stenosis is considered to be a non-cancerous gynaecological condition. In medical terms, stenosis just means a narrowing of a passageway or bodily canal. With this clarification in mind, cervical stenosis simply means that the diameter of the cervix has been reduced (narrowed) for some reason. In a patient with cervical stenosis, infertility can occur and the cervix may become full of blood and/or pus. The cervix can become completely blocked as a result of the condition. The condition is relatively uncommon.
If the condition occurs in women who have not gone through the menopause, it may cause abnormalities with the menstrual cycle. These can present as the absence of periods; painful periods; or abnormally heavy periods. Infertility is caused since the sperm is unable to pass through the cervix to fertilize the egg.
The condition can lead to an accumulation of blood in the uterus (this is called a hematometra) and if blood and cells from the uterus flow back into the pelvis, it can cause endometriosis. Pus may also form and collect in the uterus, this condition is called pyometra. These two conditions may cause the uterus to bulge, which may be felt as a lump in the pelvic region, and produce pain
In post menopausal women, cervical stenosis may not present any specific symptoms.
Causes And Treatment Of Cervical Stenosis
So, what causes stenosis of the cervix then? The answer is that the condition can be congenital (i.e. present from birth) or it can develop as a result of a number of conditions including: cervical or endometrial cancer; surgery to treat pre-cancerous cells in the cervix; procedures used to remove the lining of the uterus to deal with persistent heavy periods (endometriosis); radiation therapy or the menopause.
It is possible to treat cervical stenosis. The treatment involves gradually dilating (expanding) the cervix by inserting small rods into the cervix at first and then progressively larger ones. A cervical stent may be inserted into the cervix to keep it open for between 4 and 6 weeks. Ultrasound is used to help the clinicians ensure that the rods are correctly located during the procedure. This technique has been able to restore fertility to some women suffering from cervical stenosis.
- The cervix: https://www.macmillan.org.uk/Cancerinformation/Cancertypes/Cervix/Aboutcervicalcancer/Thecervix.aspx
- Infertility: https://www.mayoclinic.com/health/female-infertility/DS01053
- Treatment: https://cat.inist.fr/?aModele=afficheN&cpsidt=19083483