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Cervicitis
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Cervicitis is an inflammation of the cervix, the lower, narrow end of your uterus that opens into your vagina. Most cases of cervicitis are without symptoms (asymptomatic) and of little consequence; however, some cases of cervicitis are caused by infection with sexually transmitted diseases, including gonorrhea and chlamydia.
Successful treatment of cervicitis may involve addressing the cause of the inflammation. In some cases of cervicitis, antibiotics are used to clear an underlying infection.
You can reduce your risk of developing significant cervicitis by practicing safer sex and by following your doctor's recommended Pap screening schedule.
Symptoms
Most often, cervicitis causes no signs and symptoms, and you may only learn you have the condition after a Pap test or a biopsy for another condition. If you do have signs and symptoms, they may include:
- Large amounts of vaginal discharge that's grayish or yellow and pus-like (mucopurulent discharge) and that sometimes has an unpleasant odor
- Frequent, painful urination
- Pain during intercourse
- Vaginal bleeding after intercourse, between menstrual periods or after menopause
When to see a doctor
See your doctor if you have:
- Persistent, unusual vaginal discharge
- Nonmenstrual vaginal bleeding
- Pain during intercourse
Often, cervicitis produces no signs and symptoms and may be discovered only in the course of a routine Pap test — a good reason to have regular pelvic exams and Pap tests.
Causes
Two types of cells line your cervix: flat, skin-like cells (squamous cells) and glandular cells that secrete mucus. The same organisms responsible for vaginitis, an inflammation of the vagina, can cause cervicitis.
Your cervix acts as a barrier to keep bacteria and viruses that come in contact with your vagina from entering your uterus. However, when bacteria and viruses infect the cervix, they cause inflammation and may increase the risk that the infection will travel into your uterus.
Possible causes of cervicitis include:
- Sexually transmitted infections. Most often, the bacterial and viral infections that cause cervicitis are transmitted by sexual contact. Cervicitis can result from infection with common sexually transmitted diseases (STDs), including gonorrhea, chlamydia and genital herpes. There's no evidence that human papillomavirus (HPV), another common sexually transmitted infection, causes cervicitis.
- Allergic reactions. An allergy, either to contraceptive spermicides or to latex in condoms, may lead to cervicitis.
- Bacterial overgrowth. An overgrowth of bacteria that normally appear in the vagina (bacterial vaginosis) also can lead to cervicitis.
Risk factors
You're at greater risk of getting cervicitis associated with STDs if you:
- Engage in high-risk sexual behavior, such as if you have unprotected sex or sex with multiple partners
- Began having sexual intercourse at an early age
- Have a history of sexually transmitted diseases
You may also be at increased risk if you have sex with a partner who has engaged in high-risk sexual behavior or has had a sexually transmitted disease.
Complications
Cervicitis that's caused by gonorrhea or chlamydia can spread to the uterine lining and the fallopian tubes, resulting in pelvic inflammatory disease (PID), an infection of the female reproductive organs, including the uterus, fallopian tubes, cervix and ovaries. Women who develop PID may experience pelvic pain, fever and vaginal discharge, or have no signs or symptoms. PID may be detected only later when a woman has trouble becoming pregnant and learns that her reproductive organs have been damaged.
Preparing for your appointment
Cervicitis is most often discovered incidentally during a routine pelvic exam and Pap test and often doesn't require treatment. If, however, you experience unusual vaginal symptoms that lead you to schedule an appointment, you'll most likely see a gynecologist, family doctor or other health care provider.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
So that your doctor can observe and evaluate any vaginal discharge you have, avoid using tampons and don't douche before your appointment.
Also make a list of all medications or supplements you're taking or any allergies you have. Write down questions to ask your doctor. Some basic questions include:
- Can I do anything to prevent cervicitis?
- What signs and symptoms should I watch out for?
- Do I need to take medicine?
- Does my partner also need to be tested or treated?
- Are there any special instructions for taking the medicine?
- Are there any over-the-counter products that will treat my condition?
- What can I do if my symptoms return after treatment?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment if you don't understand something.
Questions your doctor may ask
Be prepared to answer questions your doctor may have, such as:
- What vaginal symptoms are you experiencing?
- Do you notice a strong vaginal odor?
- Are you experiencing any urinary problems, such as pain during urination?
- How long have you had your symptoms?
- Are you sexually active?
- Are you experiencing any pain or bleeding during intercourse?
- Do you have abdominal pain?
- Do you douche or use any feminine hygiene products?
- Are you pregnant?
- Have you tried any over-the-counter products to treat your symptoms?
- What medications or vitamin supplements do you regularly take?
Tests and diagnosis
Your doctor will likely perform a physical examination, including:
- A pelvic exam. This exam may reveal redness of the cervix and evidence of discharge. During the exam, your doctor checks your external genitalia to make sure they look normal. To see the inner walls of your vagina and cervix, your doctor inserts an instrument called a speculum into your vagina to hold the vaginal walls apart. After removing the speculum, your doctor inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she palpates your uterus, ovaries and other pelvic organs.
- A specimen collection. In a process similar to a Pap test, your doctor uses a small cotton swab or a brush to gently remove a sample of cervical and vaginal fluid. The procedure generally takes only a few minutes. Your doctor sends the sample to a laboratory to test for infections. Lab tests also may be performed on a urine sample.
Treatments and drugs
You may not need treatment for cervicitis that's not caused by an STD. If the cause is an STD, both you and your partner are likely to need treatment.
Prescription medications often can clear up the inflammation of cervicitis. Treatment for a bacterial infection is with an antibiotic. If the cause is viral, such as genital herpes, the treatment is an antiviral medication. However, antiviral medication doesn't cure herpes, which is a chronic condition.
To avoid passing an infection along to your partner, abstain from sexual intercourse until you're finished with the treatment recommended by your doctor.
Prevention
One of the best ways to reduce the risk of cervicitis from STDs is to practice safer sex. Women who become sexually active at a later age and those in monogamous relationships are at a lower risk of getting cervicitis than are those who become sexually active early in life and who have multiple partners.
Using a latex condom during intercourse reduces the risk of sexually transmitted infections. However, some women have allergies to latex condoms or to spermicidal jelly, which is used with condoms to prevent pregnancy. If you're allergic to latex, you'll need to use a nonlatex condom or another method of birth control. No other birth control method besides condoms protects against STDs.
- McCormack WM. Vulvovaginitis and cervicitis. In: Mandell GL, et al. Mandell, Douglas, and Bennett's: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa.: Elsevier Churchill Livingstone; 2005. http://www.mdconsult.com/das/book/body/161833431-5/0/1259/794.html?tocnode=51379230&fromURL=794.html. Accessed Sept. 23, 2009.
- Marrazzo J. Cervicitis. http://www.uptodate.com/home/index.html. Accessed Sept. 23, 2009.
- Eckert LO, et al. Infections of the lower genital tract: Vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/161833431-5/0/1524/147.html?tocnode=53759472&fromURL=147.html. Accessed Sept. 23, 2009
- Sexually transmitted diseases treatment guidelines 2006: Diseases characterized by urethritis and cervicitis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2006/urethritis-and-cervicitis.htm. Accessed Sept. 25, 2009.
- Marrazzo J. Cervicitis. In: Klausner JD, et al. Current Diagnosis & Treatment of Sexually Transmitted Diseases. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aid=3025026. Accessed Sept. 25, 2009.
