Overview

When we talk about health, one of the most important aspects of the health sciences is the emphasis on women's health. Cervicitis is a common condition in women, and according to research, it is estimated that all adult women, especially those assigned female at birth (AFAB), experience cervicitis at some point in their lives. The symptoms and severity of cervicitis vary from person to person—it may present with mild, severe, or no symptoms.

This article will enlighten you with every piece of information about cervicitis, highlighting its diagnosis and treatment, and emphasising women's health.

Introduction 

In simpler words, cervicitis is defined as the inflammation of the cervix. To understand cervicitis, it is important to know its anatomy. The female body exclusively has the uterus, which is a reproductive organ that holds and nourishes the fetus. The cervix is the lower part of the uterus that opens into the vagina. During labour, the cervix dilates to allow the baby to pass through the vagina via the endocervical canal (baby canal). 

Because cervicitis occurs in half of all women at some point in their lives, regardless of the severity, it should be encouraged to immediately consult a healthcare provider if there are any doubts or abnormalities. Cervicitis can be asymptomatic for a long time or present with severe symptoms. Early diagnosis and treatment can aid with the severity and duration of the disease. Furthermore, it may help prevent other complications that can arise from cervicitis in women. 

The earlier the diagnosis, the fewer the complications. While there are many root causes of cervicitis, the major focus should be on educating and empowering women regarding their health, well-being, and hygiene.

Understanding cervicitis

Cervicitis can be caused by infectious and non-infectious factors, with infectious causes being significantly more common.

• Infectious cervicitis: Sexually transmitted infections (STIs) are the major cause of acquiring infectious cervicitis. STIs can be transmitted through sexual activities, which include high-risk sexual behaviour, multiple sexual partners, sex at an early age, a history of STIs, and sexual exposure to a person who has had an STI. The pathogenic microorganisms responsible for STIs include Chlamydia trachomatis (chlamydia), Neisseria gonorrhoeae (gonorrhea), the herpes simplex virus (genital herpes), human papillomavirus (genital warts), and Trichomonas vaginalis (trichomoniasis)
• Non-infectious cervicitis: Other causes of cervicitis include the insertion of any device in the pelvis area, allergies to spermicides used for birth control, allergic reactions to the latex in condoms, exposure to chemicals, and the use of douches or vaginal deodorants¹

Symptoms of cervicitis 

Some cases of cervicitis may show no symptoms, but the following are the major symptoms found commonly:

• Abnormal vaginal bleeding that can occur after intercourse or during menstruation
• Abnormal vaginal discharge that can be grey or yellow
• Pain during intercourse
• Itchiness in the vagina
• Painful urination
• A feeling of heaviness or pressure in the pelvis

Potential complication

If any of the symptoms are present and raise doubts about cervicitis, it is encouraged to consult a healthcare provider immediately. Cervicitis can last for months to years, depending on the cause and type of infection. If left untreated, it may cause complications, further leading to pelvis inflammation, which can result in a condition known as pelvis inflammatory disease (PID). 

Diagnosis of Cervicitis

The diagnosis of cervicitis depends on the symptoms and severity of the disease. Non-infectious cervicitis usually resolves on its own and does not require any medication. However, for infectious cervicitis, the diagnosis is made through a methodical process. Below, each method of examination is explained in detail. 

Assessment of medical history

When you visit a healthcare practitioner, the first step in the diagnostic process is always reviewing your medical history. 

Physical examination

A physical examination of the pelvis is carried out by the doctor by inserting a gloved finger into the vagina while applying pressure on the lower abdomen with the other hand to check for abnormalities in the pelvic organs. Another way to check for cervicitis is to check if there is any abnormal vaginal discharge, redness, or swelling around the walls of the vagina. 

Other ways of diagnosis after the physical examination, which are more commonly carried out in infectious cervicitis, are as follows:

1. Pap smear

A pap smear is a common way of detecting and screening infected or abnormal cells for diagnosis. A sample of the vaginal discharge is collected using a swab and sent to the laboratory for testing under the microscope. The test detects any abnormalities or inflammation in the cells, which helps in early diagnosis of cervicitis. 

2. HPV testing

Along with the pap smear, another test, known as the HPV (human papillomavirus) test is run on the sample. It detects the cells that are infected with high-risk HPV strains, which may be at high risk of acquiring cervical cancer.² 

3. Cultures for sexually transmitted infections (STIs)

In the case of infectious cervicitis, a sample of discharge from the cervix is collected for microscopic testing to detect the presence of pathogenic microorganisms. This test is run specifically for STIs.

