Symptoms of cervicitis and basic approaches to treating the disease

Cervicitis is an inflammation of the tissues of the vaginal part of the cervix.

The main function of the cervical mucosa is to protect the uterine cavity from pathogenic microorganisms.

Cervical mucus consists of immunoglobulins, enzymes and various substances that have an antibacterial effect.

The cervix and cervical mucus are a natural filter that protects a woman from adverse environmental conditions. The main reasons for the development of cervicitis include:

• sexually transmitted infections;
• violation of vaginal microflora;
• various injuries to the cervical canal, for example, during childbirth, installation of uterine contraceptives, artificial termination of pregnancy;
• chemical burns of the cervix during douching;
• hormonal disorders.

Predisposing factors for the disease include early onset of sexual activity, promiscuity, early childbirth (before 18 years of age), allergic reactions to latex or condom components, use of hormonal drugs, and smoking.

Cervicitis rarely occurs in isolation; most often it is accompanied by other diseases of the genital organs, for example, vulvitis, bartholinitis, vaginitis, ectropion, etc.

There are 2 forms of cervicitis:

• specific, which is caused by pathogenic microflora (gonococcus, mycoplasma, trichomonas, chlamydia);
• nonspecific - caused by opportunistic microflora, which under certain conditions leads to the development of cervicitis (streptococci, staphylococci, E. coli, enterococci, fungi of the genus Candida and others).

Depending on the location of inflammation, exocervicitis and endocervicitis are distinguished. Exocervicitis means inflammation of the vaginal segment of the cervix, while endocervicitis means inflammation of the cervical canal of the cervix.

According to the nature of the course, cervicitis is divided into:

• spicy. In this case, the inflammatory process lasts less than 6 weeks;
• chronic, which occurs with periodic exacerbations of the process.

If you consult a specialist in a timely manner, the prognosis for the disease is favorable. In case of delay in seeking help from a doctor or insufficient treatment, acute cervicitis can become chronic, which has certain consequences.

In addition, cervicitis can result in polyps and erosions of the cervix, inflammation of the upper genital tract.

That is why it is recommended to immediately contact a medical institution when the first symptoms of the disease appear, and also undergo annual preventive gynecological examinations.

Symptoms

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Acute cervicitis is manifested by the appearance of copious discharge from the genital tract of a mucous or mucopurulent nature. In addition, pain syndrome may be present in the clinical picture of the disease. However, dull pain in the lower abdomen is not a constant sign of the disease, that is, acute cervicitis can occur without pain.

Chronic cervicitis is characterized by a blurred clinical picture. In the chronic form of the disease, periodic pain in the lower abdomen occurs, mainly aching in nature, as well as cloudy mucous discharge from the genital tract.

Depending on the type of causative agent of cervicitis, the clinical picture of the disease may vary slightly.

For example, cervicitis, the cause of which is a gonorrheal infection, is acute and rapid, the symptoms are pronounced, often with pain.

With chlamydial infection, the symptoms of the disease are less pronounced, which is why patients do not seek help from a specialist for quite a long time.

Diagnostics

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• A gynecologist can diagnose cervicitis not only when a patient presents with characteristic complaints, but also during a routine examination, when nothing bothered the patient.
• The examination begins with examining the cervix using a speculum. Depending on the causative agent of the disease, the cervix has the following appearance:

• with cervicitis of gonorrheal etiology, the vaginal part of the cervix has a bright red color, it is swollen, loose, with areas of ulceration (symptom of “continuous erosion”);
• with cervicitis, the cause of which is Trichomonas, the cervix is ​​hyperemic, edematous, loose, and small hemorrhages are detected (“strawberry cervix”);
• with chlamydial infection, which can also cause the development of cervicitis, the mucous membrane of the vaginal part of the cervix is ​​slightly hyperemic and edematous.

