Cervical erosion

Alternative names
Cervical ulceration

Definition
Cervical erosion is a partial or complete absence of the squamous epithelium (surface) of the cervix. The normal tissue on the surface of the cervix and/or around the os (mouth of the cervix), is replaced by inflamed tissue from within the cervical canal. This endocervical tissue is red and granular, so it gives the cervix a red, eroded, and infected appearance.

Causes, incidence, and risk factors

Cervical erosion may be caused by trauma (through intercourse, tampon insertion, foreign objects in the vagina, or speculum insertion), or infection (herpes, early syphilis, tampons that were not removed, severe vaginal infections), and sometimes chemicals (spermaticidal contraceptive creams or foams, douches).

There is an increased risk associated with vaginal use of chemical agents or multiple sexual partners; however, the condition is seen in women without these risk factors.

Symptoms

     
  • Abnormal vaginal bleeding (not associated with a menstrual period):       o After sexual intercourse (postcoital)       o Between menstrual periods       o Discharge (clear or yellowish mucus) - may have an odor if associated with a vaginal infection

    Note: Typically there are no symptoms.

Signs and tests

Pelvic examination reveals an area on the cervix that looks raw, red, and inflamed.

     
  • A Pap smear may show atypical cells  
  • Colposcopic examination reveals an area of raw, stripped, squamous epithelium  
  • Cervical biopsy may be necessary

Treatment

The treatment is dependent on the cause. Infections may require prescription medications. Erosion caused by trauma or chemicals may only require avoiding further trauma or chemical exposure, allowing time for the cervical surface to heal. Cauterization is also used on occasion. Estrogen vaginal cream also may help thicken the vaginal and cervical epithelium.

Expectations (prognosis)

Cervical erosion usually heals on its own. Treatment, if necessary, is usually very successful.

Complications

Cervical erosion may be an early sign of cervical cancer.

Calling your health care provider

Call for an appointment with your health care provider if you are a woman who is sexually active or over age 20, and have never had a prior pelvic examination and Pap smear.

Call for an appointment with your health care provider if you have not obtained a Pap smear at recommended intervals of:

     
  • Every year initially  
  • For women up to age 35 or 40: every 2-3 years after having three negative, consecutive annual Pap smear tests and a single sexual partner or no sexual partner  
  • Every year for women over age 35 or 40  
  • Every year for women who have had multiple sexual partners  
  • Every year for women who are taking oral contraceptives (birth control pills)  
  • Every 6 months for women who have a history of HPV (genital warts)  
  • Every year for women who were prenatally exposed to DES  
  • The frequency recommended by your health care provider after an abnormal Pap smear

Prevention

Safer sex behaviors decrease the risk for infections. Do not use douches unless recommended by a health care provider for specific medical reasons.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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