What is Female Genital Tuberculosis or Tuberculosis in Women?

Types of Genital Tuberculosis in Females

• Endometrial Tuberculosis: Involves the lining of the uterus (endometrium). Can cause irregular periods and lower abdominal pain.
• Tubal Tuberculosis: Affects the fallopian tubes, which connect the ovaries to the uterus. Can lead to blockages that prevent the egg and sperm from meeting, resulting in infertility.
• Ovarian Tuberculosis: Affects the ovaries, which produce eggs. Can lead to cysts and disrupt normal ovarian function, impacting fertility.
• Cervical Tuberculosis: Involves the cervix, the lower part of the uterus connecting to the vagina. Can cause pain and abnormal bleeding.
• Vulvovaginal Tuberculosis: Affects the external genitalia (vulva) and the vaginal area. Causes discomfort, discharge, and ulcers.

Symptoms of Female Genital Tuberculosis

Here are the Symptoms of Tuberculosis in Women:

• Menstrual Irregularities
• Pelvic Pain
• Vaginal Discharge
• Uncomfortable Intimacy
• Infertility
• General Symptoms
• Other Gynecological Issues

When to Consult a Doctor

• Report irregular periods, pelvic pain, abnormal discharge, pain during intercourse, or other unusual reproductive changes.
• If you’ve struggled to conceive or had recurrent miscarriages, consult a doctor.
• Seek evaluation for unexplained weight loss, fatigue, night sweats, or low-grade fever with reproductive symptoms.
• Inform your doctor of any tuberculosis exposure or previous TB diagnosis.
• Have unexplained pelvic pain evaluated to rule out conditions like FGTB.
• Discuss sudden menstrual changes, such as heavy bleeding, spotting, or significant flow changes, with a doctor.

Causes of Genital Tuberculosis in Females

Here are the Causes of Tuberculosis in Women:

• Hematogenous Spread: Infection travels through the bloodstream from a primary site, usually the lungs, to reproductive organs.
• Lymphatic Spread: Infection spreads through the lymphatic system from nearby infected lymph nodes.
• Direct Extension: TB infection from adjacent organs, like the urinary tract or intestines, can extend into the genital organs.
• Reactivation: Dormant TB infection can reactivate and spread to the genital tract.

Risk Factors of Genital Tuberculosis in Females

Risk factors for genital tuberculosis in females include:

• Previous Tuberculosis Infection
• Exposure to Tuberculosis
• Weakened Immune System
• Malnutrition
• Overcrowded Living Conditions
• Close Contact with TB Patients

Complications of Female Genital Tuberculosis (FGTB)

• Infertility: FGTB can cause damage to the fallopian tubes, ovaries, and uterus, leading to tubal blockages, adhesions, and scarring, resulting in infertility.
• Ectopic Pregnancy: Tubal damage caused by FGTB increases the risk of ectopic pregnancy, where a fertilized egg implants outside the uterus.
• Chronic Pelvic Pain: Scarring and inflammation from FGTB can cause chronic pelvic pain, affecting a woman's quality of life.
• Menstrual Irregularities: The infection can disrupt hormonal balance, leading to irregular periods, heavy bleeding, or other menstrual problems.
• Increased Risk of Miscarriages: FGTB-related changes in the reproductive organs can increase the risk of miscarriages.
• Spread to Other Organs: In severe cases, the infection can spread to other parts of the body, causing systemic symptoms and potentially affecting organs such as the lungs and bones.

Treatment of Female Genital Tuberculosis (FGTB)

Treatment for female genital tuberculosis (FGTB) or genital tuberculosis in females primarily involves a combination of anti-tuberculosis medications such as isoniazid, rifampicin, pyrazinamide, and ethambutol. This medication regimen typically lasts for several months, ranging from 6 to 9 months or longer.

In cases where there is significant damage to the reproductive organs, blockages, or other complications, surgical intervention may be necessary. Surgical procedures aim to repair or remove damaged tissues with the goal of restoring fertility whenever possible.

Regular medical follow-up is essential both during and after treatment to monitor progress and manage any potential side effects that may arise. For women facing infertility due to damage caused by FGTB, options like assisted reproductive technologies, including in vitro fertilization (IVF), can be considered to enhance their chances of achieving conception.

Diagnosis of Female Genital Tuberculosis

• Medical History and Physical Examination: A healthcare provider conducts a detailed medical history and physical examination to assess the pelvic region for signs of infection or inflammation.
• Laboratory Tests:
  • Microbiological Tests: Samples like vaginal discharge or endometrial tissue are cultured to detect Mycobacterium tuberculosis.
  • Nucleic Acid Amplification Tests (NAATs): PCR tests amplify bacterial genetic material for rapid diagnosis.
  • Histopathological Examination: Biopsy samples are examined under a microscope to identify FGTB-related changes.
• Imaging Studies:
  • Ultrasound: Visualizes reproductive organs to detect abnormalities such as tubal blockages or cysts.
  • Hysterosalpingography: Uses X-rays with contrast material to identify uterine or fallopian tube issues.
  • Magnetic Resonance Imaging (MRI): Provides detailed pelvic images for organ assessment.
• Tuberculin Skin Test (Mantoux Test) and Interferon-Gamma Release Assay (IGRA): Detect TB exposure; further evaluation is needed for FGTB diagnosis.
• Laparoscopy: Minimally invasive procedure to visualize organs, assess damage, and collect biopsies when necessary.

Female Genital Tuberculosis Dos and Don'ts: