Cervical stenosis is narrowing of the passageway through the cervix (the lower part of the uterus).
In cervical stenosis, the passageway through the cervix (from the vagina to the main body of the uterus) is narrow or completely closed.
Some women are born with cervical stenosis. In others, cervical stenosis results from a disorder or another condition, such as the following:
Cervical stenosis may result in an accumulation of blood in the uterus (hematometra). In women who are still menstruating, menstrual blood mixed with cells from the uterus may flow backward into the pelvis, possibly causing endometriosis (see Endometriosis).
Pus may accumulate in the uterus (as it does in some women with cervical or endometrial cancer). Accumulation of pus in the uterus is called pyometra.
Before menopause, cervical stenosis may cause menstrual abnormalities, such as no periods (amenorrhea), painful periods (dysmenorrhea), and abnormal bleeding. Cervical stenosis can also cause infertility because sperm cannot pass through the cervix to fertilize the egg.
After menopause, cervical stenosis may be present but not cause symptoms.
A hematometra or pyometra can cause pain or cause the uterus to bulge. Sometimes women feel a lump in the pelvic area.
Doctors suspect the diagnosis based on symptoms and circumstances, such as the following:
Doctors confirm the diagnosis by trying to pass a probe through the cervix into the uterus.
If cervical stenosis causes symptoms, tests are done to rule out cancer. If premenopausal women have a hematometra or pyometra, t these tests may include cervical cytology testing (such as a Pap or HPV test) and endometrial biopsy. Before these tests can be done, doctors do a procedure—called dilation and curettage (D & C—see Dilation and Curettage) widen or open the cervix. This procedure enables doctors to take samples from the cervix and from the uterine lining.
No further tests are needed if all of the following apply:
Cervical stenosis is treated only if women have symptoms, a hematometra, or a pyometra. Then, the cervix may be widened (dilated) by inserting small, lubricated metal rods (dilators) through its opening, then inserting progressively larger dilators. To try to keep the cervix open, doctors may place a tube (cervical stent) in the cervix for 4 to 6 weeks.
Last full review/revision January 2015 by S. Gene McNeeley, MD