Common problems of the cervix

Uterus and cervix

Symptoms

The symptoms you may experience will depend on the underlying condition. Some women will not have any symptoms at all. A problem with the neck of the womb (cervix) may be detected by the doctor or nurse who is examining them for another reason. For example, when a cervical smear test is taken.

Symptoms may include:

• Lower tummy (abdominal) pain.

• Pelvic pain.

• Vaginal discharge.

• Abnormal vaginal bleeding. For example, bleeding after having sex (intercourse) or bleeding in between your periods.

• Dyspareunia (pain when having sex).

Diagnosis

Most conditions that affect your cervix can be diagnosed by examining you. However, it is sometimes necessary for other tests to be undertaken. For example:

• Internal swabs may be taken. A swab is a small ball of cotton wool on the end of a thin stick. It can be gently rubbed on your cervix to obtain samples.

• A biopsy may be carried out. In this procedure, a small sample of tissue is taken from a lump. The sample can then be examined under a microscope in the laboratory.

Other tests may also be carried out, depending on your symptoms. These tests may include blood tests and an ultrasound of your womb and ovaries.

Colposcopy is a test to look at your cervix in more detail. A colposcopy is often done if your cervical smear test finds any changes to the cells of your cervix. See also the separate leaflet called Colposcopy and Cervical Treatments.

Causes of problems affecting the cervix

Infections are caused by germs such as bacteria and viruses and lead to inflammation of the neck of the womb (cervix). Inflammation of your cervix is called cervicitis. The most common symptom in women with cervicitis is vaginal discharge. Other symptoms can include pain on passing urine, lower tummy (abdominal) pain and bleeding in between periods.

Sexually transmitted infections

Infections of your cervix are usually caught through having sex. The most common sexually transmitted infections (STIs) which affect the cervix are:

• Gonorrhoea.

• Chlamydia.

• Genital herpes.

• Trichomonas.

• Human papillomavirus (HPV). HPV is very common. Some types of HPV can lead to changes in the cells of the cervix and (very rarely) some types can increase the risk of developing cancer of the cervix. The NHS cervical screening programme now offers women with borderline and mild cell changes a test to check for HPV.

See the individual leaflets for further information on these infections.

Bacterial vaginosis is not an STI. It is caused by an overgrowth of normal germs in your vagina. Some cases of bacterial vaginosis (BV) clear without treatment, whereas others can be treated with a course of antibiotic medication.

Other causes of inflammation of the cervix

Inflammation of the neck of the womb (cervix), called cervicitis, can also be caused by other conditions. These include:

• Allergies - for, example to condoms or to spermicides.

• Irritation - for example, from tampons.

• Radiotherapy - cervicitis can be a side-effect of radiotherapy which is used to treat some cancers.

For cervicitis not caused by infections, there is usually no treatment. They settle when the cause is removed.

Other problems affecting the cervix

• Polyps of the cervix. A polyp is a small growth which arises from a stalk on either the surface or the inside of the neck of your womb (cervix). They are not cancerous and do not change into cancer.

• Endometriosis.

• Cervical ectropion. Cervical ectropion (or erosion) is a harmless change. It is related to oestrogen and is therefore more common in young women, pregnant women and those taking combined oral contraceptive pills. It may cause increased vaginal discharge or bleeding. The ectropion can easily be treated with a burning technique (cautery), using an electrical current (diathermy). This treatment is under local anaesthetic (when you are awake).

• Nabothian cysts. Nabothian cysts are tiny cysts that form on the surface of the neck of the womb (cervix). They are fairly common and do not usually cause any symptoms. They do not usually need any treatment.

• Cancer of the cervix.

See the links for further information about endometriosis and cancer of the cervix.