Happy New Year! Let’s start off 2023 by delving right into a January health observance: Cervical Health Awareness Month. This observance was created to encourage women to be more attentive to their cervical health and also to learn more about some of the disorders that can affect the cervix. We’ll describe three of those disorders in this blog.
The cervix is the lower, narrow end of the uterus (womb) that forms a canal between the uterus and the vagina, the tube-like organ that serves as a passageway out of the body. Common disorders of the cervix include cervicitis, cervical stenosis and cervical cancer.
Cervicitis is inflammation of the cervix. It may be caused by a sexually transmitted infection (STI) such as gonorrhea, chlamydia, herpes or trichomoniasis. These STIs are typically passed through vaginal, anal or oral sex. Cervicitis can also be caused by irritation of the cervix from contact with the spermicides or latex in condoms, as well as with douches, tampons and diaphragms.
In many cases, cervicitis has no symptoms. When symptoms are present, they may include vaginal discharge that contains pus, pain or bleeding during sex, and vulvar or vaginal irritation. Cervicitis is very common. It has been estimated that more than half of all adult women will have the disorder at some point in their lives.
The best way to detect cervicitis is to see a health care provider for routine pelvic exams and Pap tests. The provider may also test for STIs. Treatment for cervicitis typically involves antibiotics. Treating sexual partners may also be recommended. Cervicitis can’t always be prevented, but the risk for getting STIs can be reduced by using a condom.
With cervical stenosis, the passageway through the cervix is very narrow or closed. It often causes no symptoms, but it may cause menstrual abnormalities. These may include amenorrhea (no periods), dysmenorrhea (painful periods) and abnormal bleeding. Cervical stenosis may also result in infertility because sperm cannot get through the narrowed cervix to fertilize the egg.
Cervical stenosis is often the result of another disorder or condition. Common causes include cancer of the cervix or lining of the uterus (endometrial cancer), previous procedures on the cervix or uterus, radiation treatment, endometriosis, and cysts or abnormal growths on the cervix.
If symptoms are present, a doctor will likely order tests to rule out cancer. These tests may include a Pap or HPV test and an endometrial biopsy. But before these tests, the doctor will likely perform a dilation and curettage (D&C) to widen the cervix. This way, the doctor can access the cervix to take samples of the cells for testing.
Treatment for cervical stenosis typically involves widening the cervix by inserting small, lubricated metal rods in progressively larger sizes. In an attempt to keep the cervix open, the doctor may place a tiny tube, called a stent, in the cervix for four to six weeks.
There are no known steps for preventing cervical stenosis.
Cervical cancer is a disease in which the cells of the cervix become abnormal and grow out of control. Small changes that occur in the DNA of the cells tell them to multiple excessively, and those extra cells accumulate into masses, or tumors.
Approximately 14,000 Americans are diagnosed with cervical cancer each year, and around 4,000 die. It is most frequently diagnosed in patients ages 35 to 44. Almost all cervical cancers are caused by the human papillomavirus (HPV), a common virus that is spread through sexual contact including anal, oral and vaginal sex.
Early stages of cervical cancer often have no symptoms. When it has advanced, it may cause watery or bloody discharge from the vagina that has a bad smell, or vaginal bleeding after sex, between periods or after menopause. Menstrual periods may be heavier and last longer than normal.
Routine gynecological screenings with a pelvic exam and a Pap test can detect most cases of cervical cancer. The doctor may also order an HPV test to look for signs of HPV infection. The treatments typically used for cervical cancer include radiation therapy, chemotherapy, surgery, targeted therapy and immunotherapy.
There are some steps to can take to help prevent cervical cancer. See a doctor for regular pelvic exams and Pap tests, use condoms during sex, and limit sexual partners. If eligible, consider getting vaccinated against HPV.