The simple idea (no memorising)
Unlike ordinary PID (which climbs up from below), genital TB usually spreads through the blood from a TB focus elsewhere (often the lungs), landing on the fallopian tubes and endometrium.
Because it damages both the tubes (transport) and the lining (implantation), infertility is common — and it's especially important in regions where TB is common, such as India.
A key safety rule
When investigating tubes, doctors sometimes inject dye through the cervix (an HSG — an X‑ray of the tubes). But you must never do an HSG during active genital TB — pushing dye through an actively infected tract can spread the infection. 🚩 (Classic X‑ray clues of old TB damage include a "beaded" or rigid "pipe‑stem" tube.)
The scarred lining: Asherman syndrome
Severe damage to the womb lining — from TB, or from over‑vigorous scraping of the womb (especially around pregnancy) — can make the front and back walls stick together with scar tissue. This is Asherman syndrome, and it shows up as very light or absent periods (± infertility) in someone who used to menstruate normally.
Why it matters
Both genital TB and Asherman are "silent scarrers" — they don't shout, they just quietly steal fertility and periods. Recognising the story (a past procedure, a TB risk) is what leads to the diagnosis.
Quick check ✅
- How does genital TB usually reach the reproductive tract — and which structures does it scar?
- What is Asherman syndrome, and what's the classic clue in the history?
Remember this 🌟
Where we're going next → Tubes, ovulation and sperm all meet in one topic: helping a couple conceive. Concept 29.