Cervicitis - This is a disease in which a woman develops inflammatory infections in the cervix. To more accurately determine the essence of this disease, you need to know about the structure of the genital organs of the uterus of a woman. The cervix continues the body of the uterus, located between the vagina and the uterine cavity. Cervical canal passes through the center of the cervix and connects the vagina and uterine cavity. The cervical canal contains a mucous plug, which does not allow microorganisms from the external environment to penetrate into the internal reproductive organs.
Types of Cervicitis
First of all, experts divide cervicitis into infectious and non-infectious form of the disease. Yet more often infectious cervicitis is diagnosed due to sexually transmitted diseases. In turn, the causes of the non-infectious form of the disease are often injuries, the presence of neoplasms, chemical or radiation effects.
According to the localization of the disease, it is customary to distinguish endocervicitis (in this case we are talking about inflammation of the mucous membrane of the cervical canal) and exocervicitis (the vaginal part of the cervix is affected).
The course of the disease may be like sharpand chronic. If timely treatment of the disease has not been undertaken, chronic cervicitis develops. Assessing the type of pathogen allows you to highlight specific and non-specific cervicitis.
Causes of Cervicitis
The causes of cervicitis can be diverse: they can be both infectious and non-infectious in nature. The most common etiological factors include:
- infectious diseases of the reproductive system: chlamydia,trichomoniasis,gonorrhea, as well as other STIs that are caused by staphylococci, streptococci, mycoplasmas, ureaplasmas, Pseudomonas aeruginosa and Escherichia coli,
- traumatic injuries of the reproductive organs, which may be the result of surgical intervention (curettage of the uterus and termination of pregnancy) and even inaccurate gynecological examination or incorrect conduct of some medical or diagnostic procedures (installation of an intrauterine device). Complicated childbirth is also a common cause of cervical injuries (tears, tissue tears),
- prolonged use of intrauterine contraceptives,
- hormonal failure in women,
- the presence of neoplasms of benign genesis on the cervix.
An etiological factor can be either one of the above items, or several at once.
Factors provoking the development of pathology
The factors that provoke the development of diseases such as chronic cervicitis can be:
- rough sex
- a general decrease in the body's defenses (primary or secondary immunodeficiency),
- genital prolapse,
- vaginal dysbiosis.
Push the body to the development of cervicitis in young girls can: early onset of sexual activity, frequent change of sexual partners, early childbirth.
The clinical picture of chronic cervicitis
Chronic cervicitis may not bother a woman for a long time. It is often found when the patient seeks help from a specialist about an infection of the genitourinary system. As for cervicitis in women, which has a non-infectious nature, only a gynecologist can examine its presence when examined. Indeed, in this case, symptoms may be absent altogether.
The clinical picture of the disease can be divided into 2 large groups:
- what a woman feels:
- non-intense pain projecting over the bosom. More often it is aching or pulling,
- periodically occurring abundant spotting from the genital tract not associated with the menstrual cycle. In some cases, an admixture of pus can be noted. Bleeding is spotting and goes away on its own,
- vaginal mucous membranes with a cloudy tint, not associated with a specific phase of the cycle,
- algodismenorea (painful menstruation),
- characteristic signs of an infectious process: burning, itching, discharge with an unpleasant odor,
- with an active inflammatory process, an increase in body temperature to subfebrile numbers, weakness and general malaise are noted,
- with the transition of the inflammatory process to the bladder, frequent urges to urinate appear, accompanied by painful pains.
- what the doctor sees:
- hyperemia (redness) of the mucous membrane,
- swelling of the affected tissues (see photo above),
- the mucous membrane is loose, may have traces of erosion and bruising.
The clinical picture may vary depending on the degree of neglect of the disease and the individual characteristics of the woman's body.
Classify chronic inflammation of the mucous membrane of the cervical canal as follows:
- by etiological factor:
- specific cervicitis, which is caused by specific STI pathogens,
- nonspecific - occurs under the influence of agents of non-infectious nature or as a result of the active growth and reproduction of conditionally pathogenic vaginal microflora,
- atrophic - the result of an inflammatory process localized in a thinned exocervix and endocervix.
