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.

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.

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.