Cervicitis: definitions, complications, and African care
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- On 2025-08-01
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Cervicitis: definitions, complications, and African care
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1. What is Cervicitis?
Cervicitis refers to the inflammation of the cervix, the lower, narrow part of the uterus that opens into the vagina. This inflammation can be acute, occurring suddenly and often with intense symptoms, or chronic, developing gradually and persisting for months or even years.
From a clinical standpoint, cervicitis is characterized by redness, swelling, and discharge from the cervix. It is typically caused by infectious agents but can also result from non-infectious factors such as chemical irritants or trauma.
Importantly, cervicitis is not a disease itself but a symptom of underlying problems, particularly infections, which must be addressed to prevent long-term complications.
2. Causes of Cervicitis
2.1 Infectious Causes
Most cases of cervicitis are caused by sexually transmitted infections (STIs), including:
Chlamydia trachomatis
Neisseria gonorrhoeae
Trichomonas vaginalis
Herpes simplex virus (HSV)
Mycoplasma genitalium
These pathogens are commonly transmitted through unprotected sexual contact and can often coexist, making diagnosis and treatment more challenging.
2.2 Non-infectious Causes
In some instances, cervicitis may result from:
Allergic reactions to spermicides or latex in condoms
Chemical irritants in vaginal hygiene products
Physical trauma from sexual activity or medical procedures
Radiation therapy or intrauterine devices (IUDs)
Thus, while infections are the predominant cause, cervicitis may occur even in women who are not sexually active.
3. Common Symptoms
Although many women with cervicitis are asymptomatic, others may experience a range of troubling signs, including:
Unusual vaginal discharge, often thick, yellowish or gray
Bleeding between periods or after intercourse
Pain during sex (dyspareunia)
Pelvic pain or pressure
Burning sensation during urination
Due to the nonspecific nature of these symptoms, cervicitis is sometimes confused with other vaginal infections, which highlights the need for proper medical evaluation.
4. Complications of Untreated Cervicitis
If cervicitis is not diagnosed and treated promptly, it may lead to serious health complications, especially in women of childbearing age. These include:
4.1 Pelvic Inflammatory Disease (PID)
Cervicitis can facilitate the spread of infection to the upper reproductive tract, resulting in PID—a severe condition that affects the uterus, fallopian tubes, and ovaries. PID can cause:
Chronic pelvic pain
Infertility
Ectopic pregnancy
4.2 Increased Risk of HIV Transmission
The inflammation and disruption of the cervical lining make it easier for HIV to enter the bloodstream, increasing susceptibility to HIV and other STIs.
4.3 Pregnancy Complications
In pregnant women, cervicitis can contribute to premature rupture of membranes, preterm delivery, or neonatal infections, particularly if the causative infection is passed to the baby during childbirth.
Therefore, the early detection and management of cervicitis are critical for protecting both the woman and her future offspring.
5. Diagnosis
The diagnosis of cervicitis generally involves a combination of:
Pelvic examination to assess the cervix
Laboratory tests such as swabs from the cervix for culture or nucleic acid amplification tests (NAATs)
Pap smear to detect inflammation or abnormal cells
Screening for STIs, including HIV, gonorrhea, and chlamydia
In African settings, however, access to laboratory services may be limited, making syndromic management more common, though less precise.
6. Treatment Options
6.1 Standard Medical Treatments
Once the causative agent is identified, antibiotics or antiviral medications are administered accordingly. For example:
Chlamydia: Doxycycline or azithromycin
Gonorrhea: Ceftriaxone and azithromycin
Herpes: Acyclovir or valacyclovir
It is crucial to treat sexual partners simultaneously to avoid reinfection.
6.2 Symptomatic Relief
In addition to antibiotics, patients may benefit from:
Pain relievers (e.g., paracetamol)
Warm sitz baths
Avoiding sexual intercourse during treatment
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