Cervicitis is

inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...

of the uterine cervix. Cervicitis in women has many features in common with

urethritis Urethritis is the inflammation of the urethra. The most common symptoms include painful or difficult urination and urethral discharge. It is a commonly treatable condition usually caused by infection with bacteria. This bacterial infection is oft ...

in men and many cases are caused by

sexually transmitted infection Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and ora ...

s. Non-infectious causes of cervicitis can include

intrauterine device An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting revers ...

s, contraceptive diaphragms, and

allergic Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic der ...

reactions to

spermicide Spermicide is a contraceptive substance that destroys sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicid ...

s or

latex Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well. In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiosperms ...

condom A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both male and female con ...

s. Cervicitis affects over half of all women during their adult life. Cervicitis may ascend and cause endometritis and

pelvic inflammatory disease Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be ...

(PID). Cervicitis may be acute or chronic.

Symptoms and signs

Cervicitis may have no symptoms. If symptoms do manifest, they may include: * Abnormal vaginal bleeding after intercourse between periods * Unusual gray, white, or yellow

vaginal discharge Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, amou ...

* Painful sexual intercourse * Pain in the vagina * Pressure or heaviness in the pelvis * Frequent, painful urination

Causes

Cervicitis can be caused by any of a number of infections, of which the most common are

chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several we ...

and

gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium ''Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with u ...

, with chlamydia accounting for approximately 40% of cases. Other causes include ''

Trichomonas vaginalis ''Trichomonas vaginalis'' is an anaerobic, flagellated protozoan parasite and the causative agent of a sexually transmitted disease called trichomoniasis. It is the most common pathogenic protozoan that infects humans in industrialized countri ...

herpes simplex virus Herpes simplex virus 1 and 2 (HSV-1 and HSV-2), also known by their taxonomical names '' Human alphaherpesvirus 1'' and ''Human alphaherpesvirus 2'', are two members of the human ''Herpesviridae'' family, a set of viruses that produce viral in ...

'', and ''

Mycoplasma genitalium ''Mycoplasma genitalium'' (''MG'', commonly known as Mgen) is a sexually transmitted, small and pathogenic bacterium that lives on the mucous epithelial cells of the urinary and genital tracts in humans. Medical reports published in 2007 and 2 ...

''. While sexually transmitted infections (STIs) are the most common cause of cervicitis, there are other potential causes as well. This includes vaginitis caused by bacterial vaginosis or ''Trichomonas vaginalis''. This also includes a device inserted into the pelvic area (i.e. a cervical cap,

IUD An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversi ...

, pessary, etc.); an allergy to spermicides or latex in condoms; or, exposure to a chemical, for example while douching. Inflammation can also be idiopathic, where no specific cause is found. While IUDs do not cause cervicitis, active cervicitis is a contraindication to placing an IUD. If a person with an IUD develops cervicitis, it usually does not need to be removed, if the person wants to continue using it. There are also certain behaviors that can place individuals at a higher risk for contracting cervicitis. High-risk sexual behavior, a history of STIs, many sexual partners, sex at an early age, and sexual partners who engage in high-risk sexual behavior or have had an STI can increase the likelihood of contracting cervicitis.

Diagnosis

To diagnose cervicitis, a clinician will perform a pelvic exam. This exam includes a speculum exam with visual inspection of the cervix for abnormal discharge, which is usually purulent or bleeding from the cervix with little provocation. Swabs can be used to collect a sample of this discharge for inspection under a microscope and/or lab testing for

, and ''

''. A bimanual exam in which the clinician palpates the cervix to see if there is any associated pain should be done to assess for

Prevention

The risk of contracting cervicitis from STIs can be reduced by using condoms during every sexual encounter. Condoms are effective against the spread of STIs like chlamydia and gonorrhea that cause cervicitis. Also, being in a long-term monogamous relationship with an uninfected partner can lower the risk of an STI. Ensuring that foreign objects like tampons are properly placed in the vagina and following instructions how long to leave it inside, how often to change it, and/or how often to clean it can reduce the risk of cervicitis. In addition, avoiding potential irritants like douches and deodorant tampons can prevent cervicitis.

Treatment

Non-infectious causes of cervicitis are primarily treated by eliminating or limiting exposure to the irritant.

Antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...

s, usually azithromycin or doxycycline, or antiviral medications are used to treat infectious causes. Women at increased risk of sexually transmitted infections (i.e., less than 25 years of age and a new sexual partner, a sexual partner with other partners, or a sexual partner with a known sexually transmitted infection), should be treated presumptively for chlamydia and possibly gonorrhea, particularly if follow-up care cannot be ensured or diagnostic testing is not possible. For lower risk women, deferring treatment until test results are available is an option. To reduce the risk of reinfection, women should abstain from sexual intercourse for seven days after treatment is started. Also, sexual partners (within the last sixty days) of anyone with infectious cervicitis should be referred for evaluation or treated through expedited partner therapy (EPT). EPT is the process by which a clinician treats the sexual partner of a patient diagnosed with a

without first meeting or examining the partner. Sexual partners should also avoid sexual intercourse until they and their partners are adequately treated. Untreated cervicitis is also associated with an increased susceptibility to HIV infection. Women with infectious cervicitis should be tested for other sexually transmitted infections, including HIV and syphilis. Cervicitis should be followed up. Women with a specific diagnosis of chlamydia, gonorrhea, or trichomonas should see a clinician in three months after treatment for repeat testing because they are at higher risk of getting reinfected, regardless of whether their sex partners were treated. Treatment in pregnant women is the same as those who are not pregnant.

References

External links

{{Diseases of the pelvis and genitals Inflammations Sexually transmitted diseases and infections Inflammatory diseases of female pelvic organs