- on the scale of the spread of the inflammatory process:
- exocervicitis - only the vaginal part of the uterine neck is affected,
- endocervicitis - the mucous membrane is inflamed along the cervical canal,
- diffuse - inflammation affects the entire mucous membrane,
- macular - local foci of inflammation are formed, separate from each other.
- depending on the stage of activity of the inflammatory process:
Only a qualified gynecologist can make a diagnosis of chronic cervicitis after collecting an anamnesis and examining the patient in the mirrors. If necessary, confirm the diagnosis or differential diagnosis with other diseases of the cervix uteri, studies such as:
- colposcopy - allows you to assess the condition of the cervix and identify erosive lesions, dysplasia, precancerous conditions. It is carried out using special equipment that increases the possible viewing angle,
- analysis of a smear taken from the vagina and cervical canal to determine the microflora - bacterial sowing,
- cytology - determination of cellular composition in a pathological focus,
- PCR diagnostics, ELISA, RIF - allow you to select a specific infectious agent that caused the development of the disease,
- transvaginal ultrasound - allows you to identify a thickened and deformed cervix. In some cases, exclude oncology.
- study of the hormonal status of a woman.
Treatment of chronic cervicitis
Treatment of cervicitis can be prescribed only by a qualified specialist. Self-medication, as well as self-diagnosis, is strictly prohibited.
Irrational therapy can lead to an aggravation of health, the progression of the disease and the appearance of complications.
The treatment regimen is determined by the doctor depending on the cause of the appearance of XP. cervicitis and degree of neglect.
Conservative therapy (drug treatment)
If chronic cervicitis is caused by a bacterial pathogenic flora, then the doctor prescribes antibacterial therapy taking into account the susceptibility of the pathogen to a specific drug. Drug therapy of the disease consists in local and systemic effects. Local treatment is based on the use of:
- suppositories (suppositories from cervicitis), capsules, vaginal tablets - Hexicon, Terzhinan, Polygynax, Fluomizin and other suppositories to restore normal vaginal microflora - Atzilact, Lactonorm,
- solutions - Dimexide, silver nitrate and etc.
Systemic exposure includes:
- immunomodulators - Viferon, Cycloferon, Kagocel, Isoprinosine, Groprinosin etc.,
- immunostimulants - Polyoxidonium,
- probiotics and drugs that normalize the microflora of the vagina and intestines - Bifidumbacterin, Bactisubtil, Biogai.
Menopausal women who have been given this diagnosis (atrophic form) should undergo hormone therapy with estrogens.
Suppositories from cervicitis have an anti-inflammatory, healing, antibacterial or antiviral agent (depending on the active substance).
It is necessary to treat cervicitis without interrupting the therapeutic course for a single day. Therapy should be continuous and combined. If the disease is caused by specific microorganisms, viruses or fungi, then treatment should be carried out in both sexual partners at the same time.
Physiotherapy in combination with the main methods of treatment gives good results. So, in the acute phase of the disease, a course of UHF or ultraviolet radiation on the lower abdomen is indicated. In the stage of remission and in the subacute course, you can use such methods of exposure as vaginal laser therapy, electrophoresis with magnesium, SMT.
Explain the essence of each method and talk about what it is, only the attending physician who prescribes this or that procedure can.
Surgical treatment is used if conservative medical methods have not brought the proper results.
As a radical method of influencing chronic cervicitis, coagulation of the mucous membrane of the cervix at the location of the pathological process (cauterization of the focus with electrodes by the formation of a scab, which over time is replaced by normal healthy tissue), is used.
Surgical treatment of cervicitis is most often used when it is accompanied by the development of ectopia.
In addition, such methods are widely used as:
- diathermocoagulation - laser therapy - laser vaporization. The advantages of this method are: the absence of cicatricial changes, high efficiency and accuracy of surgical intervention,
- radio wave therapy - exposure to high-frequency current. A fairly expensive technique that requires special knowledge and skills from doctors. Radio waves eliminate the upper altered layer of cells,
- cryodestruction - freezing of the lesion site with nitrogen. The technique does not need anesthesia, leaves patches of scar tissue.
