Cervicitis is a medical condition where the inner lining of the cervix becomes inflamed. It can be acute or chronic, with symptoms varying from no symptoms to mucus-like discharge and signs of illness throughout the body.

How Common is Cervicitis?

The prevalence of cervicitis is hard to measure due to differing definitions and population variations, but it is more common in sexually active individuals, particularly women aged 15 to 24.

What are signs and symptoms of Cervicitis?

Common signs and symptoms of cervicitis include: - Unusual vaginal discharge - Bleeding between periods or after sex - Pain during sex - Urinary symptoms, which could suggest simultaneous urethritis - Abdominal pain, which could indicate pelvic inflammatory disease or endometritis During a pelvic and vaginal examination, the following signs may be observed: - Yellow or slimy discharge from the cervix - Friability of the cervix, which means it bleeds easily when touched with a cotton applicator - Small dots of bleeding, known as a "strawberry vagina," which may indicate a trichomonas infection - Blisters and sores, which could suggest a herpes simplex virus (HSV) infection It's important to note that some cases of cervicitis, particularly those caused by Mycoplasma, may not show any symptoms. Additionally, if a woman has a high fever, abdominal tenderness, or pain during a cervical motion test, there may be an infection in the upper reproductive organs.

How do you get Cervicitis?

Cervicitis can be caused by infectious agents such as bacteria and viruses, as well as non-infectious factors like physical and chemical irritants.

What else can Cervicitis be?

The doctor needs to rule out the following conditions when diagnosing Cervicitis: - Pelvic inflammatory disease (PID) - Other types of vaginal infections such as trichomonas and bacterial vaginosis (BV) - Herpes Simplex Virus (HSV) - Allergies on the skin (contact dermatitis) - Wider health conditions like lichen planus - Genitourinary syndrome of menopause

What kinds of test are needed for Cervicitis?

The types of tests that are needed for cervicitis include: - Nucleic acid amplification testing (NAAT) to identify common organisms such as chlamydia and Neisseria. - Saline microscopy, amine whiff test, and checking the vagina's pH level to test for bacterial vaginosis (BV). - NAAT test to diagnose trichomonas. - NAAT test to look for mycoplasma if other tests cannot identify the organism. - HSV (Herpes Simplex Virus) testing if there is a strong suspicion of this infection based on specific symptoms.

What are the side effects when treating Cervicitis?

When treating cervicitis, the main concern is the risk of the infection spreading to the upper genital tract, which can lead to pelvic inflammatory disease (PID). PID can cause inflammation and scarring of the fallopian tubes, resulting in serious health issues such as the formation of abscesses, chronic pain and infection, ectopic pregnancy (a pregnancy outside the uterus), and infertility. Delayed treatment for PID caused by chlamydia can triple the risk of infertility.

Are there long term effects of Cervicitis?

The prognosis for cervicitis is generally positive. Most patients recover within one to two weeks, and there is no need for a follow-up test to confirm recovery. However, if treatment is not successful and the infection returns, further tests and investigations may be necessary to determine the cause and appropriate management. Chronic cases of cervicitis, which last for three months or longer, may be caused by non-infectious sources and may require different treatment approaches.

What type of doctor should I see for Cervicitis?

You should see a gynecologist for Cervicitis.

Cervicitis

What is Cervicitis?

Cervicitis is a medical condition where the inner lining of the cervix (the lower part of the uterus) becomes inflamed. It can either be acute, meaning it comes on quickly due to an infection, or chronic, which means it lasts for a long period and is usually not caused by an infection. Symptoms can range widely in patients. Some may not experience any symptoms while others may have mucus-like discharge from the cervix and show signs of illness throughout the body.

Regardless of the symptoms, all types of Cervicitis can potentially lead to serious complications like pelvic inflammatory disease (PID), a condition that affects women’s reproductive organs. Hence, it’s crucial for doctors to identify the symptoms promptly, carry out the necessary checks to reach a conclusion, and start appropriate treatment right away. This approach can help prevent the conditions from getting worse.

What Causes Cervicitis?

The cause of cervicitis, an inflammation of the cervix, can mainly be classified into two groups – infectious and non-infectious.

For infectious causes, it could be due to different types of bacteria and viruses such as Neisseria gonorrhea, Chlamydia trachomatis, and less commonly, herpes simplex, Trichomonas vaginalis, and Mycoplasma genitalium. Neisseria and chlamydia infect the inner lining of the cervix, while HSV and trichomonas affect the outer lining. Bacterial vaginosis, another type of bacterial infection, is also linked to cervicitis.

