Cervicitis: Causes, Symptoms, and Treatment of Cervical Inflammation

What is cervicitis?

Cervicitis is the inflammation of the cervix, the narrow, lower portion of the uterus that connects to the vagina. The cervix serves as a protective barrier, shielding the uterus from external infections and playing a critical role in reproductive health. Cervicitis occurs when this protective structure becomes inflamed due to infections, irritation, or other factors.

Common cervicitis causes include sexually transmitted infections (STIs) like chlamydia or gonorrhoea, allergic reactions to chemicals (like spermicides or douches), or prolonged use of tampons. Cervicitis symptoms may include unusual vaginal discharge, pelvic pain, bleeding after intercourse, or painful urination.

If untreated, cervicitis can lead to complications, including pelvic inflammatory disease (PID) or fertility issues. Diagnosis typically involves a pelvic exam and testing for infections. Effective cervicitis treatment includes antibiotics or other therapies based on the underlying cause, helping prevent complications and restoring cervical health.

Types of cervicitis

There are two main cervicitis types:

• Acute cervicitis: This type is usually caused by a sexually transmitted infection (STI) and is characterised by sudden onset of symptoms. Common infectious agents include chlamydia, gonorrhoea, and trichomoniasis. Acute cervicitis requires prompt treatment to prevent complications.
• Chronic cervicitis: This form develops gradually and persists over a longer period. Chronic cervicitis may result from untreated acute cervicitis, but it can also have non-infectious causes such as exposure to chemical irritants or a foreign body like a pessary.

How common is cervicitis?

Cervicitis is a prevalent condition, especially among women seeking care for sexually transmitted infections. Studies suggest that the prevalence of cervicitis can range from 20-40% in this population. However, many cases may go undiagnosed due to mild or absent symptoms.

How do you know if you have cervicitis?

Diagnosing cervicitis typically involves a combination of clinical evaluation and laboratory tests. Common signs and symptoms of cervicitis include:

• Increased or abnormal vaginal discharge
• Bleeding between periods or after sexual intercourse
• Pain during sex
• Easily induced cervical bleeding during examination
• Redness and swelling of the cervix
• Pus-like or mucus-like discharge from the cervix

Your healthcare provider may perform the following tests to diagnose cervicitis:

• Nucleic acid amplification testing (NAAT) to detect gonorrhoea and chlamydia
• Wet mount examination of cervical discharge to identify infections like trichomoniasis
• Gram stain of cervical discharge to assess for bacterial imbalances

What is the main cause of cervicitis?

The most common cervicitis causes are sexually transmitted infections (STIs), particularly:

• Chlamydia trachomatis
• Neisseria gonorrhoeae
• Trichomonas vaginalis
• Herpes simplex virus (HSV)
• Mycoplasma genitalium

However, cervicitis causes can also be attributed to non-infectious factors, such as:

• Allergic reactions to latex condoms or spermicides
• Irritation from douches, tampons, or pessaries
• Bacterial imbalance, such as bacterial vaginosis
• Hormonal changes during pregnancy or menopause
• Cervical cancer or precancerous changes

Identifying the specific cause of cervicitis is essential for determining the most effective treatment strategy.

Is cervicitis contagious?

Yes, cervicitis caused by sexually transmitted infections is contagious. The primary infectious agents, Chlamydia trachomatis and Neisseria gonorrhoeae can be passed on through sexual contact. Practising safe sex and getting regular STI screenings are important for preventing the spread of cervicitis.

Can you get cervicitis without an STI?

While STIs are the most common cause, cervicitis can occur without an STI due to non-infectious factors such as gynecologic procedures, chemical irritants, bacterial imbalances, or cancer treatments.

Is cervicitis a type of HPV?

No, cervicitis is not a type of human papillomavirus (HPV). While HPV can cause cervical lesions and cancer, it is a distinct condition from cervicitis, which primarily involves inflammation of the cervix.

Who is at risk for cervicitis?

Certain factors can increase a woman's risk of developing cervicitis, including:

• Being sexually active, especially with multiple partners
• Having a history of sexually transmitted infections
• Not using barrier protection during sexual activity
• Douching or using irritating feminine hygiene products
• Exposure to latex condoms or spermicides in individuals with allergies
• Bacterial imbalance in the vagina
• Hormonal changes due to pregnancy, menopause, or certain medications
• Having a compromised immune system

What are the complications of cervicitis?