Alternative (traditional methods of therapy)
Treatment of the disease with traditional medicine can be used as additional therapy to the main methods of influencing the pathological process. Currently, the most popular tools are:
- Camomile tea. For its preparation, you need 2 tbsp. pharmacy chamomile insist on 500 ml of boiling water for 20 minutes. Separate the liquid part from the flowers, moisten a gauze swab in it well and insert deep into the vagina for a quarter of an hour. Repeat the manipulation three times during the day,
- Oak bark decoction. For the preparation of anti-inflammatory and astringent, it is necessary to pour 1 tbsp. l Chopped oak bark 500 ml of boiling water and leave in a water bath for no more than a quarter of an hour. Strain the broth thoroughly, allow to cool to room temperature and use for douching twice a day,
- A mixture of medicinal plants for oral administration. Mix in equal parts oak bark, wormwood, the color of bird cherry. Add 2 parts of green raspberry leaves and 3 parts of juniper berries. Mix everything thoroughly. 2 tbsp. l pour the resulting mixture into a thermos and pour 1 liter of boiling water. Insist 12 hours. Take 100 ml before the main meals three times a day.
Cervicitis, which is not subjected to rational therapy, over time leads to the appearance of signs of ectopy. The chronic focus of inflammation provokes active hypertrophy of the tissues of the mucous membrane of the cervical canal. As a result, the inner layer that lines the channel actively grows and goes out.
Cervical ectopy of the cervix with chronic cervicitis is compared with pseudo-erosion. And, if you do not pay proper attention to the disease, true erosion will form in place of atypical cells with infiltrate over time, which will become a prerequisite for the development of the tumor process, including malignant nature.
If cervicitis of any genesis is not treated, complications may appear that adversely affect a woman’s health. These include scarring of the mucous membrane, adhesions, the development of non-invasive cancer.
If a young woman who has not yet given birth suffers from the disease, then in the future she has an increased risk of developing infertility.
What is cervicitis of the cervix
The term "cervicitis" refers to an infectious and inflammatory process localized in the cervical (cervical) canal. This part of the uterus performs a barrier function, protecting the internal genital organs from the penetration of infections. Protection is provided by a combination of factors such as the narrowness of the channel, the presence of a mucous plug, the development of a special secret. If for some reason the protective function is impaired, pathogens penetrate the cervical canal and cause an inflammatory process.
Symptoms of cervicitis of the cervix
The acute form of the inflammatory process can proceed in different ways, including asymptomatic. General symptoms include, first of all, copious discharge. They can be purulent or mucous. Sometimes the patient complains of dull pain in the lower abdomen. When viewed in the mirrors, edema and redness around the external opening of the canal, minor ulcerations and hemorrhages, protrusion of the mucosa are revealed.
Depending on the type of infectious agent that caused acute inflammation, characteristic symptoms may be observed:
- Gonococcal (most common) is acute, all the typical signs of this cervicitis in women are pronounced.
- Trichomonas is accompanied by multiple hemorrhages on the mucosa - the so-called "strawberry cervix."
- Herpetic cervicitis is determined by severe hyperemia and friability of the cervix. There is also a symptom of "continuous erosion" - numerous ulcerations.
- If actinomycetes are the cause of the pathological process, characteristic formations are detected - a symptom of a “granular yellow spot”.
- Chlamydial cervicitis has the least obvious signs, it is often ignored for this reason and becomes chronic.
- Viral cervicitis caused by HPV is often accompanied by the formation of genital warts.
Often, inflammation of the cervical canal develops in parallel with erosion, and then specific symptoms of cervicitis of the cervix arise along with contact bleeding from the vagina. If the infection spreads to the urinary tract, pain appears when urinating, burning sensations. Damage to the walls of the vagina leads to colpitis.
