Inflammatory Disease of Cervix, Endocervicitis
What is Cervicitis?
Cervicitis is an inflammation of the cervix (the neck and outlet of the womb). Cervicitis may be caused by a vaginal infection, a sexually transmitted disease (such as gonorrhea, chlamydia, or genital herpes), or injuries to the cervix from childbirth, abortion, or surgery on the uterus. Cervicitis can be an acute or chronic condition.
How is it diagnosed?
Cervicitis signs and symptoms
- Thick, yellow vaginal discharge.
- Slight sometimes unnoticeable vaginal discharge.
- Discomfort with urination.
- Discomfort with sexual intercourse.
Extensive chronic cervicitis:
- Profuse vaginal discharge.
- Bleeding between menstrual periods.
- Spotting or bleeding after sexual intercourse.
History: Acute cervicitis is often symptomless and may be an incidental finding during a routine pelvic exam. Although acute cervicitis can be symptomless, chronic cervicitis may include the following symptoms: abnormal blood-streaked vaginal discharge, pain during sexual intercourse, vaginal bleeding after intercourse, painful menstrual periods, spotting between periods, lower abdominal pain, backache, fever, painful urination, and change in urinary frequency or urgency. A yellowish discharge may indicate a chlamydia infection.
Physical exam: With the pelvic examination, the cervix is found to be inflamed and there may be a discharge. Genital herpes (HSV) may be evident as a blister or open sore on the cervix. Examination may also reveal red, granular, irregular lesions on the external area of the cervix.
Tests: Swabs are taken of any discharge and analyzed to identify the microorganism responsible. The most accurate tests involve growing the culture in the laboratory, but test results are not available for up to three days. Several rapid tests have been developed using dye to detect bacterial or viral proteins (Chlamydia or herpes), and a gram stain is a quick test for gonorrhea. Testing can be done at the time of the office visit. Chlamydia, however, is easily confused with gonorrhea because their symptoms are so similar and they often occur together. Therefore, many doctors prefer to use both methods of testing to increase the accuracy of the diagnosis.
How is Cervicitis treated?
Depending on the cause of the infection, treatment is with antibiotics. Herpes infections are treated with Acyclovir; it controls but does not cure the infection and gives symptomatic relief. Since chlamydia and gonorrhea are sexually transmitted, the individual's sexual partner(s) need to be treated, as well. If symptoms persist, the infected tissue on the cervix is destroyed with heat (cauterization), freezing (cryotherapy), or laser therapy. Minor injuries to the cervix (such as a tear in the sidewall that may occur during childbirth) are repaired, usually immediately after delivery.
- Oral antibiotics if infectious cervicitis suspected.
- Antiviral or antibiotic vaginal creams or suppositories to fight infection may be prescribed.
What might complicate it?
If untreated, the infection can spread to the lining of the uterus (endometritis) or the fallopian tubes (salpingitis) and be a causative factor of pelvic inflammatory disease (PID). These conditions increase the risk of infertility and tubal pregnancy and the development of chronic pelvic pain. A pregnant woman with untreated cervicitis may infect her baby during delivery. Eye infections in the newborn (neonatal ophthalmia) can lead to blindness. Chlamydia can also cause infant pneumonia.
With proper treatment, full recovery is expected.
Gynecologist and infectious disease specialist.
Notify your physician if
- You or a family member has symptoms of cervicitis.
- During treatment, discomfort persists longer than 1 week or symptoms worsen.
- Unexplained vaginal bleeding or swelling develops during or after treatment.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
Last updated 17 November 2011