Increased yellowish-purulent, foul-smelling discharge from the vagina can be a sign of cervicitis, which is often caused by bacteria or viruses. If the disease remains untreated, there is a risk of the infection spreading to the uterus, fallopian tubes and ovaries. Clogging of the fallopian tubes, ectopic pregnancies or infertility may result.
What is cervicitis?
Cervicitis is what doctors call an infection of the mucous membranes as well as the deeper tissue layers of the cervix. Normally, the cervix has defense mechanisms that prevent germs from ascending from the vaginal area: The viscous, slightly alkaline secretion that drains toward the vagina has the effect of neutralizing the pathogens. In addition, the isthmus, a short constriction separating the cervix from the body of the uterus, acts as a physiological closure. Various circumstances, such as frequent sexual intercourse with changing partners, poor hygiene, surgery, IUD insertion, or tissue overgrowth, cause the protective function to weaken or cause the uterine opening to widen, allowing germs to enter effortlessly.
Causes
There are many causes of cervicitis, depending on whether it is nonspecific, chronic, or acute. In nonspecific cervicitis, removal of a tissue sample or curettage sometimes allows germs to spread into the cervix, where they trigger inflammatory processes. The insertion of the IUD can also promote infection. Likewise, it can indicate a malignant tumor. The most common cause of chronic cervicitis is a change in the anatomy of the cervix: In addition to polyps, cracks in the cervix or an extreme outward protrusion of the cervical lips also favor the ascent of pathogens. Acute cervicitis is often the result of colpitis (vaginitis) or infection with sexually transmitted pathogens such as chlamydia, gonococci or herpes viruses. The acute form is often accompanied by more severe symptoms. In addition to the strong-smelling, yellowish-purulent discharge and occasional abnormal bleeding, those affected often suffer from itching and pain during urination and sexual intercourse if the vagina is also infected with germs. If deeper layers of the uterus are affected by the inflammation, pain in the lower abdomen and fever may develop.
Symptoms, complaints, and signs
The symptoms of cervicitis depend on the particular pathogen. Common symptoms include increased discharge that is yellowish in color and foul-smelling. This usually also has a purulent consistency. Bleeding during and after sexual intercourse is also noticeable. If surrounding areas of the internal genital organs are also affected, painful and increased urination, burning and itching of the vagina, intermittent bleeding, prolonged periods, lower abdominal pain and fever may also frequently occur. The interstitial bleeding as well as prolonged bleeding indicate that the cervical infection has spread to the endometrium. If the infection spreads to the uterine muscles, severe lower abdominal pain and occasional fever occur. Various bacteria, viruses, fungi or parasites are possible pathogens. In addition to inflammation, infection with herpes viruses also leads to small vesicles that stand together in groups. With HP viruses, flat, benign tissue growths develop in the transition area from the vagina to the cervix, which are also called genital warts. In most cases, the genital warts regress on their own after infection. In rare cases, however, they persist and can then be removed with dabs of trichloroacetic acid or surgically. As a complication of cervicitis, inflammation of the fallopian tubes can develop, possibly leading to adhesion of the fallopian tube and infertility. Furthermore, infection with HPV carries the risk of developing cervical cancer.
Diagnosis and course
At the first sign of cervicitis, a gynecologist should be consulted to prevent the spread of infection to other parts of the female genitalia.In an initial anamnesis interview, the doctor first enquires in detail about the woman’s complaints and medical history. This is followed by a gynecological examination, during which the surface of the cervix and the mucous membrane are examined in detail by means of a speculum examination or colposcopy, and the color, odor and consistency of the vaginal discharge are assessed. A smear, which is later analyzed microscopically in the laboratory, provides information about the type of pathogen. Other tests such as ultrasound, X-ray contrast imaging, serologic testing, or a pregnancy test may be used to rule out other conditions.
Complications
As a rule, cervicitis is associated with very unpleasant discomfort and symptoms. Those affected suffer primarily from increased vaginal discharge. There is also pain and itching in the affected region. The pain is burning and stabbing and thus has a very negative effect on the patient’s quality of life. It is not uncommon for this to lead to depressive moods or other psychological complaints. Furthermore, pain also occurs in the region of the abdomen and in the lower abdomen. The patients also suffer from increased bleeding, which is noticeable in the form of spotting or bleeding between periods. In general, the patient’s ability to cope with stress decreases sharply and those affected withdraw from social life. Diagnosis and treatment of cervicitis is usually performed by a gynecologist and still does not lead to any particular complications. In most cases, cervicitis can be treated with the help of antibiotics and the symptoms disappear relatively quickly. In more serious cases, a tumor can also cause the cervicitis and for this reason it must be removed. In this case, surgical intervention is usually necessary. In most cases, however, life expectancy is not reduced by this inflammation.
When should you go to the doctor?
