Cervicitis is an inflammatory process in the vaginal segment of the cervix. Cervicitis, the symptoms of which are characterized by purulent or mucous discharge, pain in the lower abdomen (pulling or dull), painful intercourse and urination.
Protracted chronic cervicitis leads to the development of erosion, thickening of the cervix, the spread of infection to the upper parts of the genital apparatus.
In its structure, the cervix serves as a barrier that prevents infection from entering the uterus. Under certain factors, its protective function is violated, which leads to the entry of foreign microflora into this area, thereby contributing to the development of inflammation - cervical cervicitis.
Most often, the disease occurs in women aged 18 to 45 who live an active sexual life. However, many infected women do not receive the necessary treatment, since the symptoms of cervicitis may be hidden.
The reasons
Why does cervicitis occur, and what is it? In order for a woman to develop this ailment, it is necessary to introduce various pathogenic microflora into the genitals: E. coli, streptococci, staphylococci, mycoplasmas and other microorganisms. They are able to enter the cervix through contact routes, through the blood and lymph or from the rectum, a specific microflora is transmitted sexually.
In most cases, cervical cervicitis occurs due to the presence of sexually transmitted vaginal infections:,. Herpetic genital infections can also provoke inflammation of the cervix, or. In addition, mechanical irritants can also accompany the onset of the disease, these are injuries of the cervix after abortion, childbirth, or due to other injuries.
Cervicitis rarely occurs in isolation, usually its development is accompanied by other pathologies of the reproductive system: vaginitis, ectropion, pseudo-erosion of the cervix. In order to avoid complications, you need to think in time about how to treat cervicitis, and what drugs will be required for this.
Cervicitis symptoms
The disease can occur in two ways. The first - without symptoms, the second - with the manifestation of certain signs. In most cases, the severity of the clinic depends on the causative agent of the infectious process.
With a mild form of cervicitis, a woman may not notice any symptoms at all. Perhaps the periodic appearance of small vaginal discharge, which is predominantly mucous in nature.
Main features cervical cervicitis:
- weak aching;
- pain or discomfort during intercourse;
- rare spotting from the vagina, sometimes with an admixture of pus;
- cloudy mucous discharge from the vagina, regardless of the menstrual cycle;
- painful menstruation.
With cervicitis of the cervix, there are more pronounced symptoms - bleeding, itching in the genital area, pain or discharge with blood interspersed during intercourse, burning during urination. In addition, in a woman with cervicitis, the presence of periodic and uncomfortable sensations in the lower abdomen is noted. If acute cervicitis has a severe course, then it is possible to observe an increase in body temperature, the appearance of dizziness, nausea or vomiting.
If a woman has developed gonorrheal cervicitis, then the discharge becomes yellow, with trichomoniasis they become foamy. The human papillomavirus can cause genital warts and cervical ulceration of various sizes.
Acute cervicitis is treated with antibiotics. And if the cause of the disease is gonococci, then both partners will need to be treated. Untreated at this stage, cervicitis turns into a protracted chronic process. The discharge becomes cloudy. In the chronic stage, signs of inflammation (edema, hyperemia) are less pronounced.
During pregnancy
Cervicitis during pregnancy can turn into a rather serious problem for both the woman and her child. With an infectious course of the disease, the likelihood of infection of the fetus during childbirth is high.
It is extremely difficult to treat cervicitis during pregnancy due to the fact that many antibacterial agents adversely affect the fetus. Therefore, it is necessary to cure cervicitis before the onset of pregnancy, so that there are no various pathological changes in the fetus.
Chronic cervicitis
If acute cervicitis is not treated properly or is not treated at all, after one to two weeks, the acute phenomena subside, and the inflammation acquires the features of a chronic process.
Symptoms of chronic cervicitis can be occasional aching pains in the lower abdomen, mucous discharge from the vagina. A chronic infection poses a great danger to a woman's health, because due to untimely treatment, the walls of the cervix thicken, which can cause cancer, infertility and dysplasia in the genital area in question.
Purulent cervicitis
This is an inflammatory process in the cylindrical epithelium, as well as subepithelial damage to the mucous membrane of the cervix and any area that is adjacent to the cylindrical epithelium.
Its main manifestations:
- abundant (with an admixture of pus), unpleasantly smelling discharge from the vagina;
- uterine bleeding not associated with menstruation;
- lower abdominal pain;
- , malaise (in rare cases).
If a woman has purulent cervicitis, it can almost certainly be argued that her partner has urethritis caused by a similar type of pathogens.
Cervicitis - treatment
First, you should identify the cause of the disease, and then prescribe a comprehensive treatment for cervicitis. To do this, a woman needs to be examined by a gynecologist, pass an analysis for sexual infections, the bacterial flora of the vagina, as well as standard blood and urine tests. It is worth noting that if an STI is detected, the sexual partner must also be examined.
