Cervicitis is inflammation of the cervix (the lower, narrow part of the uterus that opens into the vagina). It may be caused by an infection or another condition.
Cervicitis is often caused by a sexually transmitted infections but may result from other conditions.
The most common symptoms are an unusual discharge from the vagina and vaginal bleeding between menstrual periods or after sexual intercourse, but women may not have any symptoms.
If symptoms suggest a cervical infection, doctors use a swab to obtain a sample from the cervix to be tested for infectious organisms.
Women are often given antibiotics that are effective against chlamydia and gonorrhea (the most common causes).
Cervicitis may spread upward from the cervix and affect the lining of the uterus (causing endometritis) and other reproductive organs, such as the ovaries and fallopian tubes. This is called pelvic inflammatory disease.
Causes of Cervicitis
If cervicitis occurs suddenly, it is usually caused by an infection. If it has been present for a long time (chronic), it is usually not caused by an infection.
Infections that commonly cause cervicitis include sexually transmitted infections such as
Chlamydia due to the bacteria Chlamydia trachomatis (most common)
Gonorrhea due to the bacteria Neisseria gonorrhoeae (second most common)
Genital herpes due to the herpes simplex virus
Infection with the bacteria Mycoplasma genitalium
Often, the infectious organism causing cervicitis cannot be identified. Infections of the vagina (such as bacterial vaginosis and trichomonal vaginitis) may also affect the cervix.
Conditions other than infections can cause cervicitis. They include
Gynecologic procedures
Objects (such as diaphragms) that are left in the vagina too long
Chemicals in douches or contraceptive creams or gels
If women are allergic to latex, latex condoms
Symptoms of Cervicitis
Cervicitis may not cause any symptoms. When it does, the most common are an unusual (sometimes yellow-green and puslike) discharge from the vagina and vaginal bleeding between menstrual periods or after sexual intercourse. Some women have pain during intercourse. The area around the opening to the vagina may be red and irritated, as may the vagina.
Women may have other symptoms depending on what is causing cervicitis. For example, if the cause is pelvic inflammatory disease, women may have a fever and pain in the lower the abdomen. Herpes simplex infection can also cause fever.
Diagnosis of Cervicitis
A doctor's evaluation
Tests on a sample taken from the cervix
A woman should see her doctor if she has a persistent, unusual vaginal discharge, vaginal bleeding other than during menstrual periods, or pain during sexual intercourse. However, because cervicitis often causes no symptoms, it may be diagnosed during a routine pelvic examination.
If symptoms suggest cervicitis, doctors do a pelvic examination. They check for a discharge from the cervix and touch the cervix with a swab to see whether it bleeds easily. If a puslike discharge is present and if the cervix bleeds easily, cervicitis is likely.
If symptoms suggest pelvic inflammatory disease, doctors use a swab to obtain a sample from the cervix to be tested for infectious organisms that can cause sexually transmitted infections (such as gonorrhea, chlamydia, or trichomoniasis) or bacterial vaginosis.
Treatment of Cervicitis
Usually antibiotics
If infection is caused by the herpes simplex virus, antiviral medications
Most women are tested for infection, but treatment is started immediately, even before test results are available. This is done to provide treatment as soon as possible to avoid complications.
Initial treatment of cervicitis consists of antibiotics that are effective against chlamydia and gonorrhea:
Once the cause of cervicitis is identified, doctors adjust the medications accordingly.
If the cause is the herpes simplex virus, infection usually persists for life. Antiviral medications can control but not cure these infections.
If the cause is a sexually transmitted infection, doctors offer testing for other sexually transmitted infections and counsel about notifying and treating sex partners. For chlamydia or gonorrhea, sex partners should be tested and treated simultaneously. For herpes simplex virus, partners are treated with antiviral medications if they have symptoms.
Women should abstain from sexual activity until the infection has been eliminated from themselves and their sex partners.
Women with confirmed chlamydia or gonorrhea, and those diagnosed with trichomoniasis, should be tested 3 months after treatment because reinfection is common.