The transition of the disease to the chronic stage in the absence of proper treatment occurs after 2-3 weeks. It is also called moderate cervicitis, as it creates the illusion of recovery.The fact is that the inflammatory process extends deep into the tissues of the cervix, and the surface layer is restored. Discharges in chronic cervicitis become less abundant, more viscous and have a white or yellowish color. Laboratory blood tests often do not show signs of an inflammatory process. During the inspection revealed:
- neck compression and its increase due to edema,
- the mucous membrane around the pharynx of the cervical canal is eroded,
- extensive ulcer that occurs when the squamous epithelium is replaced by a cylindrical.
Since the regeneration of epithelial tissue is carried out incorrectly, the ducts of the glands that produce cervical mucus overlap. Nabotov cysts are formed in them and cystic cervicitis develops. Chronic cervicitis of the cervix during menopause is accompanied by atrophy of the mucous membranes.
It is difficult to establish an accurate diagnosis based on clinical symptoms, because discharge and pain accompany many inflammatory diseases of the female pelvic organs. The initial examination, which is carried out by a gynecologist, allows you to detect edema, hyperemia, ulceration and hemorrhage. After it, the patient is prescribed compulsory colposcopy.
This instrumental method of research allows you to detect characteristic structural changes in tissue. In addition, in order to identify the specific cause of inflammation, laboratory diagnostics are performed:
- smear on the flora,
- cytological examination
- PCR diagnostics.
Blood is also tested for RW and the presence of HIV.
How to treat cervicitis?
In the acute period of the disease, conservative therapy is performed. It is carried out in several successive stages:
- Elimination of the immediate cause of inflammation. According to the results of tests to identify the causative agent, appropriate drugs are prescribed for the treatment of cervicitis in women - antimicrobial or antiviral. It should be borne in mind that local medicines at this stage are not relevant, as they fight the infection superficially. Usually, systemic antiviral drugs (acyclovir, valaciclovir, interferons) and antibiotics for cervicitis are first prescribed. The latter include tetracyclines, macrolides, fluoroquinolones, fluconazole.
- As the clinical manifestations of the disease decrease, local therapy is also prescribed. The cervix and vagina are regularly treated with solutions of dimethyl sulfoxide, chlorophyllipt, silver nitrate. Combined intravaginal creams and cervicitis suppositories are also used. After the completion of antimicrobial therapy, preparations with lactic acid are indicated to restore the vaginal biocenosis.
- Immunostimulants and vitamin complexes are prescribed to activate the body's defenses. Hormonal disorders require appropriate therapy, against the background of which inflammation of the cervical canal develops. Postmenopausal women who are diagnosed with an atrophic form of the disease should use cervicitis suppositories with estrogen.
When the cause of the inflammatory process is sexually transmitted infections (ureaplasmosis, trichomoniasis, gonorrhea), both partners need to undergo antibiotic therapy. Efficiency is controlled by laboratory tests and by colposcopy.
If the visit to the doctor for any reason was untimely, or inadequate therapy (self-medication) was carried out, the process usually goes into a chronic form. Treatment of chronic cervicitis of the cervix is carried out mainly by surgical methods, since conservative ones are ineffective. Cryo- and laser therapy, diathermocoagulation are used. The infection is pre-treated with systemic drugs, and after surgery, rehabilitation therapy is prescribed.
Treatment of cervicitis with folk remedies
The use of alternative medicine prescriptions is possible only as an addition to the main therapy with the permission of the doctor. Mostly used infusions of herbs with anti-inflammatory effect (eucalyptus, calendula) in the form of douching. You can also introduce tampons soaked in them into the vagina. Self-treatment of inflammation of the cervical canal with folk remedies is unacceptable.
Can I get pregnant with cervicitis
If patency of the cervical canal is preserved, then sperm can well penetrate the uterus. However, this process is hampered by a change in the acid-base balance of the vagina, the presence of secretions. When the epithelium grows and deforms, the cervical canal is blocked and fertilization of the egg becomes impossible. In order for conception to be carried out without problems, it is necessary even before pregnancy, at the planning stage, to undergo a complete examination and cure all diseases.
Cervicitis during pregnancy
What is the risk of inflammation of the cervical canal in case of pregnancy? First of all, due to the lack of a protective barrier, the infection spreads freely along the ascending path. Infection of the fetus in the early stages most often leads to its death and spontaneous abortion. In the second and third trimesters, there is a high incidence of intrauterine infections. In addition, chronic cervicitis during pregnancy is fraught with premature birth due to cervical insufficiency.
