Cervicitis

Answer 1

Definition

Cervicitis is swelling (inflammation) of the end of the uterus (cervix).

Alternative Names

Cervical inflammation; Inflammation - cervix

Causes, incidence, and risk factors

Cervicitis is most often caused by an infection, usually caught during sexual activity. Sexually transmitted diseases (STDs) that can cause cervicitis include:

• Chlamydia
• Gonorrhea
• Herpes virus (genital herpes)
• Human papilloma virus (genital warts)
• Trichomoniasis

However, in a few cases it may be due to:

• A device inserted into the pelvic area such as:
  • Cervical cap
  • Device to support the uterus (pessary)
  • Diaphragm
• An allergy to spermicides used for Birth Control or to latex in condoms
• Exposure to a chemical

Cervicitis is very common, affecting more than half of all women at some point during their adult life. Risks include:

• High-risk sexual behavior
• History of STDs
• Many sexual partners
• Sex (intercourse) at an early age
• Sexual partner(s) who have engaged in high-risk sexual behavior or have had an STD

Bacteria (such as staphylococcus and streptococcus) and too much growth of normal bacteria in the vagina (bacterial vaginosis), can also cause cervicitis.

Symptoms

• Abnormal vaginal bleeding
  • After intercourse
  • After menopause
  • Between periods
• Unusual vaginal discharge
  • Does not go away
  • Gray, white, or yellow color
  • May have an odor
• Painful sexual intercourse
• Pain in the vagina
• Pressure or heaviness in the pelvis

Note: There may be no symptoms, so it is recommended that certain women be tested for chlamydia, even if they do not have symptoms.

Signs and tests

A pelvic examination may show:

• Discharge from the cervix
• Redness of the cervix
• Swelling (inflammation) of the walls of the vagina

Tests:

• Inspection of the discharge under a microscope (may show candidiasis, trichomoniasis, or bacterial vaginosis)
• Pap smear
• Tests for gonorrhea or chlamydia

Rarely, colposcopy and biopsy of the cervix is necessary.

Treatment

Antibiotics are used to treat bacterial infections, such as chlamydia, gonorrhea, and others. Drugs called antivirals may be used to treat herpes infections.

Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause (postmenopausal).

When these treatments have not worked or when cervicitis has been present for a long time, treatment may include:

• Cryosurgery(freezing)
• Electrocauterization
• Laser therapy

Expectations (prognosis)

Simple cervicitis usually heals with treatment if the cause is found and there is a treatment for that cause.

Complications

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

Calling your health care provider

Call your health care provider if you have symptoms of cervicitis.

Prevention

Ways to reduce the risk of cervicitis include:

• Avoid chemical irritants such as douches and deodorant tampons.
• Make sure that any foreign objects you insert into your vagina (such as tampons) are placed properly. Be sure to follow the guidelines on how long to leave the object inside, how often to change it, or how often to clean it.
• Not having sexual intercourse (abstinence) is the only absolute method of preventing sexually transmitted cervicitis. A monogamous sexual relationship with someone who is known to be free of any STD can reduce the risk. Monogamous means you and your partner do not have sex with any other people.
• You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time.

See also:

• Condoms
• Female condoms
• Safe sex

References

Eckert LO, Lentz GM. Infections of the lower genital tract: Vulva, vagina, cervix, Toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson, DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.

Biggs WS, Williams RM. Common gynecologic infections. Prim Care. 2009;36:33-51.

U.S. Preventive Services Task Force: Screening for Chlamydial Infection. June 2007. Accessed January 25, 2010.

Diseases characterized by urethritis and cervicitis. Sexually transmitted diseases treatment guidelines 2006. Update to CDC's sexually transmitted diseases treatment guidelines. 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. Available at www.guidelines.gov. Accessed January 25, 2010.

Answer 2

Definition

Cervicitis is swelling (inflammation) of the end of the uterus (cervix).

Alternative Names

Cervical inflammation; Inflammation - cervix

Causes, incidence, and risk factors

Cervicitis is most often caused by an infection, usually caught during sexual activity. Sexually transmitted diseases (STDs) that can cause cervicitis include:

• Chlamydia
• Gonorrhea
• Herpes virus (genital herpes)
• Human papilloma virus (genital warts)
• Trichomoniasis

However, in a few cases it may be due to:

• A device inserted into the pelvic area such as:
  • Cervical cap
  • Device to support the uterus (pessary)
  • Diaphragm
• An allergy to spermicides used for birth control or to latex in condoms
• Exposure to a chemical

Cervicitis is very common, affecting more than half of all women at some point during their adult life. Risks include:

• High-risk sexual behavior
• History of STDs
• Many sexual partners
• Sex (intercourse) at an early age
• Sexual partners who have engaged in high-risk sexual behavior or have had an STD

Bacteria (such as staphylococcus and streptococcus) and too much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis.

Symptoms

• Abnormal vaginal bleeding
  • After intercourse
  • After menopause
  • Between periods
• Unusual vaginal discharge
  • Does not go away
  • Gray, white, or yellow color
  • May have an odor
• Painful sexual intercourse
• Pain in the vagina
• Pressure or heaviness in the pelvis

Note: There may be no symptoms, so it is recommended that certain women be tested for chlamydia, even if they do not have symptoms.

Signs and tests

A pelvic examination may show:

• Discharge from the cervix
• Redness of the cervix
• Swelling (inflammation) of the walls of the vagina

Tests:

• Inspection of the discharge under a microscope (may show candidiasis, trichomoniasis, or bacterial vaginosis)
• Pap smear
• Tests for gonorrhea or chlamydia

Rarely, colposcopy and biopsy of the cervix is necessary.

Treatment

Antibiotics are used to treat bacterial infections, such as chlamydia, gonorrhea, and others. Drugs called antivirals may be used to treat herpes infections.

Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause (postmenopausal).

When these treatments have not worked or when cervicitis has been present for a long time, treatment may include:

• Cryosurgery (freezing)
• Electrocauterization
• Laser therapy

Expectations (prognosis)

Simple cervicitis usually heals with treatment if the cause is found and there is a treatment for that cause.

Complications

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

Calling your health care provider

Call your health care provider if you have symptoms of cervicitis.

Prevention

Ways to reduce the risk of cervicitis include:

• Avoid chemical irritants such as douches and deodorant tampons.
• Make sure that any foreign objects you insert into your vagina (such as tampons) are placed properly. Be sure to follow the guidelines on how long to leave the object inside, how often to change it, or how often to clean it.
• Not having sexual intercourse (abstinence) is the only absolute method of preventing sexually transmitted cervicitis. A monogamous sexual relationship with someone who is known to be free of any STD can reduce the risk. Monogamous means you and your partner do not have sex with any other people.
• You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time.

See also:

• Condoms
• Female condoms
• Safe sex

References

Eckert LO, Lentz GM. Infections of the lower genital tract: Vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.

Biggs WS, Williams RM. Common gynecologic infections. Prim Care. 2009;36:33-51.

U.S. Preventive Services Task Force: Screening for Chlamydial Infection. June 2007. Accessed January 25, 2010.

Diseases characterized by urethritis and cervicitis. Sexually transmitted diseases treatment guidelines 2006. Update to CDC's sexually transmitted diseases treatment guidelines. 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. Available at www.guidelines.gov. Accessed January 25, 2010.

Reviewed By

Review Date: 02/21/2010

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.