Cervicitis is an inflammation of the cervix, which is the donut-shaped opening between the vagina and the uterus. It does not always result in symptoms. When this happens, it can cause bleeding, pain during sex, and vaginal discharge.
It is most commonly caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhea, but there are a few non-infectious causes as well.
A pelvic exam and lab tests to determine the underlying cause can be used to diagnose the condition. Medication may be prescribed if an infection is present. You should also know that cervicitis can resolve on its own in some cases.
Cervicitis Symptoms
Cervicitis is not always accompanied by symptoms. If they do appear, you may notice:
- Irritation of the vulva (vulvitis)
- Pain during urination (dysuria)
- Pain during sex (dyspareunia)
- Gray, white, or yellowish vaginal discharge, in which case the condition is referred to as mucopurulent cervicitis
- Frequent urination
- Vaginal bleeding between menstrual periods or after sex
- Pelvic heaviness or pain
Complications
In rare circumstances, the infection that causes cervicitis can spread to the uterus, fallopian tubes, or ovaries, resulting in pelvic inflammatory disease (PID).
PID can cause peritonitis, a potentially fatal infection, as well as infertility.
Causes
Cervicitis can be caused by a variety of STIs, the majority of which involve Chlamydia trachomatis (the chlamydia bacteria) and Neisseria gonorrhoeae (the gonorrhea bacteria). Trichomoniasis, Mycoplasma genitalium, and genital herpes are three less common causes.
Non-sexually transmitted diseases such as bacterial vaginosis (BV) can also cause cervicitis.
There are many non-infectious causes of cervicitis:
- Radiation therapy
- Trauma to the cervix
- Chemical irritants, such as douches, spermicides, or vaginal suppositories
- Insertive devices, such as IUDs, cervical caps, tampons, or pessaries (devices placed in the vagina for internal organ support)
- Body-wide inflammation, such as that caused by autoimmune diseases
- Allergy to latex condoms
Cervicitis does not always have a specific cause. About 60% of cases have no known origin.
Risk Factors
Cervicitis risk factors are similar to those for STIs and include multiple sex partners, sex without condoms, and being younger.
Having had sex at a young age or having a history of a sexually transmitted infection raises the risk.
Treatment
Cervicitis treatment is determined by the cause of your case. If there is an infection, there are standard treatments:
- Chlamydia. This is usually treated with antibiotics. Doxycycline, taken twice daily for one week, is the recommended treatment. Alternative treatments include a single dose of azithromycin or levofloxacin taken once daily for one week.
- Gonorrhea. Your doctor may prescribe ceftriaxone 500 mg intramuscular injection.
- Trichomoniasis. Metronidazole is used to treat this condition — a single large dose for men and a lower dose taken twice daily for seven days for women. Tindamax (tinidazole) is an alternative treatment option that is administered as a single dose.
- Genital herpes. Your doctor may advise you to take antiviral medications such as Famvir (famciclovir), Valtrex (valacyclovir), and Zovirax (acyclovir). The treatment period can last from seven to ten days. Severe cases may necessitate intravenous (IV) acyclovir administration.
- Bacterial vaginosis. It is usually treated with antibiotics. Oral metronidazole or metronidazole gel or clindamycin cream, both topical antibiotics applied directly to the vagina, are recommended treatments. Tinidazole, secnidazole, or clindamycin pills may also be prescribed. Another option is to insert clindamycin ovules into the vagina.
The infection should clear up within a few days, depending on the microorganism.
Non-infectious causes of inflammation can usually be relieved by avoiding the substance or activity that is causing the inflammation.
Any underlying disease or condition that contributes to cervical inflammation must also be addressed.
Coping
Cervicitis is usually a one-time occurrence if properly treated. To prevent transmission, you should avoid sexual activity during treatment until your symptoms have resolved.
Avoid products that may cause further vaginal irritation. Use menstrual pads instead of tampons, for example. It’s also best to avoid vaginal douching at all costs.
It may also be beneficial to avoid scented soaps, sprays, or lotions, as well as constricting underwear made of synthetic fabrics. Wear soft, 100% cotton underwear instead.
Cervicitis rarely recurs unless you contract it from a sexual partner.
