Cervicitis: Possible Complications

What is Cervicitis

Cervicitis is an inflammation of the cervix, the lower, narrow end of your uterus that opens into the vagina.

It’s possible to have cervicitis and not experience any signs or symptoms. Among the signs and symptoms women sometimes notice are bleeding between menstrual periods and changes in vaginal discharge.

Often, cervicitis results from a sexually transmitted infection, such as chlamydia or gonorrhea. Cervicitis can develop from noninfectious causes, too.

Successful treatment of cervicitis involves treating the underlying cause of the inflammation.

What Causes Cervicitis?

Severe cases of inflammation are usually caused by infections that are passed during sexual activity.

Sexually transmitted diseases (STDs) that may cause cervicitis include:

• Gonorrhea
• Chlamydia
• Genital herpes
• Trichomoniasis
• Mycoplasma and ureaplasma

But many women with cervicitis don’t test positive for any type of infection. Other causes of the inflammation may include:

• Allergies to chemicals in spermicides, douches, or to the latex rubber in condoms
• Irritation or injury from tampons, pessaries, or from birth control devices like diaphragms
• Bacterial imbalance; normal, healthy bacteria in the vagina are overwhelmed by unhealthy or harmful bacteria. This is also called bacterial vaginosis.
• Hormonal imbalance; having relatively low estrogen or high progesterone may interfere with the body’s ability to maintain healthy cervical tissue.
• Cancer or cancer treatment; rarely, radiation therapy or cancer may cause changes to the cervix consistent with cervicitis.

Symptoms of Cervicitis

• Abnormal vaginal bleeding that occurs after intercourse, after menopause, or between periods
• Unusual vaginal discharge that does not go away: Discharge may be gray, white or yellow in color
• Painful sexual intercourse
• Pain in the vagina
• Pressure or heaviness in the pelvis

Note: There may be no symptoms. Women who may be at risk for chlamydia should be tested for this infection, even if they do not have symptoms

Cervicitis Diagnosis

• Your health care professional will begin with a medical history and ask about the symptoms you are experiencing. You will be asked about your medical problems, contraceptives you use, medications you are taking, family history of disease, your sexual activity, last menstrual period, and whether you have been pregnant and have given birth.
• For the physical exam, you will be placed on your back, with your bottom at the edge of the table, and your legs elevated and supported by stirrups.
  • The doctor will inspect your external genitalia for redness, swelling, or any signs of irritation or injury.
  • An instrument called a speculum will be inserted into your vagina to hold the vaginal walls apart, permitting an inspection of your cervix and vaginal lining for redness, irritation, unusual discharge, or sores.
  • The doctor will collect a sample for a Pap smear by swabbing the cervix. The doctor will also collect samples to test for gonorrhea and Chlamydia and possibly a slide preparation for the diagnosis of other infections. The Pap test can be used to rule out the possibility of cervical cancer or precancerous changes.
  • The doctor then will complete a bimanual, or 2-handed exam. Two fingers of one hand are inserted into the vagina with the other hand pressing down on the abdomen. This procedure helps the doctor determine the size and location of the uterus and cervix and to check for pain, tenderness, or any irregularity. This part of the exam produces pressure in the lower abdomen and pelvic area. It is normal to feel pressure, if you feel pain, notify your doctor immediately. With cervicitis, you may feel pain when the doctor moves the cervix from side to side.
• A biopsy (a sample of tissue is taken) might be recommended if your cervix appears abnormal.
• Colposcopy is a procedure that uses a binocular-like instrument to get a magnified view of the surface of the cervix.

Risk factors of Cervicitis

You’re at greater risk of cervicitis if you:

• Engage in high-risk sexual behavior, such as unprotected sex, sex with multiple partners or sex with someone who engages in high-risk behaviors
• Began having sexual intercourse at an early age
• Have a history of sexually transmitted infections

Cervicitis Treatment

You may not need treatment for cervicitis if a sexually transmitted infection is not the cause.

If an infection is suspected, the main goal of treatment is to eliminate the infection and prevent it from spreading to the uterus and fallopian tubes, or if you are pregnant, to your baby.

Depending on what organism is causing the infection, your doctor may prescribe:

• Antibiotics
• Antifungal medications
• Antiviral medications

Your doctor may also recommend that your partner be treated to make sure you don’t get infected again. You should not have sex until you and your partner have finished treatment.

Treatment is especially important if you are HIV positive. That’s because cervicitis increases the amount of virus that is shed from the cervix. This may increase your chances of infecting a partner. Also, having cervicitis can make it easier for you to get HIV from an HIV-positive partner.

If your symptoms persist despite treatment, you should be reevaluated by your doctor.

Nondrug treatments like douches or yogurt-based therapy do not work for cervicitis and may actually worsen symptoms.

Possible Complications Cervicitis

Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse (dyspareunia).