Impact of pulmonary tuberculosis on menstrual pattern and fertility

الملخص EN

Introduction and study objective: The association of pulmonary tuberculosis and female reproductive health problems is not well addressed in literature.

This prospective case control study was done at Assiut University and Woman's Health Hospitals to estimate the effect of pulmonary tuberculosis (TB) on menstrual pattern and fertility of females in the childbearing period.

Patients and methods : A total of Four hundred twenty nine females with pulmonary TB in the child bearing period (study group) and one hundred age matched healthy volunteers (control group) were included in this study.

A detailed history taking, clinical examination, routine investigations of pulmonary TB, and transvaginal ultrasonography (TVS) were done for all cases.

Hysterosalpingography ± combined laparoscopy and hysteroscopy whenever indicated.

Results : menstrual abnormalities were reported in 66 % of cases (286 patients).

Secondary amenorrhea (112cases, 26.5 %, p, 0.001) and hypo menorrhea (86 cases, 20 %, p, 0.001) were significantly higher in study cases compared to control subjects.

After completed antituberculous treatment 76 % had retained normal cycles.

TVS revealed functional ovarian cysts in 85 cases (19.8 %).

Among 68 cases who sought fertility within one year after completion of the treatment, per tubal and fine intrauterine adhesions were diagnosed by laparoscopy and hysteroscopy in 2 and 1 infertile case respectively whereas persistence of the simple cysts was observed in 2 cases.

Conclusions : TB had marked reversible effect on menstrual function but minimal association with genital tuberculosis and infertility.

Pretreatment counseling of pulmonary tuberculosis patients should include a hint on these reversible changes.

Persistence of menstrual dysfunction or the presence of infertility after completion of treatment should attract attention about the possibility of genital tract involvement.