Cervical Stenosis: Meaning, Causes, Symptoms, Treatment

Written by Medicover Team and Medically Reviewed by Dr B Radhika , Gynecologists

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Cervical stenosis is a condition where the cervix, the lower part of the uterus, becomes unusually narrow or blocked. This can affect periods, fertility and overall reproductive health. Though not very common, it can cause pain, discomfort and complications if not treated. Early diagnosis and care are important to prevent long-term problems and keep reproductive health healthy.

Cervical stenosis can occur due to natural changes, injuries or medical procedures affecting the cervix. Understanding the cervical stenosis symptoms, causes, risk factors and available treatment options empowers women to seek timely medical care and reduce complications.

Symptoms of Cervical Stenosis

Recognising cervical stenosis symptoms early helps provide early diagnosis and treatment. Symptoms may vary depending on whether the stenosis is partial or complete and whether a woman is menstruating, pregnant or undergoing other reproductive health processes.

• A narrow cervix can block menstrual flow, causing absent periods or painful periods.
• Some women may have very light or irregular periods due to partial blockage.
• Cervical stenosis can make it harder for sperm to reach the uterus, affecting fertility.
• Pressure in the uterus may cause discomfort or cramps.
• Procedures like Pap smears or IUD insertions can become painful or difficult.
• In some cases, it can affect embryo implantation or early pregnancy.

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Causes of Cervical Stenosis

Understanding the cervical stenosis causes can help women identify potential risks and seek timely care. The narrowing or blockage of the cervix can develop due to a combination of congenital, age related or acquired factors.

• Congenital: Some women are born with a naturally narrow cervical canal, which can lead to cervical stenosis affecting menstrual flow and fertility.
• Surgical procedures: Cervical conization, LEEP or D&C can cause scarring and narrowing, potentially leading to partial or complete cervical stenosis.
• Age-related changes: Menopause or natural aging can cause the cervix to shrink and lose flexibility.
• Radiation therapy: Cancer radiation in the pelvic area can damage the cervix, causing it to scar and narrow.
• Infections: Long-lasting infections, including sexually transmitted infections (STIs), can inflame and scar the cervix, leading to partial or complete blockage.
• Cancer treatments: Surgeries for cervical or uterine cancer can disrupt cervical structure, causing narrowing and sometimes complete cervical stenosis.
• Trauma: Injury to the cervix during childbirth, accidents, or other incidents may create narrowing, affecting menstruation, fertility and reproductive health.

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Risk Factors and Complications

Certain women are more prone to developing cervical stenosis. Recognising these risk factors is essential for prevention and early intervention.

• Previous cervical surgery or procedures
• History of pelvic infections or chronic inflammation

• Infertility due to the obstruction of sperm entry
• Endometriosis is caused by retrograde menstrual flow
• Persistent pelvic pain and cramping
• Risk of recurrent miscarriages or pregnancy complications
• Difficulty in performing gynaecological examinations or procedures

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When to See a Doctor?

Women should consult a healthcare professional if they notice any of the following:

• Severe menstrual pain or absent periods.
• Difficulty conceiving despite regular ovulation.
• Unusual vaginal bleeding or discharge.
• Pelvic pain or pressure that is persistent.
• Problems during routine gynecological procedures.

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Diagnosis & Tests of Cervical Stenosis

Accurate cervical stenosis diagnosis is critical for effective treatment. Doctors typically use a combination of physical examinations, imaging, and specialised procedures:

• Pelvic Examination: Doctors may attempt to assess the cervical opening manually, though severe stenosis can limit this method.
• Ultrasound: Transvaginal ultrasound helps evaluate the uterus and cervix and detect any blockage or fluid accumulation.
• Hysterosalpingography (HSG): An X-ray procedure where dye is inserted into the uterus to check the cervical canal and fallopian tubes.
• Hysteroscopy: A thin camera is inserted into the cervix to directly visualise and assess narrowing.
• MRI: Rarely, MRI is used for detailed imaging if complex anatomical issues are suspected.
• Pap Smear or Biopsy: Sometimes performed to rule out abnormal cervical tissue changes or malignancy.

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Treatment for Cervical Stenosis

The choice of cervical stenosis treatment depends on the severity of narrowing, symptoms, and whether fertility preservation is desired. Treatment options may include conservative, surgical, or assisted reproductive approaches.

Conservative Management:

Conservative approaches are often recommended for mild cervical stenosis to relieve symptoms and prevent complications.

• Monitor mild cases with no significant symptoms.
• Hormonal therapy may help with menopause-related or irregular periods.
• Use vaginal dilators under medical supervision for gradual widening.

Surgical Management:

Surgery is needed when stenosis causes significant symptoms or fertility issues and conservative methods fail.

• Gradually widen the cervical canal using cervical dilatation.
• Remove scar tissue or adhesions with hysteroscopic surgery.
• Place a temporary stent to keep the cervical canal open.
• Treat underlying issues like infections, inflammation or structural problems.

Assisted Reproductive Techniques:

When stenosis affects fertility, assisted reproduction bypasses cervical blockage for conception.

• IUI or IVF can bypass cervical obstruction for women facing fertility issues.

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Prevention Tips

While not all cases can be prevented, certain steps may reduce the risk of cervical stenosis:

• Avoid unnecessary cervical surgeries or trauma.
• Prompt treatment of cervical infections.
• Regular gynecological checkups for early detection.
• Careful management of postpartum or post-procedure healing.
• Avoiding radiation to the pelvic area unless medically necessary.

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Conclusion

Cervical stenosis is when the cervix becomes narrow, which can affect periods, fertility, and overall reproductive health. Early detection and treatment can help manage symptoms and prevent problems. Regular checkups and awareness of risks are important to keep reproductive health safe and healthy.

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