Irregularities of the female cycle should be examined and clarified by a doctor. If spotting, bleeding between periods or shortened as well as prolonged menstruation occurs, these are warning signs from the body that should be followed up. If bleeding starts after menopause, a doctor should be consulted. If there are changes in vaginal discharge, an unpleasant odor in the intimate area, or a purulent discharge, a doctor should be consulted. In case of fever, increased fatigue, exhaustion or internal weakness, medical examinations should be initiated. If there is irritability, a feeling of illness or general malaise, it is advisable to contact a physician. If pain occurs that is not related to menstruation or ovulation, a doctor should be consulted. Pulling or burning pain is considered unusual and should be investigated. If there is discomfort during the sexual act or motions, investigations should be initiated to determine the cause. If pain occurs during urination or defecation, a visit to the doctor is necessary. Itching in the intimate area is considered unusual. If it occurs and causes open sores, a visit to the doctor is necessary. Otherwise, pathogens enter the organism and there is a risk of blood poisoning.
Treatment and therapy
Treatment of cervicitis depends crucially on the underlying cause. An infection with gonococci (causative agent of gonorrhea) or chlamydia can be successfully treated with antibiotics. It is important to treat the partner as well, as this is the only way to prevent the ping-pong effect, i.e. the re-infection of the cured partner by the untreated, infected partner. In addition, anti-inflammatory drugs are administered so that swelling and pain subside quickly. There is currently no cure for herpes infections. Virustatics can help to alleviate symptoms and shorten the course of the disease. However, the viruses still remain in the body and can trigger a new infection when stressed. If anatomical changes such as polyps or genital warts are responsible for the cervicitis, it is possible to remove them using a laser, knife or electric snare.In the case of a malignant tumor, depending on the size, part of the cervix and the mucous membrane of the cervical canal or the entire uterus together with the holding apparatus must be surgically removed. If a hormone deficiency caused by menopause is the trigger for cervicitis, female sex hormones such as estrogen or progestin can be administered over a period of about 20 days so that the mucosa thickens again.
Outlook and prognosis
Cervicitis, if detected and treated in time, usually heals without further difficulty and can be treated well without causing complications. However, if nothing is done, there is a risk that the pathogens will spread to other parts of the internal genital organs and cause complications there. If the pathogen is bacteria such as chlamydia, it can affect the fallopian tubes and ovaries, causing adhesions and risking possible infertility. Cervicitis caused by herpes viruses cannot be cured, but its symptoms will disappear. The herpes viruses, on the other hand, remain in the body and can lead to infections again and again under conditions that are favorable for them. If this type of cervicitis occurs in a pregnant woman, there is a risk of infection of the baby due to natural childbirth. This case is an indication for a planned cesarean section to prevent the dangerous infection with neonatal herpes. If genital warts have formed, they can also become problematic during a birth. Their size is rarely the problem, rather the triggering human papillomavirus can be transmitted to the newborn and in rare cases can also lead to genital warts or benign laryngeal tumors in the newborn. That is why genital warts should be removed before birth as a precaution in the case of cervical inflammation.
Prevention
Protection against cervicitis is provided by the use of condoms, especially if sexual partners change frequently. Vaccination against human papillomavirus is also useful, as it not only provides protection against cervicitis, but is also instrumental in preventing cervical cancer from developing. Early treatment of vaginal infections prevents the pathogens from ascending into the cervix and from there, if necessary, further into the uterus or ovaries. It is important here to pay attention to intimate hygiene and regular hand washing.
Aftercare
In the case of cervicitis, the options for aftercare are very limited. In this case, the affected person is primarily dependent on the treatment of this disease to prevent further complications and discomfort. If cervicitis is not treated, in the worst case, the patient may become completely infertile. The earlier the cervicitis is detected and treated, the better the prognosis of the disease. In most cases, treatment is carried out with the help of antibiotics. Care must be taken to ensure that the correct dosage is given and that the antibiotics are taken regularly in order to alleviate the symptoms. It may also be necessary to consider interactions with other medications. When taking antibiotics, alcohol should be avoided, as this reduces the effect of the medication. Even after successful treatment, regular examinations by a doctor are very useful in order to determine further complaints and then to treat them. In some cases, hormones are also taken in order to treat the cervicitis completely. Particular complications usually do not occur, and the patient’s life expectancy is also usually not limited by cervicitis.
What you can do yourself
Medical treatment of cervicitis can be supported by some measures and preparations from the household and nature. At first, however, rest and bed rest apply. Affected women should take sick leave for a few days and take care to relieve the individual symptoms. Thus, abdominal pain can be counteracted by warm compresses or a hot water bottle. Gentle sedatives such as valerian or rose root reduce the pain and have an overall soothing effect on the typical symptoms. A proven remedy is sitz baths with essential oils and other additives. At an ideal temperature of 37 degrees, the abdomen is relaxed and the painful cramps subside.Naturopathy offers the Schüßler salts No. 3 No. 7 for inflammation. In addition, general measures such as sufficient hygiene in the genital area and the avoidance of strenuous activities apply. To avoid infection of the partner, sexual intercourse should be avoided if possible or a condom should be worn. If the symptoms have not subsided after a week at the latest despite all the measures taken, a doctor must be consulted again. Further treatment with medicines may then be necessary.
