Zervixstenose

Zervixstenose refers to a narrowing of the cervix, the lower, narrow part of the uterus that opens into the vagina. This condition can occur in women of any age but is more common after menopause. The narrowing can range from mild to complete, potentially impeding the passage of menstrual blood or affecting fertility.

The causes of zervixstenose are varied. It can be a consequence of cervical trauma, such as from difficult childbirth, multiple surgical procedures on the cervix, or aggressive treatments for cervical abnormalities like LEEP or cryotherapy. Chronic inflammation or infections of the cervix can also lead to scarring and subsequent narrowing. In some cases, hormonal changes, particularly during and after menopause, can contribute to the thinning and tightening of cervical tissues, resulting in stenosis.

Symptoms of zervixstenose depend on the severity of the narrowing. Mild cases may be asymptomatic. However, more significant stenosis can lead to irregular periods, absent periods (amenorrhea), painful menstruation (dysmenorrhea) due to the blocked outflow of menstrual blood, or difficulty conceiving. If menstrual blood backs up, it can cause pelvic pain. In severe cases, it may also affect the ability to perform gynecological examinations or procedures.

Diagnosis typically involves a pelvic examination and a review of medical history. Visual inspection of the cervix may reveal a small opening or no visible opening at all. Further diagnostic tools can include ultrasound or hysteroscopy, where a thin, lighted scope is inserted into the cervix to visualize the internal canal and assess the degree of narrowing.

Treatment aims to reopen the cervical canal. Options include dilation, where the cervix is gradually stretched using graduated dilators, or surgical intervention. Hormone therapy, particularly estrogen therapy, can sometimes help to soften and widen the cervical tissues, especially in postmenopausal women. The chosen treatment depends on the cause and severity of the stenosis.