The treatment regimen is as follows:
- prescribing antibiotics after the pathogen is identified.
- local anti-inflammatory, analgesic therapy.
- restoration of the microflora of the vagina.
- physiotherapy.
With chlamydial cervicitis, tetracycline antibiotics (doxycycline), quinolones, macrolides (erythromycin) are indicated. With candidal cervicitis, antifungal agents (itraconazole, fluconazole) are used. In the treatment of cervicitis, combined local preparations are widely used.
After the acute stage of the disease subsides, it is possible to use local methods of treating cervicitis. Candles (terzhinan) and creams are well suited for this. Thus, cervical cervicitis treatment requires a long and thorough treatment so that it does not become chronic and completely cured.
In rare cases, if a woman's cervicitis does not go away after a course of antibiotics, cauterization of the inflamed areas is performed.
Preventive measures
Prevention of cervicitis is primarily the timely treatment of endocrine disorders, the prevention of abortion, personal hygiene and the exclusion of sexual infections.
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Since the vulva, vagina and cervix form a single ecosystem, then cervicitis are rarely isolated. Often they are combined with vulvitis, vaginitis, and sometimes with salpingo-oophoritis and endometritis.
The cervix is the third biological barrier in the biological protection of the female reproductive system from infections. Protection is provided by the narrowness of the cervical canal and the presence of a mucous secretion, which contains a large number of immunity factors and has a bactericidal effect.
Causes of cervicitis
Conditions that violate barrier defense mechanisms:
- ruptures of the cervix, which cause the gaping of the external pharynx or the occurrence of ectropion, which violates the bactericidal properties of cervical mucus, as well as the narrowness of the cervical canal;
- uncontrolled use of disinfectants that destroy the saprophytic autoflora of the vagina;
- intrauterine contraceptives
- improper use of tampons that adsorb blood and create optimal conditions for the rapid reproduction of pathogenic microorganisms.
The occurrence of inflammatory processes contribute to:
- extragenital pathology, including metabolic disorders;
- chronic infections;
- ovarian hypofunction;
- stressful conditions.
Classification of cervicitis
According to localization, they distinguish:
- exocervicitis(damage to the vaginal segment of the cervix);
- endocervicitis(damage to the inner lining of the cervical canal of the cervix).
According to the clinical course, they are distinguished spicy and chronic cervicitis, according to the type of lesion - focal and diffuse.
In an acute course, the patient has abundant mucopurulent discharge, less often dull pain in the lower abdomen, swelling and hyperemia of the cervix, minor hemorrhages, and even possibly an erosive lesion of the mucous membrane. Often cervicitis occurs in an erased form in the absence of severe symptoms. In this case, it is detected on examination by a gynecologist.
Exocervicitis, which was not promptly detected and treated in the acute stage, turns into a protracted chronic process. The discharge becomes cloudy. It is possible that the mucous membrane of the cervical canal is also involved in the pathological process, with the development of proliferative changes that can be localized near the external pharynx and mistaken for small polyps, and also resemble pseudo-erosion of the cervix. Also, inflammation can spread to surrounding tissues with the formation of cysts.
Distinguish cervicitis:
- nonspecific(caused by opportunistic flora, which can be found in small amounts in the vagina of a healthy woman, but if additional concomitant risk factors occur, this flora can become pathogenic and cause an inflammatory process);
- specific(caused by pathogens of sexual infections. The most common are chlamydia trachomatis, mycoplasma genitalium, Neisseria gonorrhea, Trichomonas vaginalis, pale treponema, Koch's bacillus, herpes simplex virus, human papillomavirus and others).
Recently, the number of cervicitis associated with mixed infection has increased, which is extremely difficult to treat due to developing resistance to antibiotics and impaired immunity. At the same time, gram-negative and gram-positive obligate anaerobic microorganisms began to be detected most often in chronic inflammation of the cervix, and Escherichia coli, Proteus, Klebsiella, enterococci are also often detected.
Inflammation of the cervix caused by the presence of an infection is called cervicitis. This disease is most common - according to statistics - half of the female population has suffered cervicitis at least once in their lives. Women of any age are affected. Rarely hidden forms are found in teenage girls who are not sexually active, which is explained by the presence of an infection in the body and low immunity.
Acute inflammations caused by the presence of a specific microflora are more often treated, as they have pronounced symptoms and create inconvenience in everyday life - abundant discharge, smell, itching in the vagina. In this case, the chances that a woman will come to the gynecological office for examination and be treated are greater.
Non-specific flora causes no symptoms (or very mild), so patients rarely go to the doctor for diagnosis and treatment. The disease can be detected by chance when a woman is registered for pregnancy. The process by the time of detection can proceed in a chronic form. During the examination, a diagnosis is made - chronic low degree of activity of cervicitis.
Chronic cervicitis - what is it?