The cervix is an anatomical continuation of the lower uterine segment. It is presented in the form of a tube up to 4 cm in length and 2.5 cm wide. Outside (in the vagina), only its part is visible - the vaginal. The neck is covered with epithelium, which gives it a pale pink color. The cervix is the junction of the vagina and the uterine cavity, which provides the cervical canal.
The cervix acts as an anatomical and biological barrier that prevents the penetration of infectious agents into the uterine cavity, fallopian tubes and ovaries. Protection is provided due to the narrowness of the cervical canal, the mucous plug located in it, and the secretion of the protective glands by the cervical glands. Under the influence of certain factors, the protective function of the neck is impaired, foreign microflora penetrate into the cervical canal and the inflammatory process, cervicitis, starts.
Definition of concepts
If the vaginal part of the neck becomes inflamed, they say about exocervicitis. When inflammation develops in the epithelium of the cervical canal - this is called endocervicitis.
Often you can hear from a woman that she has found signs of cervicitis of the cervix. This is an incorrect phrase, since the word cervicitis itself means the inflammatory process of the neck, and it turns out "butter oil". A more correct expression would be without any additions, “cervicitis.”
Etiology of Cervicitis
Cervicitis is caused by causes of an infectious nature, that is, under certain conditions, the mucous membrane of the neck and cervical canal is attacked by pathogenic microorganisms, causing an inflammatory reaction. The disease can cause both nonspecific microflora (conditionally pathogenic microbes) and specific, which is transmitted sexually.
Inflammation of the cervical mucosa is provoked by the following factors:
- concomitant diseases of the genital area (erosion and pseudo-erosion of the neck, colpitis, inflammation of the uterus or appendages),
- genital infections (chlamydia and mycoplasmosis, gonorrhea and trichomoniasis, thrush, genital herpes, human papillomavirus), most often (in 25%) neck inflammation occurs against the background of gonorrhea and trichomoniasis,
- nonspecific vulvovaginitis, enterocolitis, tonsillitis and other diseases caused by nonspecific microflora,
- prolapse of the genitals (cervix, vagina),
- weakened immune defenses,
- frequent change of sexual partners or promiscuous sex,
- endocrine pathology (metabolic disorder, thyroid disease, diabetes mellitus),
- ovarian dysfunction (the balance of sex hormones is disturbed, which causes a breakdown in the protective function of the neck),
- hormonal changes in the premenopausal and menopausal period (a decrease in estrogen leads to thinning and vulnerability of the cervical mucosa - atrophic cervicitis),
- irrational use of local contraception (spermicides, douching with acids),
- trauma to the cervix (tears, cracks or abrasions) during childbirth, artificial termination of pregnancy, diagnostic curettage or during insertion / removal of the intrauterine device,
- vaginal dysbiosis (bacterial vaginosis).
With cervicitis, the symptoms are due to the course of the disease (chronic or acute). Symptoms may be pronounced or erased, which depends on the causative agent of the disease. Pronounced cervicitis is usually observed with gonococcal infection, and an asymptomatic or erased course is characteristic of chlamydia. Inflammation, as a rule, occurs first in the cervical canal (endocervicitis). As the disease progresses (intensive secretion of mucus by the neck glands, loosening of the underlying tissues), infectious agents penetrate into the deeper layers and affect the vaginal part of the neck. By this time, regeneration (healing) begins in the cervical canal, which gives a false impression of recovery. In fact, the inflammatory process "went" into the deeper layers and became chronic.
Acute neck inflammation
Manifestations of the acute form of the disease are significant. The patient is worried about purulent or profuse mucous leucorrhoea, vaginal itching and burning, which intensify with urination. Cervicitis pain may also bother you. Usually it is dull or aching pain in the lower abdomen, painful intercourse. Other symptoms of the disease are due to concomitant pathology. If the inflammatory process of the cervix has arisen against the background of cystitis, frequent and painful urination worries. With adnexitis and the inflammatory process in the cervix, there is an increase in temperature from subfebrile (above 37) to febrile numbers (38 and above). With a combination of pseudo-erosion and cervicitis, spotting may appear after coition. A distinctive feature of the disease is an exacerbation of all clinical symptoms after menstruation.