If left untreated, cervicitis can lead to several complications, such as:

• Pelvic inflammatory disease (PID): Infection can spread from the cervix to the uterus, fallopian tubes, and ovaries, causing PID. This condition can result in chronic pelvic pain, infertility, and ectopic pregnancy.
• Pregnancy complications: Cervicitis during pregnancy can increase the risk of preterm labor, premature rupture of membranes, and low birth weight.
• Increased risk of STI transmission: Inflammation and micro-abrasions on the cervix can make it easier for HIV and other STIs to enter the body.
• Cervical stenosis: Chronic cervicitis may lead to scarring and narrowing of the cervical canal, causing menstrual abnormalities and infertility.

How is cervicitis diagnosed?

Diagnosing cervicitis involves a combination of clinical evaluation, patient history, and laboratory tests:

• Clinical examination: Your doctor will look for key diagnostic factors like purulent vaginal or cervical discharge, intermenstrual or postcoital bleeding, dysuria, urinary frequency, and easily induced cervical bleeding upon examination with a cotton swab.
• Laboratory tests: The most sensitive and specific tool for diagnosing gonorrhoea and chlamydia, the most common causes of cervicitis, is nucleic acid amplification testing (NAAT).
• Other tests:
  • Wet mount examination of cervical discharge
  • Rapid tests like OSOM Trichomonas or AFFIRM VPIII
  • Thayer-Martin agar cervical culture
  • Gram stain of cervical discharge

Does cervicitis show up on a Pap smear?

A Pap smear is primarily used to screen for cervical cancer and precancerous changes, not cervicitis itself. However, a Pap smear may indicate inflammation or other abnormalities that could prompt further investigation for cervicitis. Specific diagnostic tests like NAAT are necessary to confirm the presence of infectious agents causing the inflammation.

What can be mistaken for cervicitis?

Several conditions can present with signs similar to cervicitis symptoms, leading to potential misdiagnosis. These include vaginitis, pelvic inflammatory disease (PID), and endometritis.

How do you treat cervicitis?

Cervicitis treatment depends on the identified cause:

• For infections such as chlamydia and gonorrhoea, appropriate antibiotics are typically prescribed. Empiric treatment may be initiated before test results are available, particularly for high-risk patients or those with uncertain follow-up.
• Antiviral medications can help manage, but not cure, infections caused by the herpes simplex virus (HSV).
• If inflammation is caused by a foreign body, like pessary or diaphragm, removal of the object is necessary. Antibiotics may also be given if an infection is present.

What antibiotic treats cervicitis?

Cervicitis treatment is usually determined by its underlying cause. In cases of bacterial infections, healthcare providers may suggest targeted treatments to address the specific pathogens. The treatment plan depends on factors such as the patient's medical history, symptoms, and diagnostic test results. It is important to complete the entire course of prescribed antibiotics, even if symptoms improve.

How long does it take for cervicitis to heal?

The healing time for cervicitis varies based on the cause and effectiveness of treatment:

• With appropriate antibiotic treatment, symptoms of infectious cervicitis usually resolve within 1-2 weeks.
• For non-infectious cervicitis types, treatment and recovery time can vary. Removing an irritant or addressing allergies may lead to quicker resolution.

How can I reduce my risk of cervicitis?

You can take several steps to lower your risk of developing cervicitis:

• Practice safe sex by using condoms consistently to reduce the risk of sexually transmitted infections (STIs).
• Engage in regular STI screening, especially if you are in a high-risk group, such as those with multiple sexual partners or under age 25.
• Avoid potential irritants like douches, spermicides, and chemicals in contraceptive products.
• Ensure proper use of contraceptive devices to avoid irritation or infection.

What can I expect if I have cervicitis?

If you have the condition, you may experience cervicitis symptoms such as unusual vaginal discharge, bleeding between periods or after intercourse (postcoital bleeding), pain during sex (dyspareunia), and pelvic pain.

However, it’s also possible to have unnoticeable cervicitis symptoms, which is why regular gynaecological check-ups are important. Your doctor will likely perform a pelvic exam and may recommend tests like a Pap smear, cultures, or an ultrasound to determine the cause of the inflammation. Based on the results, appropriate treatment, usually in the form of antibiotics or other medications, will be prescribed. With proper care, most cases of cervicitis resolve without complications.

When to see a doctor?

It's important to see your healthcare provider if you have symptoms that could indicate cervicitis, such as:

• Unusual vaginal discharge
• Bleeding between periods or after sex
• Pain during intercourse
• Pelvic pain

Conclusion

Cervicitis is a common condition that can significantly impact women's health. If you experience any signs or symptoms of cervicitis, don't hesitate to consult your healthcare provider for proper diagnosis and treatment.

At Metropolis Healthcare, we understand the importance of accessible and reliable diagnostic services. Our team of skilled technicians offers convenient at-home sample collection for a range of tests, including those for cervicitis. With our state-of-the-art labs and commitment to quality, you can trust Metropolis to provide accurate results and personalised care.