4. Cervical biopsy

A cervical biopsy involves removing tissue from the cervix for laboratory testing to detect precancerous or cancerous cells. This procedure is used to diagnose cervical cancer in women.

The cervical biopsy procedure can be carried out in three ways:

• Punch biopsy: This uses a circular blade and removes the tissue in a punch-like manner
• Cone biopsy: It uses a laser or scalpel to remove cone-shaped tissue from the cervix
• Endocervical curettage (ECC): An instrument called a curette is used to remove or scrape tissue from the cervix³ 

Treatment of cervicitis

The treatment of cervicitis depends on the type of cervicitis and the severity of the disease. Usually, the treatment for cervicitis involves the use of antibiotics pre and post-diagnosis. 

Antibiotic therapy for infectious cervicitis

Since infectious cervicitis is caused by sexually transmitted microorganisms, it requires strong antibiotics to treat the associated STIs. 

• Gonorrhoea is treated with antibiotics such as injections of ceftriaxone (Rocephin) and orally administered azithromycin
• Chlamydia is treated with doxycycline, azithromycin, or levofloxacin
• Trichomoniasis is usually treated with metronidazole⁴ 

Antiviral medications for viral causes

If cervicitis is caused by viruses such as genital herpes, your healthcare provider may prescribe antiviral medications such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir).

Treatment for infectious cervicitis involves addressing the infection in both the infected person and their sexual partner. 

Other treatments

Other treatment methods are typically mild, especially for non-infectious cervicitis. Topical medications can help reduce inflammation and irritation. 

Additionally, managing lifestyle and hygiene practices, treating your infected partner, and avoiding high-risk sexual activities can prevent recurrence and improve overall outcomes.

Awareness and support of women's health and well-being

Besides diagnosis and treatment, it is important to take preventive measures for diseases that can be life-threatening. The prevalence of such conditions can be minimised through a strong focus on women’s health and well-being, and raising awareness about protective practices and self-hygiene.

Education on safe sex practices

Proper education should be given in terms of safe sex practices. Women's health should be prioritised, and precautionary tests should be encouraged if there are any doubts. 

Sex education is necessary; accurate information regarding the cons of high-risk sexual activities and having multiple sex partners should be provided and promoted. 

Regular screenings and preventive care

Women must maintain a regular screening routine every six months, especially those aged 30 and above. A pap smear test is an effective preventive measure to ensure uterus and cervical health. 

Importance of communication with healthcare providers

Healthcare providers are a valuable resource for medical and lifestyle guidance. There should be no hesitation in discussing genital health and seeking professional advice. Communication is key to many preventive solutions. Healthcare providers must also create an open environment and space for women to discuss and educate them regarding cervicitis and other sexually transmitted diseases.

Emotional support and counselling

Providing emotional support and understanding women’s decisions can help prevent diseases or assist those who are already suffering from them. 

Community resources and support groups

All medical groups, social services, healthcare sectors, NGOs, and women activists should equally contribute to spreading awareness and support through social media, magazine articles, or any other resources they can, to reach the maximum count of women. 

Preventive measures

As we know, prevention is better than cure. This phrase is as pure as gold; it is always better to encourage and adopt a preventive mindset. There are ways to prevent cervicitis if proper measures are taken.

Vaccination against HPV

Get yourself vaccinated against HPV (human papillomavirus).HPV is a potential virus that causes STIs and cervical cancer in women. This vaccination can help reduce the risk of developing cervical cancer.⁵ 

Encourage the use of condoms

Using condoms correctly and consistently during sexual activity is one of the most effective ways to prevent STIs, including chlamydia, gonorrhoea, and HIV.

Limiting sexual partners

Having fewer sexual partners can reduce the risk of contracting STIs. It's important to consider safe sexual practices and communication with partners about sexual health.

Regular gynaecological check-ups

Women should have routine health check-ups, which can include screenings for STIs and cervical health, ensuring that any potential issues are caught early.⁶

Summary

Cervicitis can range from mild to severe, with the most potential risk being the development of cervical cancer in women. Women’s health should be emphasised through different platforms and resources, helping them understand the importance of genital hygiene and safe, protected sex for their overall well-being. If you or any woman you know experiences symptoms or is at high risk of acquiring the condition due to sexual activity or hygiene-related reasons, it is important to take responsibility for discussing and educating them on the matter.