Features of some cervicitis:
- Herpetic lesion of the neck
The neck has a bright red color, very loose, has foci of ulceration.
- Trichomonas neck lesion
Small hemorrhages are determined (colposcopically) on the neck, which is called "strawberry cervix."
- Damage to the neck with actinomycetes
The sign “yellow granular spot” is determined colposcopically.
- Gonorrhea of the neck
A reddened “raspberry”, edematous neck with loosened mucous membrane, which bleeds easily upon contact, is determined. Discharge purulent, copious, yellow or green - "purulent cervicitis."
- Human papillomavirus infection
Condylomas and ulceration sites form on the neck.
Chronic neck inflammation
The disease, which was not adequately and treated in time for the acute stage, is chronicled. Signs of chronic cervicitis are less pronounced or practically absent. The discharge acquires a turbid-mucous character, the flat epithelium of the vaginal part of the neck is replaced by a cylindrical from the cervical canal, pseudo-erosion of the neck is formed. Inflammatory phenomena (redness and swelling) are poorly expressed. With the spread of inflammation to the surrounding tissue and deeper, the neck becomes denser, it is possible again to replace the cylindrical epithelium with a flat epithelium during ectopy, which is accompanied by the formation of nabot cysts and infiltrates.
Inflammation of the cervix during pregnancy
Cervicitis during pregnancy is rarely diagnosed. Since the treatment of the disease, many women are still at the stage of pregnancy planning. Acute inflammation of the cervix caused by specific microflora in the early stages can lead to the penetration of the infection into the uterine cavity, infection of the membranes and cause miscarriage or gross fetal malformations. In the later stages, the inflammatory process in the cervix can also provoke abnormalities of the fetus, intrauterine growth retardation and malnutrition, premature birth and infectious complications in the mother in the postpartum period. In addition, when a child passes through an infected birth canal, it can contribute to the development of infectious diseases.
Untreated timely and adequate disease threatens with the following complications:
- the development of a chronic inflammatory process in the neck,
- ascending infection, when the inflammatory process spreads to the uterus and appendages, affects the peritoneum and bladder (in 10 out of 100 patients, adnexitis, endometritis and pelvioperitonitis are diagnosed with chlamydial or gonorrheic cervicitis),
- the occurrence of bartholinitis with specific inflammation of the cervix,
- inflammation of the appendages and the development of adhesive disease of the pelvis, which leads to infertility,
- malignant lesion of the cervix.
Antimicrobial and antiviral agents
The purpose of this or that group of drugs is determined by the selected pathogen and taking into account its sensitivity to the antibiotic / antiviral drug.
- chlamydial damage to the neck - it is recommended to take antibiotics from a number of tetracyclines (doxycycline), quinolones (tarid), macrolides (erythromycin) and azalides (azithromycin),
- fungal infection of the neck - antifungal drugs are prescribed inside (flucostat) and a place in the form of suppositories and vaginal tablets (clotrimazole, isoconazole),
- treatment of atrophic cervicitis is carried out with suppositories with hormones (ovestin),
- viral damage to the neck - the treatment is very laborious and lengthy, in the case of genital herpes, antiviral drugs (acyclovir and zovirax), immunomodulators and multivitamins, as well as antiherpetic immunoglobulin are prescribed,
- damage to the neck with specific microbes (gonococci, trichomonads) - treatment is prescribed for both sexual partners,
- papillomavirus infection of the neck - cytostatics (5-fluorouracil) are prescribed.
Local therapy is prescribed when acute events subside (prevention of ascending infection). I treat the vagina and cervix with 3% dimexide, silver nitrate solution or 2% chlorophyllipt. Douching is also indicated with a weak solution of manganese, aqueous chlorhexidine, soda or boric acid. Cervicitis drugs such as vaginal suppositories and tablets (Betadin, Terzhinan), which have an antimicrobial and anti-inflammatory effect, are used in local therapy.