An unnoticed disease that has been going on for a long time, has not been treated, is called chronic. The symptomatology is smoothed out so much that it allows a woman to lead a normal life and not experience discomfort or pain. Contributes to this condition:
- low immunity, when the body is not able to cope with the infection on its own, as it does not have the necessary resources (poor nutrition, smoking, drinking alcohol);
- concomitant diseases (lack of sex hormones, dysfunction of the thyroid gland);
- constant change of sexual partners, which contributes to an increase in the number of sexually transmitted infections;
- allergic diseases that reduce the protective potential of the body;
- viral diseases;
- mechanical damage to the cervix;
- the presence of gynecological diseases and inflammation of the pelvic organs.
With an inferior sexual life (lack of orgasm), chronic cervicitis may develop due to blood stagnation, even in the absence of pathogenic specific microflora.
Important! Without going to a medical institution, without taking measures to eliminate the disease, a woman exposes herself to the risk of malignant neoplasms that develop due to the constant presence of infection and pathological changes in tissues.
According to their origin, they are:
- getting an infection that is sexually transmitted;
- structural changes in the tissues of the cervical canal;
- activation of conditionally pathogenic flora (thrush).
According to the location of the inflammatory process:
- the entire mucosa is affected - a diffuse process;
- spotted (macular) chronic cervicitis, in which the formation of separate foci of inflammation occurs;
- exo and - either the vaginal part of the cervix or the mucous membrane of the cervical canal is affected.
Distinguish between the acute stage of the disease with characteristic symptoms and the stage of remission.
Pathogenic organisms that cause cervicitis
Among the infectious agents that cause inflammation of the cervix, we can distinguish:
- specific microorganisms. These are chlamydia, ureaplasma, trichomonas, amoeba, tubercle bacilli, gonococci, genital herpes. In the presence of this infection, the process is acute and requires urgent treatment with antibiotics and anti-inflammatory drugs, that is, chronic cervicitis of a high degree of activity is observed;
- Nonspecific. Candida fungus, gardnerella, E. coli. These microorganisms provoke chronic cervicitis of a moderate degree of activity.
In both cases, inflammation develops - this is how the body's protective reaction to microbes manifests itself.
Bacterial nature of cervicitis
Bacterial cervicitis can occur against the background of an already existing viral infection, which weakens the defenses. In this case, there is chronic active cervicitis with periodic relapses and remissions, which is difficult to treat until immunity is restored and the viral agent is eliminated.
Carefully! Against the background of viral infections, bacteria can transform into inactive forms, which, under favorable conditions, restore their activity. In this case, the woman will be the source of the infection, without knowing it herself. Similar cases with Trichomonas are described in the medical literature.
With a low immune status, the likelihood of developing sexually transmitted viral infections is high. These are:
- herpes virus;
- ureaplasmas (intermediate microorganisms between bacteria and viruses)
- human papilloma virus;
- AIDS virus.
These pathogens weaken the body and create a favorable environment in which bacteria and fungi feel good, while actively multiplying.
Causes contributing to the formation of inflammation
An exacerbation of a chronic infection can cause:
With a combination of several factors - infection, mechanical damage, low immunity - there is a high probability of an inflammatory process in the cervix.
Highly active cervicitis is manifested by the following symptoms:
- purulent discharge of yellow-green color in large quantities;
- the presence of a specific smell;
- dysuria - painful urination;
- pulling pain in the lower abdomen;
- the presence of ulcerative lesions on the vaginal part of the cervix;
- painful intercourse.
Chronic cervicitis is characterized by:
- cloudy mucous discharge;
- mild pain during intercourse;
- possible itching or burning sensation in the vagina.
Important! A chronic inflammatory process on the cervix turns into malignant tumors much more often and poses a great danger to women of reproductive age.
Asymptomatic process
With strong immunity and in the presence of infection, cervicitis can be asymptomatic. are discovered when a woman accidentally visits a doctor - for example - during a physical examination. The patient does not complain about anything and does not feel a problem. With inactive cervicitis, the cause may be the presence of erosion, ovarian cysts in the initial stage, (CIN 1), in which the dystrophic process is just beginning and does not make itself felt.
Without fail, a woman is given a referral to general tests to determine the pathogen and establish the degree of damage to the epithelium.
Low degree of activity of the inflammatory process
A moderate or low degree of activity of chronic cervicitis is not a safe condition, as it slowly undermines strength and causes changes at the cellular level, which can cause irreversible processes in the cervix without timely treatment.
Diagnostics consists of the following procedures:
- A smear from the vaginal part of the cervix to determine an active or latent infection (in the acute phase of the disease and in the latent course).
- Histology in the form of a smear for the detection of atypical cells after examination of the smear and examination with mirrors.
- . If oncology is suspected or in the presence of a high oncogenic risk human papillomavirus, a piece of tissue (or several) is required to be examined under a microscope. It is prescribed to clarify the diagnosis of dysplasia or cervical cancer after receiving poor results of a cytological examination.
