Tuberculosis (TB) is often associated with the lungs, but it can also affect other parts of the body. One less commonly discussed form is uterine tuberculosis, a type of genital tuberculosis that affects the female reproductive system. This condition can have significant health implications if not diagnosed and treated promptly. To explore uterine tuberculosis, its symptoms, risk factors, and treatment options, the Onlymyhealth team spoke to Dr Manisha Rastogi, Consultant, Obstetrics and Gynaecology, Sparsh Hospital, Jaipur.
What is Uterine Tuberculosis?
According to the India Journal of Medical Research, uterine tuberculosis is an infection of the uterus caused by Mycobacterium tuberculosis, the bacteria responsible for TB. It typically spreads to the uterus from other infected areas, most commonly the lungs. This condition can affect the endometrium (the lining of the uterus) and other reproductive organs, leading to various complications, including infertility.
Symptoms of Uterine Tuberculosis
Dr Rastogi said, “The symptoms of uterine tuberculosis can be subtle and nonspecific, making diagnosis challenging.” She listed some common symptoms of uterine TB:
- Irregular Menstrual Cycles: Women may experience irregular periods, heavy bleeding, or scanty menstrual flow.
- Pelvic Pain: Persistent pain in the pelvic region is a common symptom.
- Infertility: Uterine tuberculosis is a significant cause of infertility in women, as it can damage the reproductive organs.
- General Malaise: Symptoms like fatigue, low-grade fever, night sweats, and weight loss can also occur.
- Vaginal Discharge: Unusual or abnormal vaginal discharge may be present.
Risk Factors for Uterine Tuberculosis
“Gynaecologists have identified uterine tuberculosis as a significant cause of subfertility and infertility. In India, approximately 10% of women dealing with infertility are affected by genital tuberculosis, which includes the uterus. As a result of uterine tuberculosis, 20% of women are unable to conceive. In severe instances, the uterine lining can become excessively thin, preventing successful implantation and leading to miscarriages,” said Dr Rastogi.
That is why it is important to be aware of its risk factors. According to a study published in the journal ‘Public Health,’ several factors can increase the risk of developing uterine tuberculosis:
- Exposure to TB: Being in close contact with someone who has active tuberculosis increases the risk.
- HIV Infection: Immunocompromised individuals, especially those with HIV, are more susceptible to TB infections.
- Previous History of TB: A history of pulmonary or extrapulmonary tuberculosis can predispose an individual to uterine TB.
- Living in High TB Prevalence Areas: Women living in regions with high rates of TB infection are at greater risk.
- Weakened Immune System: Conditions that weaken the immune system, such as diabetes or malnutrition, can increase susceptibility.
Uterine Tuberculosis Treatment
“The good news about uterine tuberculosis is that if it is detected early and treatment is availed timely, then the damage caused by uterine TB can be 100% reversed,” said Dr Rastogi.
She suggested that if a patient diagnosed with uterine TB completes their course of treatment from six to nine months, it can also increase their chances of conceiving.
The treatment of uterine tuberculosis involves a combination of anti-tuberculosis medications, similar to those used for pulmonary TB. The treatment regimen typically includes:
- First-Line Anti-TB Drugs: These include isoniazid, rifampicin, ethambutol, and pyrazinamide. The standard course lasts for six to nine months.
- Monitoring and Follow-Up: Regular follow-up appointments are essential to monitor the patient’s response to treatment and manage any side effects of the medications.
- Surgery: In severe cases where there is significant damage to the reproductive organs or if there is no response to medical therapy, surgical intervention may be required.
Uterine tuberculosis is a serious but treatable condition. Awareness of the symptoms, risk factors, and treatment options is crucial for early diagnosis and effective management. If you experience any of the symptoms mentioned or are at risk, consult a healthcare provider for appropriate evaluation and treatment. Timely intervention can prevent complications and improve reproductive health outcomes.