Surreal illustration of female reproductive health and the challenges of genital tuberculosis.

Silent Threat: Understanding Genital Tuberculosis in Women

Lena Kashyap in Health & Wellness November 2025 • 4 min read.

"A Deep Dive into Symptoms, Diagnosis, and Impact on Fertility"

Genital tuberculosis (GTB) in women remains a significant concern, particularly in developing countries. Often overshadowed by pulmonary tuberculosis, GTB is a rare extrapulmonary form that primarily affects women of reproductive age. Its insidious nature and varied clinical presentations make diagnosis challenging, leading to delays in treatment and potential long-term complications.

The primary cause of GTB is Mycobacterium tuberculosis, although Mycobacterium bovis can also be responsible. The infection usually occurs secondary to tuberculosis elsewhere in the body, typically through hematogenous or lymphatic spread from a primary lung infection. In rare cases, direct sexual transmission has been reported.

One of the most devastating consequences of GTB is its impact on female fertility. The infection commonly affects the fallopian tubes and endometrium, leading to scarring, adhesions, and ultimately, infertility. Given the subtle symptoms and the significant implications for reproductive health, raising awareness and improving diagnostic approaches are crucial.

What are the Subtle Signs of Genital Tuberculosis?

Surreal illustration of female reproductive health and the challenges of genital tuberculosis.

The symptoms of GTB are often nonspecific, making early detection difficult. Many women may experience subtle signs of illness or attribute their symptoms to other causes, delaying their seeking medical attention. This delay contributes to the progression of the disease and increases the risk of complications.

A recent study conducted in Tunisia examined 47 cases of GTB in women, shedding light on the common clinical features. The study, published in the Pan African Medical Journal, revealed that the average age of diagnosis was 42.2 years, with a significant proportion of women coming from rural areas.

Insidious Onset: In nearly all cases, the onset of symptoms was gradual and subtle, making it difficult to pinpoint when the illness began.
Constitutional Symptoms: About half the women reported general symptoms such as weight loss, loss of appetite, fever, night sweats, and fatigue.
Pelvic Pain: Many women experienced chronic pelvic pain, which was often a primary reason for seeking medical attention.
Menstrual Irregularities: Changes in menstruation patterns, such as absent or irregular periods, were also common.
Infertility: A significant number of women were diagnosed with GTB during infertility investigations.

It is crucial to recognize that the absence of obvious symptoms does not rule out GTB. A high index of suspicion is necessary, particularly in women with a history of tuberculosis exposure, those from endemic regions, or those presenting with unexplained infertility or pelvic pain.

What's the Connection Between GTB and Infertility?

GTB significantly impacts female fertility by directly affecting the reproductive organs. The infection can lead to scarring and blockage of the fallopian tubes, preventing the egg from traveling to the uterus. Endometrial involvement can also disrupt implantation, making it difficult for a fertilized egg to attach and grow. Early diagnosis and treatment are crucial to minimize the damage and improve the chances of conceiving.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.11604/pamj.2018.30.71.14479, Alternate LINK

Title: Caractéristiques Épidémio-Cliniques De La Tuberculose Génitale Chez La Femme Tunisienne: Une Série De 47 Cas

Subject: General Medicine

Journal: Pan African Medical Journal

Publisher: Pan African Medical Journal

Authors: Souheil Zayet, Aida Berriche, Lamia Ammari, Mariem Razgallah, Rim Abdelmalek, Mohamed Khrouf, Badreddine Kilani, Hanène Tiouri Benaissa

Published: 2018-01-01

Everything You Need To Know

What exactly is Genital Tuberculosis (GTB) in women, and why is it considered a silent threat?

Genital Tuberculosis (GTB) in women is a rare extrapulmonary form of tuberculosis primarily affecting women of reproductive age. It's considered a 'silent threat' because its symptoms are often nonspecific and subtle, leading to delayed diagnosis and treatment. The primary cause of GTB is Mycobacterium tuberculosis, but Mycobacterium bovis can also be responsible. This delay can result in significant complications, especially concerning fertility, as the infection can severely damage the reproductive organs before it's detected. It is often overshadowed by pulmonary tuberculosis which makes it harder to diagnose.

How does Genital Tuberculosis (GTB) typically develop in women?

In women, Genital Tuberculosis (GTB) usually occurs secondary to tuberculosis elsewhere in the body, most often through hematogenous or lymphatic spread from a primary lung infection. This means that the bacteria, typically Mycobacterium tuberculosis, travel through the bloodstream or lymphatic system from an existing tuberculosis infection, such as in the lungs, to the genital organs. Rarely, direct sexual transmission has been reported. The insidious nature of GTB makes it hard to trace, since the origin is not always obvious.

What are the main symptoms of Genital Tuberculosis (GTB) that women should be aware of, and why are they difficult to recognize?

The main symptoms of Genital Tuberculosis (GTB) include insidious onset, constitutional symptoms (weight loss, loss of appetite, fever, night sweats, fatigue), chronic pelvic pain, menstrual irregularities, and infertility. These symptoms are difficult to recognize because they are nonspecific and can be attributed to other common conditions. The subtle nature of these signs means women may not immediately suspect GTB, leading to delays in seeking appropriate medical attention and diagnosis. A high index of suspicion is necessary, especially in women with a history of tuberculosis exposure.

How does Genital Tuberculosis (GTB) lead to infertility in women, and what specific parts of the reproductive system are affected?

Genital Tuberculosis (GTB) significantly impacts female fertility by directly affecting the reproductive organs, primarily the fallopian tubes and endometrium. The infection can cause scarring and blockage of the fallopian tubes, preventing the egg from traveling to the uterus, leading to infertility. Endometrial involvement can also disrupt implantation, making it difficult for a fertilized egg to attach and grow. Early diagnosis and treatment are crucial to minimize the damage and improve the chances of conceiving. GTB can also cause adhesions and other structural abnormalities that further compromise reproductive function.

What implications does the study conducted in Tunisia have for understanding Genital Tuberculosis (GTB) in women globally, and what does it reveal about the typical patient profile?

The study conducted in Tunisia, examining 47 cases of Genital Tuberculosis (GTB) in women, highlights that the average age of diagnosis was 42.2 years, with a significant proportion of women coming from rural areas. This suggests that GTB is more prevalent in specific demographic groups and regions, particularly developing countries where tuberculosis is endemic. The study underscores the importance of considering GTB in women presenting with infertility or pelvic pain, especially those with a history of tuberculosis exposure or those from endemic regions. Early detection and treatment can improve reproductive outcomes and reduce long-term complications.