The cervix is the lower part of the uterus that connects to the vagina. Cervical health is an important but often overlooked aspect of women’s health. Many women are unaware of the signs and symptoms of cervical problems. Being informed about your cervix can help you identify issues early and get the right treatment. This article provides an overview of the most common cervical problems, their causes, symptoms, diagnosis, and treatment options. Read on to learn more about how to know if you have an issue with your cervix.
What is the Cervix?
The cervix is the lower tubular part of the uterus that connects the uterus to the vagina. It is located at the top rear of the vagina. The cervix has a small opening called the os, which dilates during childbirth to allow a baby to pass through. The cervix plays several important roles:
- It produces mucus that helps sperm move through the uterus.
- It controls the flow of menstrual blood from the uterus into the vagina.
- It keeps the fetus in place during pregnancy.
- It tightens to prevent pathogens from entering the uterus during non-pregnant states.
The cervix undergoes changes in position, texture, and dilation throughout a woman’s menstrual cycle. It may rise up slightly during ovulation. The mucus it secretes also changes in volume and texture based on the menstrual cycle.
Common Cervical Issues
Some of the most common cervical problems include:
Cervical Ectropion
Cervical ectropion, also called cervical erosion, occurs when the glandular cells from the inside of the cervical canal protrude outward onto the surface of the cervix. This causes the cervix to appear red and irritated.
It is common in adolescents, pregnant women, and women taking oral contraceptives. It usually does not cause any symptoms but may sometimes lead to spotting after sex. Cervical ectropion often goes away on its own after pregnancy or stopping contraceptives. Treatment may include silver nitrate cauterization for persistent cases.
Cervicitis
Cervicitis refers to inflammation of the cervix, usually due to an infection. It causes redness, swelling, and irritation of the cervix. Symptoms include bloody or yellow vaginal discharge, spotting between periods, painful sex, and increased urge to urinate.
Cervicitis is commonly caused by sexually transmitted infections (STIs) like chlamydia, gonorrhea, herpes, and trichomoniasis. Other causes include bacteria such as staphylococcus and streptococcus. Treatment involves antibiotics for bacterial infections and antiviral medication for viral cervicitis.
Cervical Polyps
Cervical polyps are benign overgrowths attached to the surface of the cervix or cervical canal via a stalk-like base. They range from a few millimeters to a few centimeters in size. Small polyps usually do not cause any symptoms. Larger ones may cause bleeding between periods, after sex, or after menopause.
Polyps can result from chronic cervicitis or hormonal imbalances. Cervical polyps can be removed through simple polypectomy procedures. Recurrence is uncommon. In rare cases, some cervical polyps may develop into cancer over time. Hence, removal is recommended.
Cervical Dysplasia
Cervical dysplasia refers to abnormal, precancerous cell changes in the lining of the cervix. It is most commonly caused by the human papillomavirus (HPV) infection. The abnormal cells can range from mild (LSIL) to moderate/severe (HSIL).
Most women have no symptoms. However, signs can include abnormal vaginal bleeding or discharge, pelvic pain, or discomfort during sex. Without treatment, dysplasia may worsen and turn into cervical cancer. That’s why regular Pap tests are essential to detect and treat dysplasia to prevent progression.
Cervical Cancer
Cervical cancer starts when normal cells on the cervix undergo precancerous changes and become cancerous. The most common type is squamous cell carcinoma, accounting for 80-90% of cervical cancers.
In the early stages, cervical cancer usually produces no symptoms. As it progresses, abnormal vaginal bleeding, pelvic pain, pain during sex, or foul-smelling discharge may occur.
Early detection through Pap and HPV testing dramatically improves survival rates. Cervical cancer treatment options include surgery, chemotherapy, radiation, or a combination. HPV vaccination helps prevent cervical cancer.
Risk Factors
Certain factors can increase a woman’s risk of developing cervical problems:
- Multiple sexual partners
- Early sexual activity
- History of sexually transmitted infections
- Smoking
- Weakened immune system, e.g. HIV/AIDS
- Long-term oral contraceptive use
- Giving birth to many children
- Poor genital hygiene
- Family history of cervical cancer
When to See a Doctor
Consult your gynecologist if you experience any of the following symptoms:
- Bleeding between menstrual periods or after menopause
- Bleeding or spotting after sexual intercourse
- Foul-smelling or brown/bloody vaginal discharge
- Pelvic or abdominal pain
- Discomfort or pain during sexual intercourse
- Increased urinary frequency, urgency, or incontinence
These symptoms may indicate an underlying cervical problem that requires further evaluation and treatment. It is best not to ignore these signs. Schedule an appointment with your gynecologist for a pelvic exam and Pap test to check for any cervical abnormalities.
Diagnosis
If you have any symptoms of a cervical issue, your doctor will carry out certain exams and tests to make an accurate diagnosis:
Pelvic Exam
The doctor first visually examines the vulva for any signs of inflammation, warts, ulcerations or other abnormalities. Then, a speculum is inserted into the vagina to separate the walls and allow visualization of the cervix. The doctor checks for any lesions, growths, discharge, or bleeding.
Pap Smear
Pap smear or Pap test involves collecting cells from the cervix and upper vagina to screen for precancerous or cancerous changes under a microscope. It can detect abnormal changes before cancer develops.
HPV Test
The HPV or human papillomavirus test looks for infection with high-risk strains of HPV that are linked to cervical cancer. It is often done alongside a Pap test.
Colposcopy
In this procedure, the doctor uses a special magnifying instrument called a colposcope to visually examine the vagina and cervix. It helps check for abnormal areas that may require biopsy.
Cervical Biopsy
A small sample of cervical tissue is collected and sent to the lab to test for the presence of any infection, cancer, or precancerous changes if found during colposcopy.
Endocervical Curettage (ECC)
ECC involves scraping tissue from inside the cervical canal to test for abnormalities that may not be visible upon colposcopy or biopsy.
Cone Biopsy
A cone-shaped sample of the cervix is surgically removed to test for cancerous or precancerous changes extending into the cervical canal. It may also be done as part of treatment to remove these abnormal areas.
Treatment
Treatment options for cervical problems depend on the underlying cause and may include:
Medications
Bacterial infections causing cervicitis are treated with appropriate oral or topical antibiotics based on lab culture results. Antiviral medications like acyclovir can treat viral infections.
Cryosurgery
Freezing cervical lesions with liquid nitrogen destroys abnormal tissue. It is one treatment option for mild dysplasia and warts.
Loop Electrosurgical Excision Procedure (LEEP)
LEEP uses a thin wire loop carrying electrical current to safely remove abnormal cervical tissue. Local anesthesia is administered.
Laser Therapy
A focused laser beam removes lesions, tumors or precancerous areas on the cervix.
Conization
This minor surgery removes a cone-shaped portion of the cervix containing cancerous or precancerous cells. It is done under anesthesia.
Hysterectomy
Surgical removal of the uterus and cervix. It may be recommended in severe cases where cancer has spread beyond the cervix.
Prevention
You can lower your risk of cervical problems by:
- Getting vaccinated against HPV.
- Using condoms during sex.
- Limiting your number of sexual partners.
- Avoiding smoking.
- Getting regular Pap tests as advised by your doctor.
Conclusion
Many women experience cervical changes at some point, but most are harmless or easily treatable. Being aware of the signs and symptoms, getting regular screening, avoiding risk factors, and seeking timely treatment can help prevent minor issues from becoming serious. Contact your gynecologist promptly if you notice any abnormalities for proper evaluation and management. With the right care, most cervical problems can be dealt with effectively.