Understanding Cervical Stenosis: Causes & Treatment

Cervical stenosis means the cervix (endocervical canal) is narrower than normal, and can be completely closed. Stenosis means any body passage that is narrower than it should be.

Symptoms of cervical stenosis

Premenopausal women can end up with pelvic pain which has been caused by the build-up of menstrual blood in the uterus. This can result in infection, sporadic mid-cycle bleeding, and pain. The outcomes are not always positive for fertility, and endometriosis can result.

Fertility and cervical stenosis

The narrow or closed cervix can block the passage of sperm into the uterus and fallopian tubes. It may also complicate attempts to use IVF or other assisted reproduction techniques.

Why does cervical stenosis happen?

Foetal abnormalities (see Disorders (or Differences) in Sexual Development)
Surgeries to the cervix such as colposcopy, cone biopsies, or cryosurgery
Cervical trauma (accident, violence)
Postmenopausal cervical atrophy due to low oestrogen
Radiation therapy for cancer

Treatment of cervical stenosis

There are some options for women, depending on the circumstances of the cervical stenosis. Dilators can be used to open the cervix temporarily, or the delivery of a baby may open the cervix by itself. ^1,2

Stenosis caused by scarring can be treated with laser therapy.³ Surgery can shave off cervical tissue to widen the cervix.⁴ No treatment may be recommended in some cases, particularly in postmenopausal women.

References

1.
Vitale SG, De Angelis MC, Della Corte L, et al. Uterine cervical stenosis: from classification to advances in management. Overcoming the obstacles to access the uterine cavity. Arch Gynecol Obstet. Published online July 10, 2023:755-764. doi:10.1007/s00404-023-07126-1
2.
Biggs KV, Soo Hoo S, Kodampur M. Mechanical dilatation of the stenosed cervix under local anesthesia: A prospective case series. J of Obstet and Gynaecol. Published online February 7, 2022:956-965. doi:10.1111/jog.15179
3.
Perrone AM, Tesei M, Ferioli M, et al. Results of a Phase I-II Study on Laser Therapy for Vaginal Side Effects after Radiotherapy for Cancer of Uterine Cervix or Endometrium. Cancers. Published online June 21, 2020:1639. doi:10.3390/cancers12061639
4.
Izhar R, Husain S, et al. Cervical stenosis and pregnancy rate after ultrasound guided cervical dilation in women undergoing saline infusion sonography. J Ultrason. Published online June 15, 2020:e116-e121. doi:10.15557/jou.2020.0019