Genital tuberculosis happens when the bacteria that causes tuberculosis invades your reproductive system. Although it sometimes has no symptoms, it can affect fertility.

Genital tuberculosis is a form of tuberculosis (TB) that affects your reproductive organs. It’s caused by the same bacteria responsible for pulmonary, or lung, TB.

Genital TB is a type of extrapulmonary TB, or TB outside the lungs.

This article provides an overview of genital TB, including symptoms, causes, and treatments.

Genital TB is an infection of the reproductive organs caused by Mycobacterium tuberculosis bacteria.

In people with male reproductive organs, genital TB can affect any of the following:

The most commonly affected organs of the female reproductive system include:

Is genital TB contagious?

Genital TB is contagious. It can be transmitted during sex without a barrier method.

In addition, if you have genital TB and TB disease (the active form of the infection), you can transmit the infection when coughing or sneezing.

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Genital TB often has no symptoms. But people trying to get pregnant sometimes experience infertility.

Other symptoms may include:

Genital TB may also cause:

  • pain in the testicles
  • swelling or lumps
  • a sensation of heaviness in the testicles

Genital TB is caused by the same bacteria that causes standard TB infections.

Genital TB most often develops in people with existing TB infections. Bacteria from the infected tissue in your lungs travel through your bloodstream or lymphatic system to reach the reproductive organs, where they take root and begin to grow.

While it’s less common, you can also get genital TB from sex without a barrier method.

TB bacteria are usually inactive outside of your lungs, but they can reactivate in immunosuppressed people (for instance, those with HIV). This means that a genital TB infection can occur long after your initial exposure to TB bacteria.

Several factors can increase your risk of developing genital TB. These include:

  • having regular contact with a person who received a diagnosis of TB disease
  • having a previous history of TB
  • living in or traveling to parts of the world where TB is common (e.g., Africa or South Asia)
  • having a history of HIV
  • living in poverty
  • injecting illicit substances

Diagnosing genital TB can be challenging. The condition often has no symptoms, so you may not discover it until you have trouble becoming pregnant.

Genital TB can also be mistaken for other conditions that affect the reproductive system, such as menstrual irregularities or endometriosis.

To diagnose genital TB, a doctor will first perform a physical exam and ask about your medical history. You should let them know if you have a history of TB, TB exposure, or HIV.

Your doctor is also likely to order a few different tests, such as:

  • imaging tests of your reproductive organs and lungs (ultrasound, MRI, X-ray, PET scan)
  • laparoscopy, a minimally invasive procedure that allows a surgeon to visually check your pelvic cavity
  • biopsy
  • bacterial cultures to identify the species of bacteria affecting your reproductive organs
  • TB skin test or a blood test called interferon-gamma release assay to determine whether you have TB
  • blood tests to rule out other conditions

Treating genital TB usually involves the same treatments used for pulmonary TB. The treatment involves taking a combination of antibiotics over the course of 6–9 months.

If you have TB, an infectious disease doctor will likely keep you under observation. Doctors usually use a combination of the following drugs:

  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol

It’s important to complete the entire course of antibiotics your doctor prescribes in order to fully get rid of the bacteria. TB bacteria are harder to get rid of than most other bacteria.

In rare cases, doctors may order surgery to treat complications such as collections of pus (abscesses).

Side effects of treatment

Antibiotics used to treat TB can sometimes cause complications like liver damage. Tell your doctor if you experience any new or alarming symptoms during your treatment protocol, for example:

Learn more about TB treatment.

Untreated genital TB can cause the following complications:

Infertility is less common in people with male sex organs, but it can happen.

The main strategies to prevent genital TB involve:

  • following good respiratory hygiene, both at home and in public (e.g., wearing a mask, staying in well-ventilated areas)
  • avoiding close contact with people who’ve received a diagnosis of TB disease
  • practicing safer sex
  • checking in with a doctor before and after traveling to a country with a high TB rate

Genital TB is a form of TB that affects the reproductive organs.

The infection doesn’t often show any symptoms and may cause problems like pain and infertility. Treatment with antibiotics can help if you take them as directed.

To prevent genital TB, it’s important to practice respiratory hygiene and safe sex.