Irregular Menstruation, Reduced Bleeding Can Be Sign Of Genital TB

As 60-70 per cent of women fall victim to genital Tuberculosis (TB) — largely a cause of infertility — doctors have said that women with menstrual irregularities, reduced bleeding, scanty menses and infections in the cervix could be suffering from genital TB.

Terming genital TB a silent disease, the gynaecologist have said that the uterus manages to heal well only among those whose infection is diagnosed quickly and provided with timely treatment.

A thick, healthy lining of the uterus, known as the endometrium is necessary for a healthy menstrual cycle and pregnancy.

Among those with genital TB, 55 per cent affects the tubes, 40 per cent infects the endometrium or the lining of the uterus, 10 per cent affects the ovaries, five per cent affects the cervix. Only among those whose infection is diagnosed quickly and provided with timely treatment, the uterus manages to heal well, said Bandita Sinha, Consultant Obstetrician and Gynaecologist at Hiranandani Fortis hospital.

Sinha, among the leading gynaecologists of the country, said that as the uterus lining is shed every month during the menstrual cycle, the regenerated lining helps heal the uterus well. But there are instances where the healing does not happen quickly, leading to scarring and severe fibrosis or adhesions.

Doctors say that nearly 90 per cent of women with genital TB are diagnosed in the 15-40 years age group. Infertility on account of genital tuberculosis is 60-80 per cent. March 24 is world TB Day.

Among those with genital TB, 60 per cent suffer menstrual irregularities, 25 per cent have reduced bleeding, 10 per cent have scanty menses and 20 per cent do not get periods at all, said Sinha.

Recent studies have concluded that till a decade ago only 10 per cent of the total tuberculosis patients suffered from genital TB, but the percentage has now increased to 30 per cent because the disease is ignored in the initial stages and there is a lack of awareness.

Earlier, it was believed that TB is less prevalent now because of the improved socio-economic conditions, but it continues to be endemic in India.

Gauri Gore, a senior gynaecologist with Zen hospital, said: “Women with such problems often face scanty menses and for those whose uterus lining has been completely burnt out, the periods can stop completely. Timely treatment will help save the fallopian tubes but in the later stages, it can cause irreparable damages to the endometrium and the fallopian tubes too.”

With proper treatment, the menstrual irregularities can be cured, but if the fallopian tubes are damaged, then those who wish to conceive can opt for IVF. If the uterus lining is damaged permanently, then they can opt for surrogacy. At times laparoscopic surgeries are done to rectify tubo-ovarian masses or dense adhesions inside the uterus to improve the fertility of the patient, said Gore.

She added that timely diagnosis and treatment can control the harmful effects of this disease and save the fertility of the patient.

A recent study by the Indian Journal of Medical Research through its survey stated that the number of women with genital TB in India has increased to 30 per cent in 2015 from 19 per cent in 2011.

The report also stated that Saudi Arabia has the second highest number of genital TB patients with 21 per cent.