Elimination of the chronic process
In chronic cervicitis, surgical treatment is usually performed. Without fail, surgical treatment is carried out with a combination of the disease with another neck pathology (ectropion, pseudo-erosion). Surgical intervention is performed only after preliminary anti-inflammatory treatment. Of the surgical methods used:
- cryodestruction (freezing with liquid nitrogen),
- laser therapy
- diathermocoagulation (cauterization by electric current),
- cauterization with Surgitron device (radio wave treatment),
- photodynamic therapy.
After surgical treatment of the cervix, intravaginal anti-inflammatory suppositories (Terzhinan, Polizhinaks) and immunostimulating drugs (Genferon) are prescribed. Physiotherapy is carried out by an electrode inserted into the vagina (electrophoresis of drugs).
At the same time, concomitant pathology is treated (endometritis, adnexitis) to exclude relapses.
Mix of herbs No. 3
Mix two shares of sage leaves, juniper fruits and tansy flower. Add one share of eucalyptus leaves, yarrow grass and alder cones. Pour 2 tablespoons of the mixture with a glass of boiling water, simmer for a couple of 8 - 10 minutes. Insist half an hour, strain. Consume thrice a day for 1/3 cup.
The disease is easier to prevent than to treat. Prevention of inflammatory damage to the cervix is:
- regular gynecological examination (every six months),
- colposcopy annually,
- preventing unwanted pregnancies and abortions,
- having a regular partner,
- using condoms for casual sexual intercourse,
- strengthening immunity (physical education, good nutrition),
- prevention of prolapse of the genital organs (refusal to carry weights and heavy physical exertion, Kegel exercises),
- the appointment of hormone replacement therapy in menopause,
- timely and adequate treatment of infections of the genitourinary system.
Yes. By and large, the disease does not affect the process of conception. Difficulties with conception can occur with concomitant diseases (inflammation of the fallopian tubes and ovaries, endometritis, background pathology of the neck).
During gestation, only local conservative therapy is possible. Treatment of the chronic process is postponed to the postpartum period.
No, having sex with cervicitis is not contraindicated. A ban on sexual activity is imposed only if sexually transmitted infections are identified and for the period of treatment and the postoperative period.
It is not recommended, since an intrauterine contraceptive aggravates the inflammatory process, promotes the development of an ascending infection and increases the frequency of exacerbations of the disease.
Before starting treatment, you should consult a doctor and undergo a gynecological examination examination for infection. After anti-inflammatory therapy, the gynecologist will choose the optimal method of surgical treatment.
Causes of Cervicitis
The main cause of cervicitis aresexually transmitted diseases. With the development of a certain sexually transmitted disease, thinning of thick mucus gradually occurs, as a result of which inflammation of the mucous membrane begins. After this, the infection begins to spread to the base of the cervix. Due to such changes, microbes gradually enter the uterus, appendages, and later spread to the bladder, kidneys and other organs. As a result, pathological phenomena develop in the pelvic cavity of a woman, up to peritonitis.
If the main cause of the development of cervicitis in a woman is considered sexually transmitted diseases, then doctors also highlight a number of factors that contribute to the development of this disease. The risk of developing cervicitis increases significantly if a woman has been infected with the virus. herpes or human papillomavirus. Cervicitis can overtake a girl at a time when she is just beginning an active sex life. Cervicitis of the cervix can also occur as a consequence of mechanical or chemical irritation (we are talking about contraceptives or hygiene products). In some cases, the inflammatory process occurs as a result of an allergic reaction of the body to latex, other components of contraceptives or personal care products.
The factor provoking the disease is also weakened immunity due to other somatic diseases. In addition, cervicitis can develop due to injuries caused during the process. abortion or childbirth (in this case, it is important to qualitatively suture all the tears of the perineum and cervix obtained in the birth process), with the omission of the genitals in women. Also, the disease often affects women who have entered the menopause.
All the reasons described above contribute to the active reproduction of microorganisms assigned to the group opportunistic (staphylococci, streptococci, enterococci, E. coli) Under the normal state of health of a woman, such microorganisms are present in the microflora of the vagina.
