I first heard the term, “cervical stenosis” while on the phone with a friend who mentioned that I may have it, after the sudden stop of my period (and various other complications).
Although I had my doubts that stenosis of the uterine cervix was the contributing factor to my absent period, as a health journalist I couldn’t help but begin researching.
The first bit of information that pops up when searching the proper term is related to cervical spinal stenosis, which is interesting, but not what I was looking for. I annoyingly typed in “cervix” after the word, “cervical,” to gather more competent information. Of course, there isn’t much out there in the world wide web—the cervix seems to be the dark corner of the internet that no one is keen on discussing.
Cervical stenosis is the narrowing or closing “of the passageway through the cervix.” This can cause infertility. Some people are simply born with cervical stenosis but in others, menopause, cancer, surgery that involves the cervix, procedures that remove the lining of the uterus, or radiation therapy can bring on the complication. My friend suggested looking into cervical stenosis because of my LEEP, which prevents cancerous cells from forming on the cervix, and because of silver nitrate which cauterized bleeding on my cervix.
Dr. Diana Hoppe, an OBGYN, says that the narrowing of the cervix means that no blood is allowed to travel through the cervix into the vagina. In severe cases, this means that blood can build up in the uterus which leads to pelvic pain and inflammation. “This can be diagnosed at a patient’s first year of menses when she feels increased pelvic pressure due to build-up of menstrual blood in uterus. In some patients, this blood can go up through tubes (retrograde flow) and cause endometriosis ( uterine lining in pelvis).” Moreover, since the opening is so narrow, sperm may not be able to properly fertile an egg and can complicate fertility.
- no periods
- painful periods
- abnormal bleeding
- pelvic pain
“It may be congenital (in utero abnormality) or acquired (after surgical procedures) such as LEEP procedure (Loop Electrosurgical Excision Procedure) for cervical dysplasia (precancerous cells) or cone knife biopsy (severe dysplasia/CIS),” says Dr. Diana Hoppe. “Radiation to cervix can also cause narrowing as trauma or other surgeries to cervix. Also this condition can commonly be seen in postmenopausal women where cervix becomes very narrowed and /or closed due to loss of estrogen.”
Doctors will evaluate a patient based on symptoms, especially after surgery of the cervix. Moreover, when a doctor cannot insert “an instrument into the cervix to obtain a simple of tissue” during a Pap or other type of test, they may diagnose the patient with cervical stenosis.
Most people with cervical stenosis experience pain, and if this pain continues, a pelvic ultrasound can be done. “A mass might be seen, hematometra, blood mass in uterus, or endometriosis in pelvis,” says Dr. Hoppe. “Usually this can be a very curable condition depending on what the endpoint is.”
Recommendation for treatment include gentle dilation which opens the canal over time. Other times, a stent is placed to keep the cervix open in order to prevent scar tissues from reforming. The reformation of the scar tissue can lead to the cervix being closed once again. After several weeks, the stent is removed. If neither of the options is successful, a hysterscoptic is possible which shaves the scar tissue with a medical laser. IUD’s are another magical device which can be placed in the cervix and prevents scar tissue from reforming.
In short, it’s good news that cervical stenosis is highly treatable. If you have experienced a procedure where you cervix has gone under the knife, or are menopausal, talk to your doctor about the possibility of stenosis of the uterine cervix for a closer inspection.