Cervicitis: what it is, causes and symptoms

Cervicitis is inflammation of the cervix. Sometimes it is found during a routine examination when there are almost no complaints, and sometimes it explains unusual discharge or bloody spotting between periods. Let's calmly go over what happens and when a doctor is needed.

What cervicitis is

Cervicitis is an inflammatory disease of the cervix. The cervix is the part of the uterus visible during a speculum examination; the cervical canal passes through it, connecting the vagina and the uterine cavity. Inflammation affects different layers and areas, so several types are distinguished. In the chronic course, the mucous and other layers of the cervix may thicken or thin.

In the classification since 2006, gonococcal cervicitis, chlamydial cervicitis and inflammatory disease of the cervix are listed separately. The presence of inflammation is judged by test results and the number of pathogenic agents — usually they enter from outside during sexual contact.

Causes of inflammation of the cervix

The main causes are infections. In cervicitis, chlamydia, gonorrhea, trichomonas and bacterial vaginosis are checked. Mechanical damage to the cervix may also play a role. For pelvic inflammatory disease, the risk is higher after childbirth, miscarriage, abortion, hysteroscopy and insertion of an intrauterine device — procedures during which the cervical canal opens.

Symptoms of cervicitis and the nature of discharge

Often the disease is asymptomatic: the doctor sees the inflammation, but the woman has no complaints. If there are complaints, they may include pathological pain, bleeding between periods or after sex, pain during intercourse, discharge unusual in appearance, odor or sensation.

The doctor looks for purulent or mucopurulent exudate from the cervical canal and persistent bleeding when a cotton swab is gently passed through the canal. Discharge unusual in appearance, odor or sensation is assessed by the doctor based on examination and a smear.

Connection with pelvic inflammatory disease and complications

Cervicitis may be accompanied by endometritis, so with a new episode the doctor assesses signs of pelvic inflammatory disease (PID). The female pelvis is the area between the abdomen and the hips; PID is an infection of the uterus, fallopian tubes and ovaries that leaves scars behind.

The complications are serious: abscesses (collections of pus) in the fallopian tubes or ovaries, long-term pelvic pain, fertility problems, increased risk of ectopic pregnancy. An untreated abscess can become a life-threatening infection.

The risk of PID is higher if:

• you are sexually active and under 25;
• you have more than one partner or have previously had an untreated infection or PID;
• you douche — this makes it easier for bacteria to reach the reproductive organs, and signs of inflammation are masked;
• an intrauterine device was recently inserted: the risk is increased in the first three weeks.

How it is diagnosed and when to see a gynecologist

There is no single test for PID. The doctor asks about symptoms, sexual history and contraception, examines the abdomen and pelvic area, examines the cervix with a speculum in the chair and takes a smear from the cervical canal and vagina. Blood and urine tests and ultrasound may additionally be needed. For cervicitis, PCR for chlamydia and gonorrhea, and testing for bacterial vaginosis and trichomoniasis are done separately.

Microscopy to detect trichomonas is sensitive in about 50% of cases, so if the result is negative, an additional test is done — culture or PCR. More than 10 leukocytes per field of view in vaginal contents without trichomoniasis may indicate cervicitis of chlamydial etiology.

You are in control of the examination: you can ask for a female doctor and a companion. See a gynecologist for unusual discharge, bloody spotting between periods or after sex, lower abdominal pain, and if you or your partner may have encountered a sexually transmitted infection.

Cervicitis by itself is not a reason to call an ambulance. 103 or 112 — if, against the background of symptoms of pelvic infection, the lower abdominal pain is severe or worsens with movement; if lower abdominal pain is accompanied by heavy bleeding; with sharp sudden severe lower abdominal pain; with pain under the ribs on the right and in the right shoulder; with dizziness or fainting; with very high fever, chills, nausea or vomiting.

This text is for reference: it helps you get your bearings and ask your doctor your questions, but does not replace a gynecologist's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer