Cervicitis

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Introduction

What is cervicitis?

Cervicitis is inflammation of the cervix, the lower portion of the uterus that protrudes into the vagina. Cervicitis is most commonly due to sexually transmitted infections, or STIs, although it may be due to other types of infections, irritation or allergy. Cervicitis is a common condition; more than half of all women develop it at some point (Source: PubMed).

Sexually transmitted infections that can cause cervicitis include Chlamydia, gonorrhea, Trichomonas, herpes, and the human papilloma virus, or HPV, the virus that causes genital warts. These infections may be present without symptoms, or they may cause problems, such as vaginal discharge, itching, pain during intercourse, pelvic pain, vaginal bleeding, or a sensation of pelvic pressure or fullness. Several of these conditions can be cured with antibiotics. Herpes and genital warts cannot be cured; however, management of their symptoms may be possible.

Diagnosing cervicitis includes testing for sexually transmitted infections, including chlamydia, gonorrhea, HIV, syphilis and hepatitis C. All sexual partners should be contacted and offered treatment if testing diagnoses a sexually transmitted infection.

Chemicals, spermicides, lubricants and condoms can cause cervicitis due to irritation or allergy, depending upon their composition. Vaginal devices that rest against the cervix, such as cervical caps, diaphragms, and pelvic support devices (pessaries), can also cause cervicitis, as can certain bacteria or bacterial imbalances. Symptoms may mimic those seen with sexually transmitted infections. Treatment depends upon the cause, but may include antibiotics, estrogen therapy in postmenopausal women, or avoidance of products that cause irritation or allergy.

The risk of cervicitis can be reduced by observing safe sexual practices and avoiding known irritants or allergens.

Left untreated, some cervical infections can develop into pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs) and result in pelvic abscesses, generalized inflammation of the pelvic tissues, and inflammation of the area around the liver. Seek immediate medical care (call 911) for serious symptoms, such as high fever (higher than 101 degrees Fahrenheit) or severe pain in the pelvis or abdomen, or if you develop symptoms of cervicitis during pregnancy.

Some types of cervicitis require treatment to avoid long-term complications. If you have symptoms of cervicitis or if you have been exposed to a sexually transmitted infection, seek prompt medical care. Also seek prompt medical care if you are being treated for cervicitis but symptoms recur or are persistent.

Symptoms

What are the symptoms of cervicitis?

Symptoms of cervicitis can include vaginal discharge, itching, pain during intercourse, pelvic pain, vaginal bleeding, or a sensation of pelvic pressure or fullness. If it progresses into pelvic inflammatory disease, fever, pain in the right upper abdomen, and malaise may develop.

Common symptoms of cervicitis

Common symptoms of cervicitis include:

  • Pain during sexual intercourse
  • Pelvic pain
  • Pelvic pressure or fullness
  • Vaginal bleeding
  • Vaginal discharge
  • Vaginal itching

Serious symptoms that might indicate a life-threatening condition

In some cases, complications of cervicitis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of cervicitis during pregnancy or have any of these life-threatening symptoms including:

Causes

What causes cervicitis?

Sexually transmitted infections, such as Chlamydia, gonorrhea, Trichomonas, herpes, and the human papilloma virus (HPV, the virus that causes genital warts), are the most common cause of cervicitis. It can also be caused by bacterial infections with Streptococcus or Staphylococcus or by an overgrowth of the bacteria normally found in the vagina.

Irritation and allergy can also cause cervicitis. Irritation may be due to a vaginal device, such as a diaphragm, cervical cap, or uterine support device (pessary) rubbing on the cervix, or due to chemicals or components of spermicides or lubricants. Latex is a common cause of cervicitis due to an allergic reaction.

What are the risk factors for cervicitis?

A number of factors increase the risk of developing cervicitis. Not all people with risk factors will get cervicitis. Risk factors for cervicitis include:

  • Allergies to latex or spermicides

  • Multiple sexual partners

  • Personal high-risk sexual behavior

  • Personal history of a sexually transmitted infection

  • Sexual contact with someone who engages in high-risk sexual behavior or who has had a sexually transmitted infection

  • Use of deodorant tampons or douches

  • Use of spermicides or lubricants with irritants

  • Young age at first sexual intercourse

Reducing your risk of cervicitis

You may be able to lower your risk of cervicitis by:

  • Avoiding known irritants or allergens

  • Avoiding sexual intercourse

  • Engaging in sexual intercourse with a single monogamous partner

  • Following instructions when using something, such as a diaphragm, cervical cap, pessary, or tampon

  • Getting tested for sexually transmitted infections annually if you have multiple sexual partners or a new sexual partner

  • Getting vaccinated against human papilloma virus (HPV)

  • Using condoms during sexual intercourse

  • Using estrogen creams when using a pessary, if prescribed by your health care provider

Treatments

How is cervicitis treated?

Treatment of cervicitis depends upon its cause. Infections with Streptococcus or Staphylococcus and bacterial imbalances can be treated with antibiotics, as can sexually transmitted infections, such as Chlamydia, gonorrhea and Trichomonas. With sexually transmitted infections, it is important that your partner be treated at the same time to avoid reinfection. Although herpes infections are not curable, antiviral medications can help minimize symptoms and reduce the frequency of outbreaks. Human papilloma virus (HPV) infections are also not curable, but cervical changes due to HPV can be treated with cryotherapy (freezing), electrocautery, or laser surgery.

Estrogen cream can help treat cervicitis in postmenopausal women who use pelvic support devices (pessaries). In cases where irritants or allergens can be identified, avoidance can lead to resolution of cervicitis.

Common treatments for cervicitis

Common treatments for cervicitis include:

  • Antibiotics, such as azithromycin (Zithromax), ceftriaxone (Rocephin), cefixime (Suprax), clindamycin (Cleocin), doxycycline (Vibramycin), or metronidazole (Flagyl)

  • Antiviral medications, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex)

  • Cryotherapy (freezing)

  • Electrocautery

  • Estrogen cream (Estrace cream, Premarin cream, Vagifem) or gel (Estrogel)

  • Laser surgery

What you can do to improve your cervicitis

When sexually transmitted infections, such as Chlamydia, gonorrhea and Trichomonas are the cause of cervicitis, following your treatment plan can help reduce your risk of reinfection and complications. Other ways to improve your cervicitis include:

  • Abstaining from intercourse until you and your partner(s) have completed treatment and have no symptoms

  • Finishing all medication as prescribed

  • Getting retested three months after completing therapy

  • Referring your sexual partner(s) for testing and treatment

What are the potential complications of cervicitis?

Complications of untreated cervicitis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of cervicitis include:

  • Cervical cancer

  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)

  • Fitz-Hugh-Curtis syndrome (inflammation around the liver)

  • Genital warts

  • Infertility

  • Pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs)

  • Permanent or chronic pelvic pain

  • Tubo-ovarian abscess (abscess of the ovary and fallopian tube)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Cervical cancer. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002464/.
  2. Sexually transmitted diseases (STDs). Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2010/default.htm.
  3. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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