To diagnose the uterine cavity, if you suspect a doctor may prescribe hysteroscopy. This is a procedure in which a device with a camera is inserted into the uterus, which transmits an image to a computer monitor. Thus, it is possible to identify the pathology of the inner layer, various thickenings of the muscle layer.
Important! It is effective to use several types of diagnostics, which make it possible to accurately diagnose and prescribe productive treatment. All types of diagnostics are prescribed when it is necessary to exclude the occurrence of a rare type of cancer - for example, papillary.
When diagnosing HPV, the doctor will definitely prescribe a biopsy in order to identify koilocytes - cells with modified enlarged nuclei. Koilocytic atypia is characteristic of papillomavirus infection: there are cells with two or more nuclei that have a peculiar glow around the center.
Koilocytosis is a long process of cell transformation. It is observed only in the active stage of HPV, which indicates unstable immunity and the need for treatment.
The danger of cervicitis - what is it
Venereal cervicitis can provoke the disease perihepatitis, mainly associated with the activity of chlamydia or gonococci. Capsules with accumulation of microbes appear in the liver, causing. A symptom of this pathology is pain in the right hypochondrium. In 9 out of 11 cases, chlamydial infection was detected in history or in an active form.
With untreated cervicitis, the inflammatory process can have an upward trend and affect the uterus with appendages, which usually leads to the formation of adhesions in the tubes and subsequent ectopic pregnancy.
Carefully! Attachment of the fetal egg in the tube causes its rupture and the need for urgent removal. Subsequently, this leads to the need for in vitro fertilization (IVF).
Sometimes the ducts of the Bartholin glands become inflamed, which, when the process is started, leads to a purulent abscess and decomposition of the gland.
The occurrence of cervical erosion against the background of a prolonged inflammatory process and hormonal disorders.
In the presence of HPV, the risk of magnification increases tenfold. The initial symptom can be considered in which the epithelium of the cervix changes. White plaques appear, which stand out against the background of healthy tissue in the form of an elevation.
Chronic cervicitis can worsen during pregnancy due to a natural decrease in immunity and a heavy load on the body. With a low social status of a woman, this condition provokes poor malnutrition, which is not enough to meet the needs of a woman and a child. The body is programmed for the survival of the fetus, so most of the vitamins and minerals are used to form the systems and organs of the child. A woman gets very few useful substances, which weakens her body. The infection gets a chance to multiply.
Treatment of chronic cervicitis
The treatment regimen for chronic cervicitis depends on the type of infection, the age of the patient, the state of the immune system, and the presence of concomitant diseases.
With a viral infection, the cost of treatment is disproportionately higher, since the use of stimulants, immunoglobulins, and vitamins is necessary. In addition, it is necessary to strictly monitor the quality and diet.
The age of the woman also plays a role. During menopause, additional hormonal therapy and calcium supplements may be required to balance the state of the body. Treatment of cervicitis during pregnancy is complicated by the fact that many drugs are contraindicated and you need to use homeopathic suppositories or tablets with bactericidal properties.
To boost immunity, you can drink dietary supplements on a plant basis. As an option - Entocide - a dietary supplement that tidies up the intestines.
Important! The main part of immune cells is located in the human intestine, so the normalization of its work affects the general condition of the body.
All types of chronic and acute cervicitis can be treated with broad-spectrum antibiotics, for example, Azimed (active ingredient azithromycin). In addition, anti-inflammatory drugs are prescribed, which can be replaced with decoctions of herbs that have similar properties: St. John's wort, sage, yarrow, oregano, echinacea.
Women during menopause can be advised to use decoctions of herbs that normalize hormonal levels, which contribute to recovery: boron uterus, red brush, flaxseed, sage, hop cones, licorice root, sesame seed. It is recommended to include apricots in the diet, which are rich in substances similar in action to estrogen. Dried fruits have the same qualities as fresh ones.
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conclusions
Treatment of chronic cervicitis of a low degree of activity is long and requires a responsible approach on the part of the woman. If she is interested in the further birth of children, then it is worth devoting a significant part of her time to her health.
Cervicitis is an inflammatory process, the localization of which is concentrated in the region of the vaginal segment of the cervix. Cervicitis, the symptoms of which are characterized by turbid discharge, pain in the lower abdomen (pulling or dull), painful intercourse and urination, in its protracted chronic form can lead to erosion. In addition, such a course of it can provoke thickening (i.e. hypertrophy) or thinning of the cervix, as well as cause the spread of infection to the upper genital organs.
general description
The cervix itself acts as a barrier, which is an obstacle to penetration into the uterus, as well as into the upper genital tract (in the form of a protective secret, mucous plug and cervical canal) infection. The impact of certain factors provokes a violation in its protective functions, which leads to the entry of foreign microflora into this area, thereby contributing to the development of the inflammatory process. It is precisely such a process that cervicitis is, which also includes exocervicitis (inflammation of the exocervix, or the vaginal segment in the uterus) and endocervicitis (inflammation of the endocervix, or inflammation in the region of the inner membrane belonging to the cervical canal of the cervix).
