Cervicitis

Overview Of Cervicitis

Cervicitis is an inflammation of the cervix, the lower part of the uterus that opens into the vagina. It can be caused by infections, particularly sexually transmitted infections (STIs) such as *Chlamydia trachomatis* and *Neisseria gonorrhoeae*, or by non-infectious factors such as chemical irritants, allergic reactions, or physical trauma. Cervicitis can be acute or chronic and may present with symptoms such as abnormal vaginal discharge, postcoital bleeding, or pelvic pain. However, many cases are asymptomatic, particularly in the early stages. If left untreated, cervicitis can lead to complications such as pelvic inflammatory disease (PID), infertility, or an increased risk of HIV transmission. Early diagnosis and treatment are essential to prevent long-term consequences.

Causes of Cervicitis

• The primary causes of cervicitis are infections, particularly sexually transmitted pathogens like *Chlamydia trachomatis* and *Neisseria gonorrhoeae*. Other infectious agents include *Trichomonas vaginalis*, herpes simplex virus (HSV), and *Mycoplasma genitalium*. Non-infectious causes include exposure to chemical irritants (e.g., douches, spermicides), allergic reactions to latex condoms or contraceptive devices, and physical trauma from procedures such as intrauterine device (IUD) insertion or cervical biopsies. Hormonal imbalances, particularly low estrogen levels in postmenopausal women, can also contribute to cervicitis by thinning the cervical mucosa and making it more susceptible to inflammation. Risk factors include unprotected sex, multiple sexual partners, and a history of STIs.

Risk Factors of Cervicitis

• Several factors increase the risk of developing cervicitis. Unprotected sexual activity, including vaginal, anal, or oral sex, is the primary risk factor. Having multiple sexual partners or a new sexual partner within the past two months also elevates the risk. A history of sexually transmitted infections, particularly chlamydia or gonorrhea, increases susceptibility. Intrauterine device (IUD) use, especially in the first few weeks after insertion, can increase the risk of cervicitis due to physical trauma or introduction of bacteria. Poor hygiene practices, such as douching or using irritating feminine hygiene products, can also contribute. Hormonal changes, such as those during menopause, can make the cervical mucosa more vulnerable to inflammation.

Prevention of Cervicitis

• Preventing cervicitis involves adopting safe sexual practices and reducing exposure to risk factors. Consistent and correct use of condoms during vaginal, anal, and oral sex significantly reduces the risk of transmission. Limiting the number of sexual partners and avoiding sexual activity with individuals who have symptoms of STIs can also lower the risk. Regular screening for STIs, particularly for individuals with multiple partners or a history of STIs, is recommended. Avoiding douching and other practices that disrupt the vaginal microbiome can reduce the risk of infection. For postmenopausal women, hormonal therapy may help maintain cervical health. Education and access to healthcare services are key components of prevention efforts.

Prognosis of Cervicitis

• The prognosis for cervicitis is generally good with appropriate treatment. Most patients experience significant improvement within a few days of starting antibiotics or removing the irritant. However, untreated or inadequately treated cervicitis can lead to complications, such as pelvic inflammatory disease (PID), infertility, or chronic pelvic pain. Recurrent cervicitis may occur, particularly in individuals with ongoing exposure to risk factors such as unprotected sex or multiple partners. Long-term outcomes are improved with early diagnosis, adherence to treatment, and addressing risk factors. Regular follow-up and screening for STIs are essential for preventing recurrence and complications.

Complications of Cervicitis

• If left untreated, cervicitis can lead to several complications. The infection can ascend to the upper reproductive tract, causing pelvic inflammatory disease (PID), which can result in chronic pelvic pain, infertility, or ectopic pregnancy. Cervicitis increases the risk of HIV transmission due to inflammation and breaks in the cervical mucosa. Chronic cervicitis can lead to cervical stenosis (narrowing of the cervical canal), which may cause menstrual irregularities or difficulty with fertility treatments. In pregnant women, untreated cervicitis can lead to preterm labor, low birth weight, or neonatal infections. Prompt treatment and follow-up are essential to prevent these complications.

Related Diseases of Cervicitis

• Cervicitis is closely associated with several other reproductive and sexually transmitted conditions. Pelvic inflammatory disease (PID) is a common complication of untreated cervicitis and can lead to chronic pelvic pain or infertility. Vaginitis, caused by infections such as bacterial vaginosis or candidiasis, can coexist with cervicitis and complicate diagnosis. Sexually transmitted infections like chlamydia, gonorrhea, and trichomoniasis are frequent causes of cervicitis and require comprehensive management. Cervical dysplasia or cancer, detected during Pap smears, may present with similar symptoms and require further evaluation. Understanding these related diseases is essential for accurate diagnosis and effective treatment.

Treatment of Cervicitis

The treatment of cervicitis depends on the underlying cause. For infectious cervicitis caused by *Chlamydia trachomatis* or *Neisseria gonorrhoeae*, antibiotic therapy is essential. Recommended regimens include a single dose of azithromycin or a 7-day course of doxycycline for chlamydia, and a single dose of ceftriaxone for gonorrhea. Metronidazole or tinidazole is used for *Trichomonas vaginalis*. For non-infectious cervicitis, identifying and removing the irritant or allergen is key. Hormonal therapy, such as topical estrogen, may be beneficial for postmenopausal women with atrophic cervicitis. Sexual partners should be tested and treated to prevent reinfection. Follow-up is recommended to ensure resolution of symptoms and address any complications.