The cervix is the lowermost part of the uterus. It extends slightly into the vagina. This is where menstrual blood exits the uterus. During labor, the cervix dilates to allow a baby to pass through the endocervical, or birth, canal. Like any tissue in the body, the cervix can become inflamed for a variety of reasons. Inflammation of the cervix is known as cervicitis.
Some women have no symptoms. When symptoms are present, they can include:
- abnormal vaginal bleeding
- persistent gray or white vaginal discharge that may have an odor
- vaginal pain
- pain during intercourse
- a feeling of pelvic pressure
The cervix can become very inflamed if cervicitis progresses. In some cases, it can develop an open sore. Pus-like vaginal discharge is a symptom of severe cervicitis.
The most common cause of this inflammation is an infection. Infections that lead to cervicitis may be spread during sexual activity, but this isn’t always the case. Cervicitis is either acute or chronic. Acute cervicitis involves a sudden onset of symptoms. Chronic cervicitis lasts for several months.
Acute cervicitis is typically due to a sexually transmitted infection (STI), such as:
- herpes simplex type 2, or genital herpes
- human papillomavirus (HPV)
It can also be the result of an infection due to other factors, such as an allergy to spermicide or condom latex, a cervical cap or diaphragm, or sensitivity to the chemicals found in tampons. Regular vaginal bacteria can also cause cervicitis.
Chronic cervicitis is common after childbirth. It may also occur during pregnancy because increased hormone levels cause increased blood flow to the cervix.
If you have symptoms of cervicitis, see your doctor for an accurate diagnosis. The symptoms of cervicitis can also be signs of other vaginal conditions. Sometimes, a routine exam will discover cervicitis if you aren’t having any symptoms.
There are multiple ways your doctor can diagnose cervicitis.
Bimanual Pelvic Exam
For this test, your doctor will insert a gloved finger into your vagina while also applying pressure to your abdomen. This allows your doctor to detect abnormalities of the pelvic organs, including the cervix.
Pap Smear Test
For this test, also known as a Pap smear, your doctor will take a swab of cells from your vagina and cervix. They’ll then have these cells tested for abnormalities.
Your doctor would perform this test only if your Pap smear detected abnormalities. For this test, also called a colposcopy, your doctor will insert a speculum into your vagina. They’ll then take a cotton swab and gently clean the vagina and cervix of mucus residue. Your doctor will look at your cervix using a colposcope, which is a type of microscope, and examine the area. They’ll then take tissue samples from any areas that look abnormal.
Cervical Discharge Culture
Your doctor may also decide to take a sample of the discharge from your cervix. They’ll look at the sample under a microscope to look for signs of a yeast infection, which is called candidiasis, bacterial vaginosis, or trichomoniasis, among other conditions.
You may also need tests for sexually transmitted infections (STIs). You’ll need treatment for any STIs that are contributing to your cervicitis. This should heal the cervical inflammation.
There’s no standard treatment for cervicitis. Your doctor will determine the best course for you based on several factors, including:
- your overall health
- your medical history
- the severity of your symptoms
- the extent of the inflammation
Common treatments include antibiotics to kill any infections and watchful waiting, especially after childbirth.
Your doctor may perform cryosurgery or apply silver nitrate in severe cases when there’s damage to cervical cells. Cryosurgery involves using freezing temperatures to freeze abnormal cells in the cervix, which then destroys them. Silver nitrate can also destroy abnormal cells.
Your doctor can treat your cervicitis after they know the cause of your cervicitis. Without treatment, however, cervicitis can last for years, causing painful intercourse and worsening symptoms.
Cervicitis caused by gonorrhea or chlamydia can move to the uterine lining and fallopian tubes, causing pelvic inflammatory disease (PID). PID causes additional pelvic pain, discharge, and a fever. Untreated PID can cause fertility problems.
There are ways to reduce your risk of developing cervicitis. Abstaining from sexual intercourse will protect you from cervicitis caused by an STI. Reduce your risk of contracting an STI by using a condom every time you have sexual intercourse.
Avoiding chemical solutions, such as douches and scented tampons, can reduce your risk of an allergic reaction. If you insert anything into your vagina, such as a tampon or diaphragm, follow the directions for when to remove it and how to clean it.
You Asked, We Answered
- What kinds of tests will I need to find out if my cervicitis is caused by a sexually transmitted infection (STI)?
This would entail doing a general STI screen. First of all, while some STIs are caused by bacteria, others are caused by a virus. Screening for bacterial STIs generally involves collecting a sample of fluid from the infected area and then culturing the fluid for gonorrhea or trichomonas. Some viral STIs are screened by drawing blood samples. Other viral STIs, such as herpes and genital warts, are often diagnosed by visual identification of a lesion. Some STIs, such as HIV, herpes, and syphilis, can be identified by blood tests.- Steve Kim, M.D.