The indicated opportunistic microflora that provokes cervicitis in the uterus is found through contact through the lymph and blood, as well as through the rectum. As for specific viruses, they enter the uterus sexually.
It should be noted that cervicitis can develop under the influence of certain factors, which include birth injuries related to the cervix, diagnostic curettage and termination of pregnancy, as well as the use of contraceptives (in particular, we are talking about installing and removing an intrauterine device). Various types of cicatricial deformities, as well as formations in the cervix of a benign type, are distinguished as factors provoking cervicitis. A decrease in immunity is also not excluded when considering the actual factors leading to the development of cervicitis.
Features of the development of cervicitis indicate that this disease rarely occurs in isolation - basically its “companions” are certain diseases related to the reproductive system: vulvitis, pseudo-erosion or eversion of the cervix, bartholinitis.
As for the age category, the disease we are considering most often occurs among women of reproductive age (about 70% of incidence cases), less often cervicitis occurs with. It is noteworthy that cervicitis is one of the most common causes in which pregnancy becomes impossible, in addition, it is cervicitis that in most cases provokes premature birth. As a consequence of this disease, polyps are formed, as well as inflammation in the upper genital tract. Cervicitis occurs in acute or chronic form, in addition to its other varieties, which we will also consider below.
Acute cervicitis
Acute cervicitis is, accordingly, an acute inflammation that occurs in the cervix. In this case, inflammation mainly concerns only the endocervical glands, while in rare cases, damage to the squamous epithelium can also be noted. Some of the researchers are of the opinion that the nature of inflammation (that is, its persistence, area of localization, distribution pathways) is directly determined based on the specific type of pathogen. Gonococci, for example, affect exclusively epithelial cells belonging to the endocervical glands, while they spread along the surface of the mucosa. If we are talking about inflammation provoked by staphylococci or streptococci, then their localization is concentrated directly in the endocervical glands, affecting the stroma of the cervix. The lymph flow ensures that pathogens reach other organs in the pelvis, which, accordingly, leads to their infection.
Focusing specifically on the symptoms, it should be noted that the first of them at the initial stage of the disease manifests itself in the form of secretions, and the nature of these secretions may be different. Meanwhile, the content of admixture of pus in them is most often noted, while their character is simultaneously profuse, which is especially important in the case of the relevance of such a disease as gonorrhea.
In addition, the acute course of the disease is often accompanied by a slight increase in temperature, the occurrence of dull pain in the lower abdomen. Often there are sensations of hot flashes concentrated in the pelvic region of the organs. In addition, patients often experience lower back pain, urinary disorders (polyuria or dysuria, increased urine output or decreased urine output, respectively), and pain that occurs in the vulva and pelvic organs during sexual intercourse.
When diagnosing acute cervicitis, in addition to a gynecological examination, microscopic examination of smears is used, as well as sowing secretions of the cervical canal directly on a nutrient medium.
If we are talking about diagnosing gonorrheal cervicitis in an acute form, then here, as a rule, it is performed extremely rarely due to patients visiting a doctor only in those cases in which the inflammatory process already passes to the uterine appendages. Given this, in the presence of pain in the adnexal region in the acute form of the course of gonorrheal cervicitis, it is necessary to apply a slightly different treatment than in ordinary acute cervicitis, because in this case the inflammatory process is quite specific.
Chronic cervicitis
Chronic cervicitis is formed when the genital organs are affected by various bacteria, as well as when they are affected by fungi and viruses. The onset of the infectious process in this case can occur when the cervix or vagina is prolapsed, as well as when hormonal and contraceptive drugs are used improperly. In addition, concomitant factors in the development of chronic cervicitis are promiscuity, poor hygiene and inflammatory diseases in the pelvic organs.
The clinical manifestations of this form of cervicitis are determined by the specific type of pathogen, as well as the general reactivity in each specific case of the patient's body. Among the main symptoms are scanty mucous discharge of a cloudy consistency, in some cases an admixture of pus is possible. There is also reddening of the uterine mucosa, its swelling. The acute form of the manifestation of the chronic form of the pathology is manifested, respectively, in a greater severity of symptoms. Again, there are dull pains that occur in the lower abdomen, itching, pain and burning during urination, bleeding that occurs after intercourse.
The disease is more than serious for a woman, because the delay in treatment leads to thickening of the walls of the cervix, followed by hypertrophy, which contributes to the formation of another type of pathology. Due to this, the risk of possible oncological diseases, infertility and dysplasia in the considered area of the genital organs also increases.
To make a diagnosis, the uterus is examined using a colposcope and a mirror. Blood and urine are examined for the presence of sexually transmitted infections. Ultrasound is also performed, followed by a study of the state of the pelvic organs.