Next, colposcopy is performed - a diagnostic method that allows you to assess the condition of the mucous membrane of the vaginal part of the cervix using a special optical device (colposcope). In the course of this study, the nature of the pathological changes in the cervix is ​​clarified. In addition, colposcopy allows you to determine the location of the pathological focus, which is necessary for targeted biopsy of the cervix. There are 2 types of colposcopy:

1. A simple colposcopy, during which the cervix is ​​examined using a colposcope without any drug tests.
2. Extended colposcopy, during which the cervical mucosa is pretreated with a 3% solution of acetic acid (or 0.5% salicylic acid solution) and an aqueous Lugol solution (the so-called Schiller test), after which the cervix is ​​examined using a colposcope .

The procedure is absolutely painless and does not require prior preparation on the part of the patient.

It is believed that colposcopy must be performed only if any changes in the cervical mucosa are detected during examination with a gynecological speculum.

However, it is currently recommended that this study be performed by women who are sexually active at least once a year for preventive purposes.

Microscopic examination allows us to determine the number and ratio of normal, pathogenic and opportunistic microorganisms, as well as cellular elements, which allows us to conclude about the presence of an inflammatory process, the degree of its severity and the nature of the microflora populating the vaginal part of the cervix.

In acute cervicitis, a large number of leukocytes (30 or more), lymphocytes and pathogenic microorganisms are detected. A bacteriological study allows you to identify the type of pathogen that caused the development of cervicitis, as well as determine the sensitivity of the microorganism to a range of antibiotics, which will help in choosing a specific antibiotic for treatment.

It is not always possible to identify the causative agent of the disease using a bacteriological examination of a smear; in such cases, PCR diagnostics are performed. This is, of course, a fairly powerful and effective modern diagnostic method, which allows one to quickly and accurately determine the causative agent of an infectious disease.

It is also worth noting that PCR diagnostics has high specificity and sensitivity. Thanks to the numerous advantages of this diagnostic method, an existing disease in a person can be detected even at the stage of the incubation period, when there are still no clinical and laboratory signs of the disease.

Treatment

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Treatment of cervicitis is aimed at eliminating the cause and predisposing factors to the onset of the disease. For this purpose, antibacterial, antiviral or antifungal drugs are prescribed depending on the causative agent of the disease.

Local treatment is carried out only after the acute process of the disease has subsided. It includes douching, the introduction of vaginal creams, suppositories, treatment of the cervix with a 3% solution of dimethyl sulfoxide, and a solution of silver nitrate. It is important to emphasize that the use of local therapy in the acute period of cervicitis is strictly prohibited due to the risk of developing an ascending infection.

Physiotherapeutic treatment is also used, which is prescribed after the acute period of the disease has stopped. For example, vaginal laser therapy, magnetic therapy, darsonvalization and the like can be used.

Chronic cervicitis is poorly responsive to drug treatment. Therefore, the following surgical treatment options are used:

• Diathermocoagulation is a treatment method whose effect is to cauterize tissues with high-frequency current;
• cryotherapy is a treatment method based on the effect of cold on tissues;
• laser therapy is a treatment method based on exposure of tissue to a concentrated beam of light.

Preventive measures aimed at preventing the development of cervicitis include observing personal hygiene rules, avoiding sexually transmitted infections, their timely treatment, and treatment of endocrine disorders. An important condition for preventing cervicitis is timely treatment of thrush.

Medicines

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Prescription of antibacterial drugs is necessary for the bacterial etiology of cervicitis. The following groups of antibiotics are used:

1. Tetracyclines. One of the representatives of this group of antibacterial agents is doxycycline, which is active against both gram-positive and gram-negative microorganisms. Contraindicated in children under 8 years of age, pregnant and breastfeeding women, people with liver failure, as well as myasthenia gravis (if intravenous administration of the drug is used).
2. Macrolides. The most common macrolide is azithromycin. This antibiotic has a wide spectrum of antibacterial action, which allows it to be used against various gram-negative and gram-positive microorganisms. The mechanism of action of the drug is to slow down the growth and reproduction of bacteria. Azithromycin is quite well tolerated; side effects rarely occur while taking the drug; it is contraindicated only if the patient has an allergic reaction to any of the components of the drug, pregnancy and lactation, as well as children under 12 years of age.
3. Fluoroquinolones:
   • moxifloxacin. It has a bactericidal effect covering a wide range of microorganisms. The drug is well tolerated among representatives of different ages. If necessary, it is allowed to prescribe to pregnant women, since animal studies did not reveal a teratogenic effect, which means the occurrence of malformations due to the use of the drug. It is worth refraining from use in children under 18 years of age, since clinical trials of the drug have not been conducted indicating the safety of moxifloxacin in children;
   • Levofloxacin. The drug has a bactericidal effect and is active against both gram-negative and gram-positive microorganisms. Levofloxacin is well tolerated, the following adverse reactions rarely occur: nausea, diarrhea, discomfort in the epigastric region (upper abdomen), muscle weakness.