Causes of Chronic Cervicitis
In most cases, chronic inflammation of the cervical mucosa occurs against the background of an untreated acute inflammatory process, however, it can also develop gradually, without vivid clinical signs. There are two groups of causes of cervicitis:
- Infectious agents. The disease is caused by STI pathogens - gonococci, chlamydia, Trichomonas, genital herpes viruses and papillomatosis. Cervicitis also occurs with the activation of opportunistic microflora (yeast, staphylococci, streptococci, Escherichia coli, etc.).
- Noncommunicable factors. Inflammation complicates injuries of the cervix, neoplastic processes, allergic reactions to contraceptives, drugs and hygiene. The cause of the development of atrophic cervicitis is a decrease in estrogen levels during menopause.
An important role in the occurrence of the disease is played by risk factors. Chronic cervicitis provoke:
- Mechanical damage. The cervix is often inflamed in patients who have had abortions, complex births, invasive diagnostic and treatment procedures.
- Gynecological diseases. Chronic inflammation can develop against the background of the prolapse of the vagina or spread from other parts of the female reproductive system.
- Promiscuous sex life. Frequent change of partners increases the risk of STIs. In this case, cervicitis is either the only manifestation of infection, or is combined with vulvitis, vaginitis, endometritis, adnexitis.
- Decreased immunity. Immunodeficiency in women with severe concomitant pathology or taking immunosuppressive drugs contributes to the activation of opportunistic microorganisms.
- Hormonal imbalance. Inflammation often occurs when taking improperly selected oral contraceptives and diseases with reduced secretion of estrogen.
- Accompanying illnesses. The chronic course of cervicitis is noted in patients with Behcet's syndrome, urological and other extragenital pathology.
The development of the disease is determined by a combination of several pathogenetic links. Signs of the inflammatory process are moderate and localized mainly in the endocervix. The mucous membrane of the cervical canal becomes edematous, thickened, folded. There is plethora of blood vessels, lymphohistiocytic inflammatory infiltrates are formed, epithelial cells secrete more mucus. In exo- and endocervix, regenerative processes slow down and degenerative changes occur. In the lower layers of the mucosa connective tissue elements grow. The outlet glands of the glands overlap with a flat epithelium with the formation of nabot (retention) cysts. As the disease develops, the connective tissue and cervical muscles are involved in the inflammation.
The cellular and humoral immune systems function inadequately: the number of B and T lymphocytes decreases, T-dependent immune responses are inhibited, and phagocytic activity is disrupted. As a result, pathogens are able to persist both in the cervical epithelium and in the cells of the immune system. In cervical mucus, the level of immunoglobulins G and M decreases against the background of an increased content of IgA. Autoimmune processes develop with the phenomenon of "molecular mimicry" between foreign proteins and proteins of their own tissues.
Symptoms of Chronic Cervicitis
Usually the disease is asymptomatic. During the period of remission, the woman notes scanty mucous or mucopurulent vaginal discharge, which becomes more abundant before menstruation or immediately after menstruation. Pain is usually absent. Clinical signs during exacerbation are more noticeable. The number of vaginal discharge mucous membranes that become cloudy or yellow due to the appearance of pus increases. The patient is concerned about discomfort and dull pulling pains in the lower abdomen, which intensify during urination and during intercourse. After sex, spotting spotting occurs. If cervicitis is combined with colpitis, a woman complains of minor itching and burning in the vagina.
Prognosis and prevention
The prognosis of the disease is favorable. For the timely detection of possible cervical dysplasia, the patient after a course of treatment needs to undergo colposcopy twice a year, take cytological smears and bacteriosis. Prevention of chronic cervicitis includes regular examinations by a gynecologist, adequate treatment of inflammatory diseases of the female genital area, and the reasonable appointment of invasive procedures. It is recommended that you follow the rules of intimate hygiene, streamline your sex life, use condoms (especially during sexual intercourse with unfamiliar partners), and exclude sex during menstruation. For the prevention of relapse, courses of general strengthening and immunotherapy, adherence to sleep and rest, protection from hypothermia of the legs and pelvic area are effective.