Purulent cervicitis
Purulent mucous cervicitis provides for the presence of an inflammatory process in the region of the cylindrical layer of epithelial cells, as well as the relevance of subepithelial damage to the cervical region. In addition, damage can also occur in all simultaneously sections of the cylindrical epithelium, which is ectopically concentrated on the outside of the cervix (that is, there is an unnatural displacement of the epithelium).
Remarkably, if a woman has purulent cervicitis, it can almost certainly be argued that her partner has a similar type of pathogens, but with great difficulty in diagnosing. Purulent cervicitis is one of the most common sexually transmitted diseases, as well as serving as the most common cause of inflammatory processes localized in the pelvic organs. In the presence of symptoms of purulent cervicitis among expectant mothers, the risk of disrupting the normal course of the entire pregnancy, as well as subsequent childbirth, greatly increases.
As a rule, the cause of the formation of pathology lies in the gonococci or in the trachoma bacillus. Unofficial statistics indicate that one out of three cases is marked by the occurrence of the disease due to exposure to ureaplasmas. Symptoms in this case are similar to diseases caused by the herpes virus and Trichomonas. In general, purulent cervicitis is formed against the background of the course of gonorrhea.
Viral cervicitis
Viral cervicitis with its characteristic inflammatory process occurs when the infection is transmitted sexually. Localization of the inflammatory infectious process determines such forms of the disease as exocervicitis and endocervicitis, with damage to the outer tissues of the cervix and damage to its inner part, respectively.
The generally accepted classification determines the division of the inflammatory process into a specific form of its course and non-specific. The specific form is a concomitant manifestation of viral cervicitis, respectively, we are talking about a viral etiology with the actual transmission of the virus through sexual contact (, HPV).
As a rule, women of the age of the childbearing group are affected. The main symptoms include pain in the lower abdomen, general discomfort and severe itching that occurs on the outside of the genitals. In addition, there are discharges with impurities in the form of pus or mucus. In the acute stage of viral cervicitis, the discharge is characterized by abundance, in the chronic stage - by scarcity.
Bacterial cervicitis
Bacterial cervicitis is also quite common in cases of patients visiting a gynecologist. The disease is infectious, while its localization is concentrated in the cervical canal or in the vagina in the region of the area bordering the cervix. Accompanying its course is a violation of the vaginal microflora, there is no strong inflammatory reaction.
Cervicitis occurs exogenously, while its development occurs against the background of affected mucous viruses such as herpes, papillomavirus, or, however, there is no connection with the sexual infections themselves in this case. In addition to the listed causes that cause bacterial cervicitis, urogenital tuberculosis is also isolated. Bacterial vaginosis is the most common cause for the formation of nonspecific chronic cervicitis.
The most common symptoms of this form of the disease are dysuria (i.e. urinary disorders), dull pulling pains that occur in the lower abdomen, as well as painful sensations that accompany sexual intercourse. In addition, patients have vaginal discharge of various consistency, while their abundance or, conversely, scarcity. The presence of impurities in the form of mucus or pus is also noted.
Atrophic cervicitis
Atrophic cervicitis has a number of features, but its development proceeds in accordance with the general principles that are relevant for cervicitis. The causes that provoke the occurrence of this form of cervicitis can be various types of diseases that form in the genitourinary system (cervical erosion, inflammation of the appendages). In addition, the development of an atrophic form of cervicitis is also possible with unprotected sexual contact, in particular when pathogens of one or another type of sexually transmitted diseases enter the body. Mycoplasmosis, as well as viral diseases, act as infectious agents. In addition, non-specific infections (staphylococci, streptococci) are also isolated.
The development of atrophic cervicitis also occurs in the area of the damaged area. The cause of injury in this case can be curettage, abortion, rupture of the uterus during its labor activity. Atrophic cervicitis is accompanied by a characteristic thinning that occurs in the tissues of the cervix. In severe forms of atrophy, urination disorders occur. As a rule, this form of the disease becomes the result of a chronic course of cervicitis.
Cystic cervicitis
In this case, a combination of infections (chlamydia, gonococci, streptococci, fungi, staphylococci, gardnerella, Trichomonas, etc.) is identified as the cause of the disease, which leads to the growth of the cylindrical epithelium along the surface of the uterus. This, in turn, leads to a gradual and continuous overgrowth of cysts. Quite often cysts are combined with manifestations in the form of erosions.
Diagnosis of cervicitis
Quite often, as we have already noted, cervicitis occurs without any symptoms, which, accordingly, leads to an untimely visit to a specialist. As a rule, the detection of the disease occurs randomly during a routine physical examination or when visiting a doctor with suspicion of another disease.
Diagnosis of cervicitis occurs on the basis of data such as:
- examination of the cervix through the use of mirrors for this;
- upon receipt of the results of colposcopy, allowing to detail the pathological changes in the epithelium in case of relevance of cervicitis;
- based on the results of laboratory tests (smear microscopy, microflora culture, PCR).
