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Cervicitis

CAug 13 04

 

What Is It?

The cervix is the donut-shaped opening to the uterus. Cervicitis is an inflammation and irritation of the cervix. Symptoms of cervicitis can be similar to vaginitis, with vaginal discharge, itching or pain with intercourse.

Cervicitis usually is caused by sexually transmitted diseases (STDs), such as gonorrhea and chlamydia. Genital herpes also can cause cervicitis. Trauma to the cervix, in childbirth or from an intrauterine device (IUD), is a more rare cause of cervicitis.

Symptoms

Symptoms of cervicitis include pain during intercourse, a bloody vaginal discharge, or vaginal spotting or bleeding between periods. If the urethra (urine tube) also becomes infected, you may feel burning when you urinate or you may urinate more often. Cervicitis can spread to your uterus, fallopian tubes or ovaries, which is a condition called pelvic inflammatory disease. If you have pelvic inflammatory disease, you may have abdominal pain or fevers.

Diagnosis

Your health-care provider will ask about your medical history and whether you have any new sexual partners. He or she will do a pelvic exam to look at your cervix. This is done with a device called a speculum. This is a metal or plastic device shaped like a duckbill that holds the vagina open. If you have cervicitis, the lining of the cervix may appear red, inflamed, swollen or irritated. In more severe cases, pus may be coming from the cervix. During the pelvic exam, your doctor will take a sample of discharge or pus from your cervical opening so it can be tested in a laboratory and examined under a microscope. By looking at the discharge under a microscope in the office, your health-care provider can check for any signs of yeast, bacterial vaginosis or trichomonas infection that could give similar symptoms.

Your health-care provider also will examine your pelvic area using his or her fingers to look for tenderness of the cervix, uterus or ovaries. To do this, your health-care provider will place his or her fingers are placed inside your vagina.

If your cervix is tender, it’s possible you have an STD or a condition called pelvic inflammatory disease in addition to cervicitis. Your health-care provider will order tests on discharge from your cervix area to determine if you have gonorrhea, chlamydia or genital herpes.

Expected Duration

Once cervicitis is diagnosed and the appropriate treatment is started, symptoms should start to improve within a few days. If there are any signs of pelvic inflammatory disease, you will need to take antibiotics for two weeks.

Prevention

Cervicitis most often is caused by an STD, so it is important to use a condom every time you have sex, and to limit the number of sexual partners you have. If you are diagnosed with an STD, your recent sexual partners also should get tested and treated as well.

Treatment

Treatment is guided by the type of infection you have. If the physical examination suggests you might have cervicitis, your health-care provider may start treatment with antibiotics for STDs before the test results come back. This might involve an injection of the antibiotic ceftriaxone (Rocephin) or a high single dose of the antibiotic azithromycin (Zithromax). These medications treat both gonorrhea and chlamydia. Doxycycline (sold under several brand names) is commonly used to treat chlamydia, and may be prescribed in addition to one of the other antibiotics. If you are allergic to any of these antibiotics, an alternative can be prescribed.

If you have genital herpes, an antiviral medication will be prescribed. This could be acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir). You will need to take the medication for up to ten days the first time you develop genital herpes. If the condition comes back, you will need to take the medication for up to five days.

If you are diagnosed with an STD, it is important to tell any recent sexual partners that they must see a health-care professional for testing and treatment. This is especially important so that you do not get the infection again after you have been treated successfully.

The other less frequent bacterial causes of cervicitis — trauma, instrumentation or an IUD — are treated with an antibiotic targeted to the type of infection. The associated inflammation will heal within days to a few weeks. It will help to avoid sexual intercourse until symptoms improve to avoid any further irritation to the cervix.

When To Call A Professional

If you have recurring pain during intercourse, a new vaginal discharge or discharge that has changed in color, vaginal spotting, or bleeding between periods, you should make an appointment to see your health-care provider.

If your symptoms also include fever or abdominal pain, you should see your health-care provider as soon as possible.

Prognosis

Cervicitis will go away within a few days to a week after you start taking antibiotics. If you have pelvic inflammatory disease, it may take a few weeks to treat the infection completely. Pelvic inflammatory disease can cause more serious problems, such as infertility or pain from scar tissue. While these additional conditions can be treated, they sometimes require surgery.

Cervicitis rarely comes back if it is treated with the appropriate antibiotic, unless you get a new infection from a sexual partner. Genital herpes can return, and may require taking antibiotics again or taking antiviral medications every day.

Johns Hopkins patient information

Last revised: December 7, 2007
by Mamikon Bozoyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
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