What is cervicitis?
The cervix is the lowest 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 birth canal (endocervical 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 with cervicitis experience 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
- backaches
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:
Infection with HPV that has progressed may cause cervical inflammation, which is usually a later sign of cervical cancer or precancer.
It can also be the result of an infection due to other factors that could include:
- an allergy to spermicide or condom latex
- a cervical cap or diaphragm
- sensitivity to the chemicals found in tampons
- regular vaginal bacteria
If you have symptoms of cervicitis, see your doctor for an accurate diagnosis. The symptoms of cervicitis can also signal other vaginal or uterine conditions.
You doctor may also discover cervicitis during a routine exam even if you aren’t having any symptoms.
There are multiple ways your doctor can diagnose cervicitis.
Bimanual pelvic exam
For this test, your doctor inserts a gloved finger of one hand into your vagina while also applying pressure to your abdomen and pelvis with the other hand. This allows your doctor to detect abnormalities of the pelvic organs, including the cervix and uterus.
Pap test
For this test, also known as a Pap smear, your doctor takes a swab of cells from your vagina and cervix. Then they’ll have these cells tested for abnormalities.
Cervical biopsy
Your doctor would perform this test only if your Pap test detected abnormalities. For this test, also called a colposcopy, your doctor inserts a speculum into your vagina. They then take a cotton swab and gently clean the vagina and cervix of mucus residue.
Your doctor looks at your cervix using a colposcope, which is a type of microscope, and examines the area. They 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 have the sample examined under a microscope to check for signs of an infection, which could include candidiasis and vaginosis, among other conditions.
You may also need tests for STIs, such as trichomoniasis. If you have an STI, you’ll need treatment to heal cervicitis.
There’s no standard treatment for cervicitis. Your doctor will determine the best course for you based on factors including:
- your overall health
- your medical history
- severity of your symptoms
- extent of the inflammation
Common treatments include antibiotics to kill any infections, and watchful waiting, especially after childbirth. If the cervicitis is due to irritation from a foreign body (a retained tampon or pessary) or use of certain products (a cervical cap or contraceptive sponge), treatment would involve discontinuing use for a short time to allow healing.
If you have cervical inflammation due to cervical cancer or precancer, you doctor may perform cryosurgery, freezing abnormal cells in the cervix, which destroys them. Silver nitrate can also destroy abnormal cells.
Your doctor can treat your cervicitis after they know its cause. Without treatment, 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 also lead to fertility problems.
There are ways to reduce your risk of developing cervicitis. Using a condom every time you have sexual intercourse can reduce your risk of contracting an STI. Abstaining from sexual intercourse will also protect you from cervicitis caused by an STI.
Avoiding products containing chemicals, 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 or how to clean it.
Q:
What kinds of tests will I need to find out if my cervicitis is caused by an STI?
A:
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 trichomoniasis.
Some viral STIs, such as HIV, are screened by drawing blood samples. Other viral STIs, such as herpes and genital warts, are often diagnosed by visual identification of a lesion.
Steve Kim, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.