A Short Course on Cervical Health

January is Cervical Health Awareness Month. The cervix is the lower, narrow end of the uterus, or womb. It forms a canal between the uterus and vagina, which opens to the outside of the body. The cervix acts as a gateway to the uterus through which sperm travel to reach and fertilize an ovum, or egg cell, to create an embryo.

The aim of Cervical Health Awareness month is to encourage women to visit their health care providers for routine gynecological exams. Simple screening tests are available that can detect  common cervical disorders, such ashuman papillomavirus infection and cervical cancer. Other disorders of the cervix include cervicitis,cervical stenosis and incompetent cervix.

Human papillomavirus, or HPV, is a common virus that is passed through skin-to-skin contact. There are more than 100 strains of HPV that affect different parts of the body. About 30 of them affect the genitals. HPV, which is typically transmitted during sex, is the most common sexually transmitted infection in America. Approximately 79 million people in the US are infected with HPV. It is so common that about 80 percent of sexually active people, men and women, are infected with HPV at some point in their lives.

In about 90 percent of cases, HPV infections go away on their own. But some can lead to genital warts and cancer of the cervix, anus and throat. Certain strains of HPV – mainly types 16 and 18 – cause changes in the cells of the cervix, a condition called cervical dysplasia. If not treated, cervical dysplasia can progress to cervical cancer.

A vaccine is available for the prevention of genital warts and cancers caused by HPV infection. The US Centers for Disease Control and Prevention recommends the vaccine be given to boys and girls ages 11 or 12 because it produces a stronger immune response when given during the preteen years. But the vaccine can be given to adults as well. 

According to the American Cancer Society, there are approximately 13,000 new cases of cervical cancer diagnosed each year resulting in about 4,000 deaths annually. Cervical cancer often has no symptoms in its early stages. Advanced cervical cancer may cause abnormal discharge from the vagina or unusual bleeding, such as bleeding after sex.

There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma. Most cervical cancers (up to nine out of 10 cases) are squamous cell carcinomas. They develop in the outer part of the cervix, which is covered in squamous cells. Adenocarcinomas develop in the glandular cells of the cervix.

Treatments for cervical cancer include surgery, radiation therapy and chemotherapy. The treatment recommended depends on the kind of cervical cancer you have and how far it has spread.

Cervicitis is inflammation of the cervix caused by a sexually transmitted infection, an allergic reaction to spermicide or bacterial overgrowth. It often has no symptoms but when symptoms do appear, they may include an abnormal vaginal discharge, pain during sex, bleeding after sex and vulvar or vaginal irritation. Cervicitis is usually treated with antibiotics, but in severe cases laser therapy or surgery may be required. 

Cervical stenosis is narrowing of the passageway through the cervix. If often causes no symptoms, but it can result in changes to your menstrual periods, painful periods and abnormal bleeding. In cases of severe stenosis, the cervix can be widened by inserting small, lubricated metal rods in progressively larger sizes into the cervical opening. Your doctor may place a stent to keep the cervix open.

Incompetent cervix, also called cervical insufficiency, occurs when the cervix opens too early during pregnancy. It occurs in about one in 100 pregnancies and can result in miscarriage or premature birth. Incompetent cervix has no signs or symptoms. The most common treatment is cerclage, a procedure to sew a stitch in the cervix to make it stronger and keep it closed.       

Your health care provider can diagnose most cervical disorders during a pelvic exam and Pap test, which involves collecting a sample of cells from the cervix for testing. Depending on the disorder, your provider may order:

• HPV test – detects the presence of the human papillomavirus
• Transvaginal ultrasound – provides clear images of a woman’s reproductive organs
• Colposcopy – allows your provider to get a close-up look at your cervix.

Your health care provider can tell you how often your need to have a pelvic exam and Pap test to help prevent cervical cancer and detect other common disorders of the cervix. 

iFoundMyDoctor.com article by Patti DiPanfilo