What Is Cervicitis?

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Cervicitis is inflammation of the cervix, the donut-shaped opening that connects the vagina to the uterus. It doesn't always cause symptoms. When it does, they may include bleeding, pain during sex, and vaginal discharge.

Cervicitis most often results from a sexually transmitted infection (STI) such as chlamydia or gonorrhea, although there are a handful of non-infectious causes as well.

The condition can be diagnosed with a pelvic exam and lab tests to identify the underlying cause. If an infection is involved, medication may be prescribed. In some cases, cervicitis resolves without treatment.

Gynecologist ready to perform a cervical smear or pap test on a teenage patient
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Cervicitis Symptoms

Cervicitis does not always cause symptoms. If symptoms do develop, they may include:

  • Gray, white, or yellowish vaginal discharge, in which case the condition is referred to as mucopurulent cervicitis
  • Vaginal bleeding between menstrual periods or after sex
  • Pain during sex (dyspareunia)
  • Pain during urination (dysuria)
  • Frequent urination
  • Pelvic heaviness or pain
  • Irritation of the vulva (vulvitis)

Some causes of cervicitis—such as herpes simplex virus (HSV)—rarely cause symptoms. Inflammation of the cervix may only be spotted during a routine pelvic exam.

Complications

In some cases, the infection causing cervicitis can spread to the uterus, fallopian tubes, or ovaries, causing a painful condition known as pelvic inflammatory disease (PID).

PID can lead to a potentially fatal infection called peritonitis, as well as infertility.

Causes

Cervicitis can be caused by any of a number of STIs, the majority of which involve Chlamydia trachomatis (the bacteria that cause chlamydia) and Neisseria gonorrhoeae (the bacteria that causes gonorrhea).

Less common causes include trichomoniasis, Mycoplasma genitalium, and genital herpes.

Cervicitis also may be caused by non-sexually transmitted diseases like bacterial vaginosis (BV).

There are many non-infectious causes of cervicitis as well, including:

  • Trauma to the cervix
  • Insertive devices, such as IUDs, cervical caps, tampons, or pessaries (devices placed in the vagina for internal organ support)
  • Allergy to latex condoms
  • Chemical irritants, such as douches, spermicides, or vaginal suppositories
  • Body-wide inflammation, such as that caused by autoimmune diseases
  • Radiation therapy

Cervicitis doesn't always have a known cause. In a 2013 study, around 60% of cases were of unknown origin.

Given the majority of cervicitis cases involve either chlamydia or gonorrhea, those of unknown origin usually are approached as an STI and treated with antibiotic drugs.

Risk Factors

The risk factors for cervicitis are similar to those for STIs and include multiple sex partners, sex without condoms, and younger age.

Having engaged in sex at an early age or having a history of a sexually transmitted infection also increases the risk.

Diagnosis

The first step in diagnosing cervicitis is to establish whether the cause is infectious or non-infectious.

Acute cervicitis, cervical inflammation that develops suddenly and severely, is usually caused by an infection.

Chronic cervicitis, inflammation that arises slowly and persists, is more likely due to a non-infectious cause.

If you're being evaluated for cervicitis, your healthcare provider will begin with a review of your symptoms and medical history. This may include questions about your sexual practices, including the number of partners you've had and whether or not you practice safer sex.

Pelvic Exam and Lab Tests

Next, the healthcare provider will do a manual exam of your vagina to check for tenderness involving the cervix, uterus, or ovaries.

A pelvic exam will be done next. This involves using a speculum to hold open your vagina so there's a clear view of your cervix and nearby tissues.

A sample of discharge from your vagina or cervix may also be taken using a cotton swab or brush. You may be asked to submit a urine sample as well. These samples will then be sent to a lab for evaluation.

Most lab test results are returned within two to three days and will detail what, if any, infections you have. Cultures for HSV can take up to two weeks.

Treatment

Cervicitis treatment depends on what caused your case. If an infection, there are standard approaches:

  • Chlamydia is treated with antibiotics. The recommended treatment is doxycycline taken twice daily for one week. Alternative treatments include azithromycin taken in a single dose or levofloxacin taken once daily for one week.
  • Gonorrhea is treated with a 500-milligram (mg) intramuscular injection of ceftriaxone.
  • Trichomoniasis is treated with metronidazole—a single large dose for men and a lower dose taken twice daily for seven days in women. Tindamax (tinidazole), given as a single dose, is an alternative treatment option.
  • Genital herpes is treated with antiviral drugs, such as Famvir (famciclovir), Valtrex (valacyclovir), or Zovirax (acyclovir). The treatment course can range from seven to 10 days. Severe cases may require intravenous (IV) acyclovir.
  • Bacterial vaginosis is treated with antibiotics. The recommended treatments include oral metronidazole or either metronidazole gel or clindamycin cream, which are both topical antibiotics applied directly to the vagina. Alternatively, tinidazole, secnidazole, or clindamycin pills may be prescribed. Clindamycin ovules, which are inserted into the vagina, are another option.

Depending on the microorganism involved, the infection should clear within several days.

Non-infectious causes can usually be alleviated by avoiding the substance or activity inciting the inflammation.

Any underlying disease or condition that promotes cervical inflammation will also need to be controlled.

It is important to treat cervicitis promptly. Untreated infections may lead to pelvic inflammatory disease, a painful and often debilitating condition that can cause scarring, ectopic pregnancy, and infertility.

Coping

Cervicitis is generally a one-off thing if appropriately treated. During treatment, you should avoid sexual intercourse until symptoms resolve in order to prevent transmission.

Try to avoid products that may cause additional vaginal irritation. For example, use menstrual pads instead of tampons. It's also best to avoid vaginal douching altogether.

Additionally, it may help to steer clear of scented soaps, sprays, or lotions and constricting underwear made of synthetic fabrics. Instead, wear comfortable, 100% cotton underwear.

Cervicitis rarely returns unless you get a new infection from a sexual partner. The consistent use of condoms and a reduction in the number of sex partners can greatly reduce your risk.

The only exception is genital herpes, which cannot be cured. However, if you have recurrent outbreaks, you can decrease their frequency and severity by taking an antiviral drug like Zovirax (aciclovir) or Valtrex (valciclovir).

A Word From Verywell

Many women with cervicitis have no symptoms. Because it's most often caused by an infection, it is important to be screened for STIs if you are sexually active. Your sexual partners should be screened as well.

The U.S. Preventive Services Task Force currently recommends sexually active women 24 years and younger and those 25 years and older who are at an increased risk of infection be screened once a year for chlamydia and gonorrhea.

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10 Sources
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