Cervicitis
Cervical inflammation; Inflammation - cervix
Cervicitis is swelling or inflamed tissue of the end of the uterus (cervix).
External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.
Cervicitis is the inflammation of the cervix. It is usually caused by an infection but may also be caused by chemical exposure or the presence of a foreign body.
The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.
Causes
Cervicitis is most often caused by an infection that is caught during sexual activity. Sexually transmitted infections (STIs) that can cause cervicitis include:
- Chlamydia
- Gonorrhea
- Herpes virus (genital herpes)
- Human papilloma virus (genital warts)
- Trichomoniasis
Other things that can cause cervicitis include:
- A device inserted into the pelvic area such as a cervical cap, diaphragm, IUD, or pessary
- Allergy to spermicides used for birth control
- Allergy to latex in condoms
- Exposure to a chemical
- Reaction to douches or vaginal deodorants
Cervicitis is very common. It affects more than one half of all women at some point during their adult life. Causes include:
- High-risk sexual behavior
- History of STIs
- Many sexual partners
- Sex (intercourse) at an early age
- Sexual partners who have engaged in high-risk sexual behavior or have had an STI
Too much growth of some bacteria that normally are present in the vagina (bacterial vaginosis) can also lead to cervical infection.
Symptoms
There may be no symptoms. If symptoms are present, these may include:
- Abnormal vaginal bleeding that occurs after intercourse, or between periods
- Unusual vaginal discharge that does not go away: discharge may be gray, white or yellow in color
- Painful sexual intercourse
- Pain in the vagina
- Pressure or heaviness in the pelvis
- Painful urination
- Vaginal itching
Women who may be at risk for chlamydia should be tested for this infection, even if they do not have symptoms.
Exams and Tests
A pelvic exam is done to look for:
- Discharge from the cervix
- Redness of the cervix
- Swelling (inflammation) of the walls of the vagina
Tests that may be done include:
- Inspection of the discharge under a microscope (may show candidiasis, trichomoniasis, or bacterial vaginosis)
- Pap test
- Tests for gonorrhea or chlamydia
Rarely, colposcopy and biopsy of the cervix is necessary.
Treatment
Antibiotics are used to treat chlamydia or gonorrhea. Medicines called antivirals may be used to treat herpes infections.
Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause.
Outlook (Prognosis)
Most of the time, simple cervicitis usually heals with treatment if the cause is found and there is a treatment for that cause.
Most of the time, cervicitis does not cause any symptoms. It doesn't need treatment as long as tests for bacterial and viral causes are negative.
Possible Complications
Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse.
Untreated cervicitis may lead to inflammation involving the female pelvic organs, causing a condition called pelvic inflammatory disease (PID).
When to Contact a Medical Professional
Contact your health care provider if you have symptoms of cervicitis.
Prevention
Things you can do to reduce your risk of developing cervicitis include:
- Avoid irritants such as douches and deodorant tampons.
- Make sure that any foreign objects you insert into your vagina (such as tampons) are properly placed. Be sure to follow instructions on how long to leave it inside, how often to change it, or how often to clean it.
- Make sure your partner is free of any STI. You and your partner should not have sex with any other people.
- Use a condom every time you have sex to lower your risk of getting an STI. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time.
References
Abdallah M, Augenbraun MH, McCormack W. Vulvovaginitis and cervicitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 108.
Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.
Swygard H, Cohen MS. Approach to the patient with a sexually transmitted infection. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 269.
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PMID: 34292926
Version Info
Last reviewed on: 1/10/2022
Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
