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Cervicitis +sur-vu-!sI-tus

by David E. Soper, MD

Cervicitis is inflammation of the cervix (the lower, narrow part of the uterus that opens into the vagina). It may be caused by an infection or another condition.

If cervicitis appears suddenly, it is usually caused by an infection. If it has been present for a long time (is chronic), it is usually not caused by an infection. Infection may spread upward from the cervix and affect the lining of the uterus (causing endometritis) and other reproductive organs (causing pelvic inflammatory disease—see Pelvic Inflammatory Disease (PID)).

Infections that commonly cause cervicitis include sexually transmitted diseases such as chlamydial infections (due to the bacteria Chlamydia trachomatis) and gonorrhea (due to the bacteria Neisseria gonorrhea). Cervicitis may also be caused by genital herpes due to the herpes simplex virus or tuberculosis. Infections of the vagina (such as bacterial vaginosis and Trichomonas vaginitis) may also affect the cervix. Often, the microorganism that causes cervicitis cannot be identified.

Conditions other than infections can cause cervicitis. They include gynecologic procedures, objects (such as diaphragms) that are left in the vagina too long, chemicals in douches or contraceptive creams, and, if women are allergic to latex, latex condoms.

Symptoms

Cervicitis may not cause any symptoms. When it does, the most common are an unusual (sometimes yellow-green and puslike) discharge from the vagina and vaginal bleeding between menstrual periods or after sexual intercourse. Some women have pain during intercourse, urination, or both. The area around the opening to the vagina may be red and irritated, as may the vagina.

Women may have other symptoms depending on what is causing cervicitis. For example, if the cause is pelvic inflammatory disease or herpes simplex infection, women may have a fever and pain in the lower the abdomen.

Diagnosis

A woman should see her doctor if she has a persistent, unusual vaginal discharge, vaginal bleeding other than during menstrual periods, or pain during sexual intercourse. However, because cervicitis often causes no symptoms, it may be diagnosed during a routine pelvic examination.

If symptoms suggest cervicitis, doctors do a pelvic examination (see Gynecologic Examination). They check for a discharge from the cervix and touch the cervix with a swab to see whether it bleeds easily. If a puslike discharge is present and if the cervix bleeds easily, cervicitis is likely.

If symptoms suggest pelvic inflammatory disease, doctors test a sample taken from the cervix for microorganisms that can cause sexually transmitted diseases (such as gonorrhea or a chlamydial or Trichomonas infection) or bacterial vaginosis.

Treatment

If cervicitis appeared suddenly, most women are given antibiotics that are effective against chlamydial infections and gonorrhea, particularly if they have risk factors for sexually transmitted disease (such as being younger than 25, having new or several sex partners, or not using protection during sex). These drugs are continued until test results are available. Once the cause is identified, doctors adjust the drugs accordingly. For example, azithromycin or doxycycline, given by mouth, is used to treat chlamydial infection. Ceftriaxone, given one time by injection into a muscle, is used to treat gonorrhea.

If the cause is a sexually transmitted disease caused by bacteria, sex partners should be tested and treated simultaneously. Women should abstain from sexual intercourse until the infection has been eliminated from them and their sex partners.

If the cause is the herpes simplex virus, infection usually persists for life. Antiviral drugs can control but not cure these infections.

After being treated for 3 to 6 months, all women are tested again to determine whether the infection has been eradicated or is under control.

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • ZITHROMAX
  • PERIOSTAT, VIBRAMYCIN
  • ROCEPHIN