Hello Everyone, Dr. Licciardi here with today’s message.
In this blog we will discuss a topic that I have been waiting to write about for quite some time, Cervical Stenosis. This is an important topic because it affects a large number of women in a negative way. Cervical stenosis is responsible for infertility, pain, and IVF failure. It can even cause endometriosis. And like most things I write about, the subject is rarely discussed in a way that is clear and understandable. Here we go.
Let’ start with some pictures. Below is a drawing of the ovaries uterus and cervix.
As you can see the cervix is really just the lower part of the uterus. But the structure of the cervix is very different from the structure of the uterus. The uterus is a nice fleshy muscle whose job is to stretch during pregnancy. The cervix is the opposite, the tissue is tough and firm, and it is designed not to stretch during pregnancy. If you squeeze the bulb of your nose you can feel the approximate consistency of the cervix.
The cervix has a narrow hollow center that is basically a tunnel from the vagina to the uterus. Because it is so narrow, even the slightest scarring can partially or fully block off the tunnel, and that’s what stenosis is.
Stenosis is a problem because it keeps things form coming out, like menstrual blood, and it keeps things from going in, like sperm or catheters for insemination or embryo transfer.
Let’s use some more pictures to make thing a little more clear. Here is another basic drawing of the uterus and cervix.
This is the view as seen from front to back. I took out the tubes and ovaries to make things simpler.
This is a picture of the same thing, it’s just a side view.
I wanted make this familiar to you because many pictures published in books and on the net show one view or the other.
Just two more new words to know: the external os and the internal os.
Os means opening or hole. The external os is the opening of the cervix going from the vagina upwards. This is where the pap smear is taken. The internal os is the opening of the cervix from the uterus downwards. This is usually the first part of the cervix to open during childbirth. This is usually not a significant distinct area of the cervix, it’s just the place where the cervix and uterus meet.
These are the two most common locations for cervical stenosis to occur.
The next drawing is here to emphasize that while the os are the 2 most common sites of stenosis, anywhere along the cervical canal can be stenotic.
Here is another drawing showing typical scenarios
Next time we will go over the causes and treatments of cervical stenosis. Thanks for reading and please read disclaimer 5.17.06