Written by Ada’s Medical Knowledge Team
What is cervicitis?
Cervicitis is an inflammatory condition of the cervix, the neck of the womb. The inflammation can be infectious, most often caused by bacteria or viruses , or non-infectious, caused by physical or chemical irritation, injury to the cervix or allergies.
Sexually transmitted infections (STIs), including chlamydia and gonorrhea, are the most common cause of cervicitis.
Some women don't experience any symptoms at all as a result of cervicitis, while others may experience symptoms such as vaginal discharge, lower abdominal (stomach) pain or pain and bleeding after sexual activity. Antibiotics or antiviral medications may be necessary to treat infectious cervicitis, however most people recover fully from the condition.
Cervicitis may cause no symptoms at all, or symptoms such as: 1
- Grayish or yellowish vaginal discharge
- Vaginal bleeding or spotting; either after sexual intercourse or between periods
- Pain during sexual intercourse
- A burning sensation when urinating; usually the result of the condition spreading to the urethra
If cervicitis spreads to the uterus, fallopian tubes or ovaries, this is a condition called pelvic inflammatory disease (PID). People with PID may experience symptoms such as abdominal pain and fever.
People who are experiencing symptoms that may be linked to cervicitis or PID should seek medical attention as a matter of urgency. The free Ada app can also be used to carry out a symptom assessment.
Causes of cervicitis
Cervicitis is typically caused by infection, most commonly by sexually transmitted infections (STIs).
STIs that may cause cervicitis include: 2
Less commonly, cervicitis may be caused by factors such as: 3
- Bacterial vaginosis, an imbalance of normal bacteria in the vagina
- An allergy to the chemicals found in condoms, spermicides or douches
- Injury or irritation caused by things such as diaphragms, tampons or pessaries
- A hormonal imbalance
- Cancer or cancer treatment
Women displaying the symptoms of cervicitis should see a doctor for diagnosis. Doctors will be able to identify the condition, as well as any other conditions that involve similar symptoms.
Diagnosing cervicitis will usually involve tests including: 4
A speculum exam
In this test, a device called a speculum is inserted into the vagina. The speculum is gently opened to widen the vagina so that the vagina interior and cervix can be seen. The doctor will be looking for signs of redness, discharge and inflammation of the vaginal walls.
A pap smear
Also known as a pap test, this exam involves swabbing cells from the vagina and cervix and testing these cells for abnormalities. This can be performed during the speculum exam.
A bimanual pelvic exam
This test involves the doctor inserting a gloved finger into the vagina to examine for abnormalities.
Tests for STIs
There is no specific treatment for cervicitis. Instead, a doctor will recommend a treatment method based on the root cause of the condition, as well as the affected person’s symptoms, age, overall health and medical history.
Cervicitis treatment: antibiotics and antivirals
In cases where cervicitis is caused by a bacterial infection, antibiotics will generally be prescribed. A certain kind of antibiotics are also commonly prescribed if an infection with the microscopic parasite trichomonas is suspected or confirmed. Antibiotics should be taken according to the instructions of the doctor, as well as the instruction pamphlet enclosed within the packaging. It is important to take antibiotics for the entirety of the prescribed course, even if the problem clears before this time.
If caused by a virus, such as the herpes virus, antiviral medication will normally be prescribed. This medication may be topical, i.e. applied directly to the affected area or administered orally, or both.
Treatment should always involve both the affected person and their sexual partner. Without this, the risk of re-infecting each other is very high. Moreover, all sexual activity should be halted until seven days after each partner has completed treatment or as long as specified by the doctor. 6
Cervicitis treatment: other methods
If the condition is a result of irritation from condoms or tampons, for example, treatment may involve ceasing to use these products to allow time for healing.
If the symptoms of cervicitis are particularly severe or have developed into pelvic inflammatory disease, the person is pregnant or their immune system is weak, the affected person may be admitted to hospital for specialized care and support. 7
Cervicitis in pregnancy
Newly pregnant women or those attempting to become pregnant should be screened for cervicitis as soon as possible. When caused by an STI, cervicitis can lead to negative outcomes during pregnancy, including premature labor and miscarriage. 8
People who are sexually active with multiple partners during pregnancy should also be tested after each encounter. Doctors are able to effectively treat cervicitis during pregnancy, but it is important that this treatment is received as early as possible.
Prevention of cervicitis
Using condoms during sexual intercourse can help prevent bacterial and viral infections of the cervix. Condoms, however, cannot guarantee full protection. Avoiding causes of non-infectious cervicitis, such as things which cause allergies, may help prevent some episodes of cervicitis.
Complications of cervicitis: pelvic inflammatory disease (PID)
If cervicitis is caused by chlamydia or gonorrhea and it spreads to the uterus or fallopian tubes, this can result in a condition known as pelvic inflammatory disease (PID). Symptoms of PID include abdominal pain and fever, and can in some cases lead to fertility problems.
PID can typically be treated using antibiotics. People experiencing symptoms that may be linked to PID should visit a doctor as soon as possible. The free Ada app can also be used to carry out a symptom assessment.
Q: What is the difference between acute cervicitis and chronic cervicitis?
A: The difference between acute and chronic cervicitis pivots on how long the condition lasts. Acute cervicitis usually has an infectious cause, most typically STIs, and if properly treated will resolve relatively quickly. If not properly treated, it may become chronic, lasting for a longer period of time. Cervicitis caused by an irritant may also be acute, but is more often a chronic problem, especially if the cause – certain condoms or tampons, for example – are not avoided, and the inflammation is not allowed the time to heal properly. 9
Q: Is it possible to get cervicitis without an STI?
A: Yes, in some cases, cervicitis is not caused by an STI. Sexually transmitted infections are the most common cause of the condition, but it can also be caused by allergies, injury, and vaginal bacteria imbalance (bacterial vaginosis), among other things.
Q: Can cervicitis cause infertility?
A: Yes, in cases, where cervicitis is caused by chlamydia or gonorrhea and it spreads to the uterus or fallopian tubes via mechanisms not yet fully understood, but probably related to various inflammatory processes in infections with trichomonas, or when pelvic inflammatory disease (PID), a related condition, develops. 10 11 If you are worried about the possibility of cervicitis complications, seeking immediate medical attention is advised. The Ada app can also be used to carry out a symptom assessment.