What is Chronic Cervicitis?
Chronic Cervicitis is a medical condition of the female reproductive system where there is persistent inflammation of the cervix (lower part of the uterus). Chronic cervicitis occurs when acute cervicitis is not treated which then persists leading to chronic cervicitis, which can cause further complications. Chronic cervicitis is also known as chronic inflammation of the cervix and chronic cervical inflammation.
There are many causes of Chronic Cervicitis; however, it commonly results from non-infectious causes, such as birth control agents (cervical caps, contraceptive creams) and chemicals that cause allergy.
Chronic Cervicitis produces symptoms, such as inflammation and redness of the cervix, itching around the genital region and abnormal vaginal discharge. The diagnosis of chronic cervicitis can be made with a Pap smear and tissue culture studies.
Treatment of Chronic Cervicitis depends on what has caused it. Prognosis of chronic cervicitis with treatment is often good; but this condition may recur.
Causes of Chronic Cervicitis
Chronic cervicitis can affect women of any race, ethnic groups and from any geographic location. The primary cause of Chronic Cervicitis is a non-infectious cause; however, there are also other causes for it. Acute cervicitis, which has not been treated properly or not treated at all, turns into Chronic Cervicitis. In some patients, the exact cause of chronic cervicitis is not clear.
Non-Infectious Causes of Chronic Cervicitis
- Irritation to the cervix from the use of contraceptive devices, such as cervical tampon or cap.
- Allergies to contraceptive creams, vaginal douches and condoms.
- Allergic reaction to chemicals.
- Iatrogenic causes, such as radiation therapy or any surgery, which involves the cervix.
- Cervical polyps.
- Injury to the vagina.
Infectious Causes of Chronic Cervicitis
- If there are Nabothian cysts present and there is blockage in them, then it can cause infection resulting in Chronic Cervicitis.
- Sexually transmitted infections caused by Neisseria gonorrhea bacterium.
- Chronic bacterial infections caused by streptococcus, staphylococcus, E coli and anaerobic bacteria can cause Chronic Cervicitis.
- Follicular cervicitis can also sometimes lead to Chronic Cervicitis.
- Parasitic infections caused by Trichomonas vaginalis can also cause Chronic Cervicitis.
- Viral infections occurring from herpes simplex virus can also lead to Chronic Cervicitis.
Risk Factors for Chronic Cervicitis
- Untreated or inadequately treated acute cervicitis.
- Older women are at increased risk to develop Chronic Cervicitis.
- Women in their childbearing age or who have already borne children commonly tend to suffer from chronic cervicitis. However, women of any age group can have chronic cervicitis, but older women are a higher risk.
- Previous history of sexually-transmitted diseases (STDs) increases the risk of chronic cervicitis.
- Having unprotected sex or sex with multiple partners increases the risk of chronic cervicitis.
- Use of contraceptives, which cause irritation to the cervix, increases the risk of chronic cervicitis.
- Use of vaginal douches, as this changes the chemical balance in the vagina and causes growth of different bacteria, which thrive in the changed environment.
- Radiation therapy to the cervical region increases the risk of chronic cervicitis.
- Surgery involving the cervical region increases the risk of chronic cervicitis.
Signs & Symptoms of Chronic Cervicitis
Most of the women with Chronic Cervicitis may not have any signs and symptoms. Those who have symptoms will experience the following:
- Itching in the genital region.
- Redness and swelling of the cervix.
- Ulcers in the cervix.
- Abnormal vaginal discharge.
- Painful intercourse (dyspareunia).
- Increased urinary frequency.
- Feeling of pressure in the pelvis.
Diagnosis of Chronic Cervicitis
- Physical examination and medical history of the patient is done.
- Pelvic exam is done where the cervix can be visually inspected. There can be redness and ulceration seen in the cervix. Some patients can also have vaginal discharge.
- Urine tests are done.
- Pap smear exam is done where a swab of cells are taken from the cervix and are examined under the microscope.
- A culture of the vaginal discharge or cervical tissue is done.
- Biopsy can also be done where a tissue sample from the cervix is taken and sent to lab for analysis.
Treatment of Chronic Cervicitis
Depending on the cause of inflammation, treatment of chronic cervicitis consists of:
Symptomatic treatment of the symptoms of the chronic cervicitis if it is caused by non-infectious agents is done where the patient is prescribed medicines to reduce inflammation.
Antibiotics are prescribed if bacterial infection is the cause of Chronic Cervicitis.
Antiviral medications are prescribed if viral infection is the cause of Chronic Cervicitis.
Procedures such as cryotherapy and laser therapy can also be done to treat Chronic Cervicitis.
Avoiding sexual intercourse is important till the completion of treatment and until the chronic cervicitis is completely resolved. It is also important to treat the patient’s partner if the cause of chronic cervicitis is a sexually transmitted infection.
Complications of Chronic Cervicitis
If chronic cervicitis is not treated, then it can lead to the following complications:
- The infection can spread from the cervix to the uterus, endometrium (endometritis), urinary bladder (cystitis), fallopian tube and ovaries, all of which can ultimately result in pelvic inflammatory disease (PID).
- Pelvic inflammatory disease (PID) can cause ectopic pregnancy and infertility.
- Pregnant women suffering from untreated chronic cervicitis are more susceptible for complications, which include premature labor and miscarriage.
- Patient develops increased susceptibility to HIV infection.
- Chronic cervicitis can recur even after it has been treated.
Prevention of Chronic Cervicitis
- If the patient is suffering from acute cervicitis, then she should immediately get it treated to prevent chronic cervicitis.
- Patient should avoid potential irritants and allergens, which include spermicidal creams, douches and cervical caps.
- Safe sex should be practiced and having sex with multiple partners should be avoided to prevent the development of chronic cervicitis.
- Prolonged contact of the cervix with a chemical or foreign body should be avoided.
- Drinking water immediately after sexual intercourse and emptying the bladder helps in preventing chronic cervicitis.
- It is important to maintain proper hygiene and cleanliness of the genital region all the times; and especially before and after sexual intercourse.
- Patient should regularly get Pap smears done so that early detection and treatment of cervicitis can be done to prevent it from developing into chronic cervicitis.
Prognosis of Chronic Cervicitis
The prognosis of Chronic Cervicitis is good with treatment and this condition usually resolves after the cause is identified and treated properly. However, Chronic cervicitis can recur if the patient does not practice proper hygiene, uses chemicals and irritants to the cervical region and indulges in unprotected sex.