Treatment of cervicitis
In modern conditions, gynecology has many different methodological possibilities that allow the treatment of cervicitis. Meanwhile, the first thing that needs to be done in this treatment is to eliminate the factors predisposing to the development of the disease in question.
In the treatment of cervicitis, antiviral, antibacterial and other agents are used, which is determined based on the specific pathogen identified and its characteristic sensitivity to the selected drug. The stage in which the inflammatory process is located is also taken into account. Widely applicable in the treatment of cervicitis local preparations of the combined type, as well as creams and suppositories.
Specific infections require concurrent partner treatment.
The chronic stage of the disease is characterized by less success of conservative treatment, which, accordingly, determines the need for the use of surgical methods (cryotherapy, diathermocoagulation, laser therapy) in the preliminary disposal of infections.
In case of suspicion of cervicitis, as well as the presence of symptoms corresponding to this disease in one form or another of their manifestation, you should consult a gynecologist. Additionally, you may also need an examination by a urologist.
The female reproductive system is very complex and delicate. In the absence of any pathologies, a woman can live a full life: work productively, actively relax, have sex and give birth to children. But if any of the components of the reproductive system fails, various problems appear. As a rule, failures occur due to diseases and pathological processes. One of these processes is cervicitis. What is such a deviation and how to deal with it? Let's try to figure it out.
By its nature, cervicitis is a kind of inflammatory process that occurs in the vaginal segment of the cervix. In the presence of such a defect, specific discharge comes out of the vagina, pain discomfort in the lower abdomen may be present. In addition, pain may be accompanied by urination, as well as sexual contact.
This pathology is quite dangerous, because. it can lead to further complications. What causes cervicitis?
Causes of cervicitis
The fact is that the cervix is a kind of natural shield that protects the uterus itself and the upper genital tract from infectious agents. Under the influence of harmful factors, the protective functionality of the cervix may fall. As a result of this weakening, pathogenic microflora penetrates into the uterus, and the pathological process begins. This process is called cervicitis.
Cervicitis of the cervix according to the localization of inflammation is divided into 2 types:
- exocervicitis;
- endocervicitis.
With exocervicitis, the vaginal part of the cervix becomes inflamed. With endocervicitis, the inner lining of the cervical canal is affected.
The occurrence of the considered pathology can be provoked by a variety of pathogens.
As a rule, cervical cervicitis occurs due to exposure to:
- staphylococcus;
- coli;
- streptococcus;
- pathogenic fungi;
- gonococcus;
- syphilis;
- trichomonas;
- certain protozoan infectious agents.
Mechanical damage to the cervix can also affect the formation of cervicitis.
Causes of cervicitis can be:
- trauma to the cervix during childbirth;
- damage to the inner lining of the vagina during prophylactic curettage;
- low-quality abortion;
- poor installation or unprofessional removal of the intrauterine device.
Inflammation can develop if a woman has benign formations in the vaginal area. Weakness of the immune system can contribute to the onset of such inflammation.
Often, cervicitis progresses on a large scale, provoking the appearance of additional defects. In particular, vaginitis, vulvitis, pseudo-erosion of the cervix may develop.
As for the risk group, women of reproductive age are in it. According to statistics, more than 70% of women who had any type of cervicitis were aged from 20 to 45 years. However, occasionally cervicitis can also be found in a woman at the menopausal stage.
Pathology is extremely dangerous for pregnant women. It can provoke premature birth or miscarriage.
Symptoms
Symptoms of cervicitis differ depending on the type of pathology. Medicine distinguishes several varieties of cervicitis (depending on the characteristics of the course). So, according to the flow time, they distinguish:
- chronic cervicitis;
- acute cervicitis;
- hidden cervicitis.
According to the degree of affecting the segments of the reproductive system, cervicitis can be
- focal
- diffuse.
Occasionally, a latent type of flow may occur. In acute cases, discharge of a mucous or purulent type may be present. Less commonly, a woman may be tormented by pain discomfort in the lower abdomen. Often there is swelling of the external opening of the cervical canal. Hemorrhages and ulcers may also be observed.
The severity of cervicitis also depends on the type of pathogen and the strength of the immune system, the symptoms may vary depending on the organism.
For example, the gonorrheal type of cervicitis is acute, with clear symptoms. Cervicitis is quickly diagnosed.
If the causative agent turned out to be chlamydia, the symptoms may be less pronounced.
When the cause of the pathology is herpes, there is a strong reddening of the cervix. In addition, with inflammation of a herpetic nature, ulcers often form on the uterine neck.
If cervicitis is of trichomonas origin, there is a high probability of weak hemorrhages. At the same time, a swab taken for analysis may contain atypical cellular components.
When the causative agents of cervicitis are actinomycetes, there is a so-called “yellow granular spot” symptom.
