Cervicitis: Symptoms, Causes & Treatment

Cervicitis is inflammation of the cervix. It can cause symptoms such as vaginal discharge, genital itching, bleeding outside your period, pain when urinating, and/or pain during sex.

Cervicitis can be caused by sexually transmitted infections, such as gonorrhea or chlamydia. It can also happen due to trauma from pessaries, tampons, or diaphragms, or from chemical irritants, such as spermicides or latex condoms.

If you have symptoms of cervicitis, it is important to see a gynecologist for an accurate diagnosis. Treatment may include antibiotics, antivirals, or vaginal creams, depending on the cause.

Common symptoms

The main symptoms of cervicitis are:

• White, yellow, or gray vaginal discharge, which may have a foul smell

• Pain when urinating (dysuria) and/or during sex (dyspareunia)

• Itching in the genital area

• Bleeding after sex and/or outside your period

• Frequent urge to urinate

• Lower abdominal pain

When cervicitis affects higher parts of the genital tract, such as the uterus, endometrium, ovaries, and bladder, it can also cause a high fever, abdominal pain, or increased cervical tenderness.

Confirming a diagnosis

Cervicitis should be diagnosed by a gynecologist or other women’s health provider based on your symptoms and your medical and sexual history.

To confirm the diagnosis, the provider performs a pelvic exam and may request tests for sexually transmitted infections. According to the CDC, women with cervicitis should be tested for Chlamydia trachomatis and Neisseria gonorrhoeae using NAAT testing on vaginal, cervical, or urine samples.

A Pap smear may also be done to check for cervical cell changes, but it is not used by itself to diagnose cervicitis.

Main types

The types of cervicitis, based on the cause and duration, are:

1. Acute cervicitis

Acute cervicitis starts suddenly and is usually caused by infections, especially sexually transmitted infections (STIs). It can cause symptoms such as pus-like vaginal discharge and cervical tenderness.

Some microorganisms linked to acute cervicitis include Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus, Trichomonas vaginalis, syphilis, tuberculosis, and Mycoplasma genitalium.

Acute cervicitis may also be related to bacteria that cause bacterial vaginosis.

2. Chronic cervicitis

Cervicitis is considered chronic when the infection lasts 3 months or longer. It may cause milder symptoms, such as persistent discharge.

This type of cervicitis is usually caused by non-infectious conditions, such as trauma from surgical instruments or foreign objects, including pessaries, diaphragms, tampons, and condoms, as well as chemical irritants.

More rarely, systemic inflammatory conditions such as lupus or sarcoidosis can also cause chronic cervicitis.

Possible causes

Cervicitis is inflammation of the cervix that can be caused by factors such as:

• STIs, STIs, such as gonorrhea, chlamydia, trichomoniasis, and syphilis

• Bacterial vaginosis

• Trauma caused by surgical instruments, tampons, diaphragms, intrauterine devices (IUDs), and pessaries

• Chemical irritants, such as latext condoms, vaginal douches, soaps, spermicides, and lubricating gels

• Systemic inflammatory diseases, such as lichen planus, lupus, sarcoidosis, and Behçet’s syndrome

• Vaginal atrophy

Although it is less common, cervicitis can be associated with cervical cell changes. However, cervicitis itself is not considered a direct precursor to cervical cancer.

Based on ACOG cervical cancer screening guidance, Pap testing is generally recommended every 3 years from ages 21 to 29. From ages 30 to 65, screening may include Pap testing every 3 years, high-risk HPV testing every 5 years, or co-testing every 5 years.

Treatment options

Treatment for cervicitis should be guided by a gynecologist or other women's health provider and usually involves:

• Oral antibiotics, such as azithromycin, doxycycline, ceftriaxone, or metronidazole, depending on the type of microorganism causing inflammation of the cervix

• Antivirals, such as acyclovir, if cervicitis is caused by the herpes simplex virus

• Vaginal creams containing miconazole 2% may be used if a vaginal yeast infection is also present

During treatment, women are advised to avoid sexual intercourse. Their partner should also be treated to prevent reinfection and transmission of cervicitis.

Is cervicitis curable?

Yes, cervicitis is usually curable because it is a treatable condition. However, cure depends on an accurate diagnosis and correctly identifying the cause.

Possible complications

When cervicitis is not properly treated, the infection can spread to the uterus, bladder, endometrium, ovaries, and fallopian tubes, causing pelvic inflammatory disease (PID).

Cervicitis can also cause endometritis, abscess formation, chronic pain, ectopic pregnancy, infertility, and pregnancy complications. In addition, cervicitis increases the risk of HIV infection.

Frequently asked questions

The most common questions about cervicitis include:

1. What is chronic cervicitis with squamous metaplasia?

Chronic cervicitis with squamous metaplasia is chronic inflammation that causes changes in the tissue lining the cervix.

Squamous metaplasia is the name of a change that can happen in response to infection with some types of human papillomavirus (HPV).

2. Can chronic cervicitis turn into cancer?

Chronic cervicitis itself is not considered a direct cause of cervical cancer. However, persistent inflammation or infections, especially HPV infection, can be associated with cervical cell changes that may need monitoring.

Therefore, when symptoms of cervicitis persist and no cause is found, the doctor may investigate possible non-infectious causes, such as polyps or cervical dysplasia.

3. Is cervicitis serious?

Cervicitis can be serious, especially if it is not properly diagnosed and treated.

In these cases, cervicitis can cause complications such as ectopic pregnancy, cervical cancer, pregnancy complications, and pelvic inflammatory disease, for example.