Non-infectious causes include physical and chemical irritants. These can include surgical tools, or personal items like pessaries (which are inserted into the vagina to support it), condoms, diaphragms, cervical caps, or tampons that can cause physical injury to the cervix. Chemical irritants which cause allergic reactions involve things like soaps, laundry products, spermicides, latex, vaginal washes, and contraceptive creams.

Cervicitis can also be linked with systemic inflammatory diseases like lichen planus and Behcet syndrome. In post-menopausal women, whether due to natural ageing or surgery, the thinning of the vaginal and uterine lining can also mimic cervicitis.

However, it’s important to note that in more than half the cases, the exact cause of cervicitis cannot be determined. Also, just by looking at the cervix, it’s not possible to distinguish whether the inflammation was caused by physical or chemical irritants or due to infection.

Risk Factors and Frequency for Cervicitis

Cervicitis, or inflammation of the cervix, is a condition whose prevalence is hard to measure, mainly due to differing definitions and population variations. The primary risk factor for this condition is sexual activity, and it’s therefore more common in sexually active people. Roughly one-third to half of the patients visiting sexually transmitted infection (STI) clinics could be affected by cervicitis.

Most of the cases are found in sexually active women aged 15 to 24.
It’s more frequently seen in women with Human Immunodeficiency Virus (HIV), with around 7400 in every 100,000 women diagnosed with HIV having cervicitis.
An organism called Mycoplasma is often responsible for the condition in this group.
Cervicitis caused by Chlamydia is 4 to 5 times more prevalent than the form caused by gonorrhea.

Interestingly, one study showed that 61% of women partaking in a randomized trial did not have any of the common pathogens that cause cervicitis (like chlamydia, Neisseria, trichomonas, or mycoplasma), identified by a specific type of testing known as nucleic acid amplification testing (NAAT). These findings imply that many cases of cervicitis might be caused by unknown agents.

Signs and Symptoms of Cervicitis

When trying to identify risk factors in patients who might have cervicitis, it’s crucial to take a comprehensive medical history. Importantly, women, whether they present with symptoms or not, should be asked about their sexual history. The five key topics to discuss are:

Sexual partners
Sexual practices
Pregnancy prevention
Protection from sexually transmitted infections (STIs)
History of STIs

Common signs of cervicitis are unusual vaginal discharge and bleeding between periods or after sex. Pain during sex is another symptom. Additionally, we must also investigate if they are experiencing urinary symptoms (which could suggest simultaneous urethritis), and abdominal pain (which could indicate pelvic inflammatory disease or endometritis).

Every woman suspected to have cervicitis should have a pelvic and vaginal examination. These patients often have a yellow or slimy discharge from the cervix. The cervix might also bleed easily when touched with a cotton applicator – a condition known as friability. However, a normal physical exam doesn’t necessarily mean there’s no infection. Also, small dots of bleeding (known as a strawberry vagina) hints at a trichomonas infection, while blisters and sores could suggest a herpes simplex virus (HSV) infection. It’s worth noting that Mycoplasma cervicitis often doesn’t show any symptoms, so many cases remain undiscovered.

If a woman has a high fever, abdominal tenderness, or pain during a cervical motion test, there might be an infection in the upper reproductive organs.

Testing for Cervicitis

Once a doctor has made an initial diagnosis based on your symptoms and physical examination, the next step would be to figure out what’s causing the infection. For this, they usually use a test called the nucleic acid amplification testing (NAAT). This test is excellent at finding the most common organisms responsible for the infection, such as chlamydia and Neisseria. They can perform this test using samples taken from the end of the cervix, vaginal fluid, or urine.

If the doctor suspects you might have another type of vaginal infection at the same time, they might test for conditions like trichomonas and bacterial vaginosis (BV). For BV, they typically use a few different tests such as saline microscopy, amine whiff test, and checking the vagina’s pH level. On the other hand, for diagnosing trichomonas, they usually prefer the NAAT test. If these tests cannot identify the organism causing your symptoms, the doctor might use NAAT to look for another organism called mycoplasma.

The doctor usually wouldn’t test for HSV (Herpes Simplex Virus) unless they strongly suspect that you have this particular infection based on your specific symptoms.

