Cervicitis

Definition
Inflammation of the uterine cervix, usually caused by infection.

Alternative names
Cervical inflammation; Inflammation - cervix

Causes, incidence, and risk factors
Cervicitis is most often caused by an infection. However, in a few cases it may be attributed to chemical exposure or a foreign body such as a pessary (a device inserted into the vagina to support the uterus), cervical cap (a birth control device), or diaphragm. The condition may also be caused by an allergy to contraceptive spermicides or to latex in condoms. In cases of cervicitis attributed to foreign objects, infection is still frequently the cause, but the presence of the foreign object may make the cervix more susceptible to infection (irritated or raw areas, buildup of discharge, unsanitary insertion methods, etc.).

Cervicitis is very common, affecting more than half of all women at some point during their adult lives. Increased risk is associated with intercourse at an early age, high-risk sexual behaviour, multiple sexual partners, and a history of sexually transmitted disease. Increased risk is also associated with having a partner who has engaged in high-risk sexual behavior or who has had a previous sexually transmitted disease. Gonorrhea, chlamydia  , and trichomonas are commonly seen sexually transmitted infections that can cause cervicitis. Infection with the herpes virus (genital herpes)  and human papilloma virus (genital warts) are two other sexually transmitted diseases that can cause cervicitis and abnormal changes in a Pap smear. Organisms such as staphylococcus and streptococcus, and excessive growth of normal vaginal bacteria (bacterial vaginosis) can also cause cervicitis.

Prevention
Studies indicate that women who begin sexual activity at a later age and engage only in a monogamous relationship have a markedly decreased incidence of both cervicitis and abnormal Pap smears. Safer sex behaviors, including monogamy, will reduce the likelihood of cervicitis. Chemical irritants such as douches and deodorant tampons should be avoided. Women who have active cervicitis should avoid using spermicidal contraceptives, if possible. However, if they are the only form of contraceptive available to you, it is better to practice safer sex by using them. Many women use barrier methods of contraception (diaphragm, condoms, cervical caps), which must be used with a spermicidal jelly for best protection against unwanted pregnancy. See your health care provider to discuss alternative contraceptive methods prior to stopping your present barrier method.

Make sure that any foreign objects that you insert into your vagina, such as a pessary, diaphragm, sponge, or tampon, are inserted and placed properly. Be sure to follow the recommended guidelines as to how long to leave the object in, how often to change it, or how often to clean it. Good hygiene is always recommended.

Symptoms

• unusual vaginal discharge
• abnormal vaginal bleeding
• sexual intercourse, painful
• vaginal pain

Note: There may be no symptoms.

Signs and tests
A pelvic examination reveals redness of the cervix or evidence of a cervical discharge. It may also reveal inflammation of the vaginal walls caused by the infected discharge.

Tests:

• Tests for gonorrhea or Chlamydia may be positive.
• A wet mount inspection of the discharge may show evidence of candidiasis, Trichomonas, or bacterial vaginosis.

A Pap smear may show evidence of inflammation or infection.