What is cervicitis?
Cervicitis is the term for inflammation of the cervix. Majority of the cases of cervicitis are due to infectious causes, particularly sexually transmitted infections. Cervicitis is a very common condition in women and the inflammation is more often related to sexual contact. The cervix is the lower part of the uterus which narrows and becomes continuous with the vagina. The part of the cervix that opens into the vagina is known as the external os while the portion that opens into the uterus is known as the internal os. It is lined with squamous epithelial cells and mucus-secreting cells. The cervix is the barrier part of the female genital tract that restricts the passage of microorganisms in the vagina from entering the uterus. However, it is also prone to any diseases that affect the vagina, particularly infections that gradually ascend up into the cervix and may eventually involve the uterus.
Causes of Cervicitis
Most cases of cervicitis are due to an infection. Of the various routes of transmission, it is more frequently seen with sexual contact. These sexually transmitted cases are due to bacteria, viruses or parasites that may cause gonorrhea, chlamydia, genital herpes and trichomoniasis. Although the human papilloma virus (HPV) is known to play a major role in the development of cervical cancer (cancer of the cervix), it is unlikely to cause cervicitis. Both HPV and HIV infection, however, may be possible risk factors for cervicitis.
Sometimes the naturally-occurring bacteria in the vagina may multiply excessively and affect the micro-environment within the vagina. This can subsequently lead to irritation of the vagina (bacterial vaginosis) and cervix. It is more likely to arise in women who use vaginal douches on a regular basis thereby affecting the population control within the micro-environment and introduces other microorganisms into the vagina.
Injury is largely due to chemical irritation caused by douches, lubricants and tampons. Mechanical injury with sexual activity is not a common cause of cervicitis but should not be ruled out entirely. Allergies may be another possible causes of cervicitis when a women is hypersensitive to the latex of condoms, lubricants and certain tampons. High quality products are less likely to cause these allergic reactions as it has been produced with hypoallergenic material and tested thoroughly prior to commercial availability.
Risk factors largely relates to sexual behavior and includes having sex from an early age and intercourse with multiple partners, particularly unprotected sex. Women who douche on a frequent basis are also at a greater risk of developing cervicitis.
Signs and Symptoms of Cervicitis
The clinical presentation is not significantly different from inflammation/infection of other organs of the female reproductive system. Often the neighboring structures are involved as well and the term pelvic inflammatory disease (PID) is used as an umbrella term for the condition. Signs and symptoms of cervicitis may include :
- Abnormal vaginal discharge often with a foul odor
- Intermenstrual bleeding – bleeding/spotting between periods
- Lower abdominal pain and/or lower back pain
- Itching and/or burning of the vagina
- Pain during intercourse often with bleeding afterwards
- Urinary frequency and pain upon urination (dysuria)
Diagnosis and Treatment of Cervicitis
The medical history along with the findings of a clinical examination may be sufficient for diagnosis. A swab may be used to collect samples of vaginal and cervical fluid and discharge for further laboratory testing.
The treatment depends on the cause and in the case of infections, the causative organism. Medication may therefore include antibiotics and antiviral agents. Supportive treatment and discontinuation of the causative action may sometimes be all that is necessary to allow the inflammation to subside and for the cervix to heal. Surgery is very rarely indicated and only in severe cases. This may include procedures such as cauterization to destroy the affected tissue.