Treatment Options for Cervicitis

The resolution of symptoms of cervicitis, an inflammation or infection of the cervix, depends on what’s causing the condition. The Center for Disease Control (CDC) recommends immediate treatment for women at higher risk of sexually transmitted infections (STIs), such as women under 25, those with a new sexual partner, a partner with an STI, or multiple simultaneous sexual partners. This treatment aims to prevent infections like chlamydia and gonorrhea.

Immediate treatment is also suggested for women who have cervicitis, but the cause hasn’t been identified. However, for women at lower risk of STIs, treatment can wait until confirmatory tests are available and the cause is known.

The standard treatment could involve antibiotics like azithromycin or an antibiotic combination such as oral doxycycline combined with cefixime or ceftriaxone. If a specific infectious agent is discovered through tests, different treatments might be used:

Chlamydia and Gonorrhea are treated with a combination of azithromycin and either doxycycline, or a combination of ceftriaxone.
Mycoplasma is treated with moxifloxacin, especially if azithromycin doesn’t work.
Trichomonas and bacterial vaginosis are treated with either metronidazole or tinidazole.
Herpes simplex virus (HSV): is treated with acyclovir.

Treating sexual partners is also recommended, and to avoid spreading the infection, you should abstain from sexual activity until the treatment is complete and the symptoms have cleared.

It’s worth noting that women with HIV who have cervicitis are given the same treatment as those without HIV. Treating cervicitis promptly in these women can reduce viral shedding and may lower the risk of spreading HIV.

Women who suffer from cervicitis are often at a higher risk of having sexually transmitted infections (STIs). Therefore, it’s crucial they get tested for these. When the test results for infections come back negative, doctors will then consider non-infectious causes. These might include allergies on the skin (contact dermatitis) or wider health conditions like lichen planus. It’s important to note that for women who are postmenopausal, symptoms of a condition known as genitourinary syndrome of menopause can seem a lot like cervicitis. However, this syndrome also comes with other signs such as atrophic vaginitis.

What to expect with Cervicitis

: Generally, the outlook for cervicitis – or inflammation of the cervix due to infection – is positive. Most patients recover within one to two weeks, and there is no need for a follow-up test to confirm recovery.

However, if treatment isn’t successful and the infection returns, the first thing to do is to confirm through additional tests that the infection-causing organism has been completely eradicated previously. Then, the doctor will check thoroughly your history for potential reinfection (like having a new or untreated sexual partner) or non-infectious causes (such as chemical irritants or systemic diseases – diseases affecting the whole body). If another infection is ruled out, the doctor doesn’t have many options for further management. Keeping on taking antibiotics is also not advised because there’s no proof that it helps, and it could contribute to antibiotic resistance – when bacteria evolve to defy drugs created to kill them.

A chronic case of cervicitis – which means lasting symptoms like persistent discharge for three months, even after excluding or treating any infection – is usually caused by non-infectious sources. There is no standard approach to these cases. However, this type of cervicitis with unknown cause may respond to antibiotics, or treatments such as the application of silver nitrate or a loop electrosurgical excision procedure (a method to remove abnormal tissues from the cervix).

Possible Complications When Diagnosed with Cervicitis

The main concern with cervicitis, or inflammation of the cervix, is the risk of the infection spreading to the upper genital tract, causing a condition known as pelvic inflammatory disease (PID). PID can lead to inflammation and scarring of the fallopian tubes, which can result in serious health issues. These issues can be immediate or long-term, and can include the formation of abscesses, chronic pain and infection, an ectopic pregnancy (a pregnancy outside the uterus), and infertility. Research has shown that the risk of infertility can triple if treatment for PID, caused by chlamydia, is delayed.

Common Risks:

Spread of infection to the upper genital tract
Pelvic Inflammatory Disease (PID)
Inflammation and scarring of the fallopian tubes
Formation of abscesses
Chronic pain and infection
Ectopic pregnancy
Infertility

Preventing Cervicitis

Like all sexually transmitted diseases, teaching patients about prevention is crucial to reducing the spread of these diseases. The ‘ABC’ strategy, which means ‘Avoid sex (Abstinence), Be faithful, and always use Condoms’, when used, could help slow down the transmission of these diseases. This is particularly important for women who are capable of having children because getting treatment quickly can help prevent a variety of complications that can occur if the disease spreads to the upper female reproductive system.