The human papillomavirus is also capable of causing this type of inflammation, the symptoms in this case have some differences. With this reason, condylomas may occur. Also, the likelihood of cervical ulcers is high.
In the absence of timely therapeutic measures, the inflammatory process becomes chronic, the symptoms change slightly. Chronic cervicitis is less pronounced. The discharge becomes more cloudy, pseudo-erosion of the vaginal component of the uterus may occur. With the transition to the chronic form, the main symptoms of cervicitis (such as swelling) become less pronounced. The pathological process may affect nearby tissues and glands. There is a high risk of cyst formation. Almost always, the structure of the cervix becomes atypically dense.
Diagnostics
The main danger of cervicitis is that it often occurs without symptoms, which is why women rarely seek help from specialists. As a rule, this type of inflammation is detected during routine gynecological examinations of the cervix, or after examinations, when women come to the hospital for other problems. If there is a suspicion of cervicitis, all diagnostic measures are directed to determine the root cause of the pathology.
Often, the diagnosis of cervicitis includes:
- examination of the cervix with the help of mirrors;
- colposcopy, thanks to which you can clearly see atypical changes in the uterine epithelium;
- all kinds of laboratory examination methods (microexamination of smears, bakposevy, cytomorphological examinations).
In acute course, smears contain many leuko-lymphocytes and histiocytes. In chronic cervicitis, cellular components of the cylindrical epithelium of various sizes are visible. Occasionally it is possible to detect traces of cellular destruction.
Thanks to bacteriological examination, you can find out the genus and type of organisms that provoked inflammation. Also, through such an analysis, it is possible to select the most appropriate type of antibiotics.
Cytomorphology of the smear makes it possible to thoroughly study the damage to cellular components. Also, thanks to it, you can observe the dynamics of cellular changes at the stage of treatment. A procedure called PCR allows you to detect pathogens of an infectious nature (gonorrhea, chlamydia, papillomavirus).
Treatment
Fortunately, modern medicine knows a lot of techniques that can be used to treat cervicitis. Treatment is primarily aimed at eliminating provoking factors (weak immunity, hormonal disruptions). In addition, comorbidities must be treated.
Cervicitis is a pathology that can cause many complications and health problems. If you notice symptoms of cervicitis, contact a specialist. Treatment should be carried out by an experienced doctor!
As a rule, treatment involves the use of antibacterial and antiviral drugs. The selection of funds is carried out by the attending physician. The choice depends on the susceptibility of the pathogenic component to a particular drug and on the stage of the pathological process.
With chlamydial inflammation, tetracycline antibiotics (for example, monomycin), macrolides, quinolones are prescribed. With cervicitis of the candidal type, fluconazole is often prescribed. To get the best result, different drugs can be combined, which speeds up the treatment. The type of medicines can be different: both tablet forms of medicines and suppositories are used.
Local treatment can be activated when the pathological process is already beginning to weaken. With local therapy, the vagina and cervix can be treated with a three percent solution of dimethyl sulfoxide, a two percent chlorophyllipt solution. In addition, doctors often prescribe treatment with a silver nitrate solution.
Treating viral cervicitis is quite problematic. So, in the presence of genital herpes, the treatment is quite long. It involves taking antiviral agents (for example, acyclovir), special anti-herpes Ig, vitamin complexes, immune system stimulants.
To eliminate papillomavirus lesions, interferons, cytostatics are used; if necessary, warts are removed. If the inflammation is atrophic, treatment involves the use of female hormones. This measure helps to restore the vaginal and uterine epithelium. In addition, the balance of microflora and tissue of the cervix is restored. If there are specific infectious lesions, the sexual partner of the sick woman must also be treated.
In chronic cervicitis, conservative treatment measures are less effective. For this reason, doctors prescribe surgery:
- diathermocoagulation;
- cryotherapy;
- laser processing.
However, for the operation to be allowed, the woman must be free of infections. Before and after the operation, measures are continued to eliminate associated defects; efforts are also being made to normalize the balance of microflora.
So that the doctor can control the entire treatment process, a woman periodically undergoes a colposcopy. Also, swabs are taken for laboratory examination. The cervix may be examined on a gynecological chair to monitor treatment.
Prevention measures
As you can see, cervicitis is an extremely unpleasant pathology that can negatively affect a woman's life.
However, "acquaintance" with her can be avoided. To do this, you need to follow a number of simple preventive measures:
- regularly observe intimate hygiene;
- to be protected from unwanted pregnancy, so as not to have an abortion later, which can provoke inflammation and cervicitis;
- timely treat infectious lesions of the vagina and cervix;
- follow all medical recommendations during pregnancy and at the stage of childbirth, so as not to damage the cervix at the birth of a child;
- timely eliminate dysfunctions of the endocrine system.
These rules are quite enough to protect yourself from cervicitis and related problems caused by it.
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