Tuberculosis remains a major health hazard throughout the world and specifically in developing countries. Most cases detected are those of pulmonary (lung) tuberculosis. However, extra pulmonary tuberculosis is also on the rise. Endometrial tuberculosis is tuberculosis in the inner lining (endometrium) of uterus. It is one form of female genital tract tuberculosis.
The symptoms of female genital tuberculosis are not apparent for many years. But some of the symptoms to be watched are pain in pelvis, abnormal bleeding from vagina after intercourse, infertility, irregular menses etc. Infertility is the common long term sequel of endometrial tuberculosis. Treatment protocol of endometrial tuberculosis is similar to that of lung TB or any other form of tuberculosis.
Causes Of Endometrial Tuberculosis
Like any other type of tuberculosis, endometrial tuberculosis is caused by acid fast bacteria called mycobacterium tuberculosis. The disease is rampant in developing countries, although its spread is across the globe.
Tuberculosis bacteria can attack any part of body, but in majority of cases the primary site of affection is lungs. The bacteria enter into the lungs through droplets released in sputum and cough of an infected person. Once in the lungs it may attack the lungs or spread through hematogenous (blood) route to other parts of the body such as the brain, kidney, bones, intestine, spine and genital tract.
Endometrial TB mainly develops through the hematogenous route from primary focus in the lung to the inner lining of uterus. The spread can also occur through lymphatic channel of intestine when the primary site is in the intestine.
A woman can also develop endometrial tuberculosis if she comes in close intimate contact with a man suffering from genital TB. Not all women who come in contact with the germs will develop the disease. But women having low immunity are most vulnerable group to develop genital tuberculosis if they are constantly in close contact of an infected person.
Signs And Symptoms Of Endometrial Tuberculosis
Infertility in young woman is one of the most serious sequelae of endometrial tuberculosis. But except this prominent symptom, the disease remains asymptomatic for long period of time. The condition is often diagnosed during investigation carried out to find the cause of infertility.
Some women may develop symptoms such as:
- Irregular menstruation may be a symptom of this disease. Some women may bleed for a long time during menstrual period and some women may suffer from amenorrhea (absence of menses).
- At least 30 to 50 percent women suffering from endometrial TB manifest pain in lower abdomen and pelvis. Pain may occur any time and has no connection with menses. Pain is often mild or severe.
- The woman may complain of bleeding after intercourse.
- Vaginal discharge stained with blood.
- Infertility as mentioned above is most common presenting feature in majority of patients suffering from endometrial tuberculosis.
- Night time fever with sweating, loss of appetite, weight loss, tiredness etc are some general symptoms indicative of tuberculosis.
Treatment Of Endometrial Tuberculosis
Infertility remains one of the most concerning consequences of endometrial tuberculosis. If endometrial TB is detected in its early stage and treated, there is ray of hope for preserving fertility of the infected woman. In such situation there is greater chance of conceiving. If the condition remains untreated for long duration, it results in scanty menses or in majority of cases complete stoppage of menses due to scarring of endometrium.
Treatment of endometrial tuberculosis is in no way different from any other type of TB. Treatment consists of 3 to 4 anti tuberculosis drugs. The multiple drug therapy is referred as anti koch’s therapy (AKT) and it is the main stay treatment for any form of tuberculosis.
The medicines have to be taken for long time. Usually the doctor recommends 6 to 9 months of therapy course. Along with medicines patient has to eat nutritious diet so as to strengthen her immunity.