Antiviral drugs are used, for example, for herpes infections. In this case, acyclovir is often prescribed. The dosage of the drug and the frequency of administration are determined by the attending physician, based on the severity of the process and the severity of clinical manifestations. Adverse reactions while taking the drug are rarely detected.

The most common symptoms include abdominal discomfort, nausea, vomiting, diarrhea, and headache. Detection of an allergic reaction is an indication for discontinuation of the drug.

While taking acyclovir, it is recommended to monitor kidney function, that is, monitor changes in biochemical blood tests such as creatinine and urea.

The drug is very well tolerated and side effects are extremely rare.

The most common adverse reactions include abdominal pain, nausea, flatulence, dryness of the oral mucosa, and stool disorders such as constipation.

Folk remedies

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Cervicitis should be treated by a specialist in this field of medicine. Self-medication at home is not recommended, since the lack of timely qualified treatment of acute cervicitis can lead to a chronic course of the process.

As is known, in some cases, cervicitis has a blurred clinical picture, which is why a woman does not seek help from a specialist in a timely manner. To avoid such situations, it is recommended not to forget about preventive examinations with a gynecologist, which should be carried out at least 2 times a year.

In addition, it is important to observe the rules of personal hygiene in order to eliminate the emergence of favorable conditions for infection. The number of sexual partners a woman has plays an important role in the possibility of developing cervicitis.

Therefore, the number of sexual partners should be limited, and casual sex should be excluded. To prevent the occurrence of sexually transmitted infections, it is necessary to use a barrier method of contraception (condom) during sexual intercourse.

If this method of protection is neglected, it is strongly recommended to be examined for the presence of sexually transmitted diseases, especially if there is no regular sexual partner.

In addition, it is necessary to promptly treat infectious and inflammatory diseases of the internal genital organs, as well as to prevent oneself from provoking factors that lead to exacerbation of chronic diseases. To do this, you should avoid hypothermia, various injuries, and psycho-emotional stress.

It is also important to take care of your diet; special attention should be paid to the consumption of vegetables and fruits, which are rich in various vitamins and microelements, dairy products, and cereals. Particular attention is paid to the sleep and rest regime, the observance of which helps to strengthen the general condition of the body.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Source: https://yellmed.ru/bolezni/cervicit

Cervicitis | Symptoms | Diagnostics | Treatment – ​​DocDoc.ru

Cervicitis is an inflammatory process in the cervix, which can occur against the background of endometritis, colpitis, salpingitis, erosion or other pathologies. In gynecology, there are two types of disease:

• Endocervicitis is an inflammation of the inner lining of the cervical canal of the cervix (exocervix), the main causative agents of which are pathogenic microorganisms and fungi. Women of reproductive age are more susceptible to this disease than women after menopause.
• Exocervicitis - inflammation spreads in the vaginal segment of the cervix. The pathology is characteristic of an infectious or fungal infection.

Causes of the disease

Among the causes of the development of cervicitis can be both genetic anomalies or a malfunction in the body’s immune system, as well as sexually transmitted infections. There are several factors that increase the risk of developing cervicitis:

• Cervical injuries.
• Frequent change of partners.
• Hormonal imbalance.
• Allergy to tampons or contraceptives.
• HIV, papilloma virus, genital herpes, the presence of opportunistic microflora.

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Symptoms of cervicitis

When the prismatic epithelium of the mucous membrane of the endocervical canal is affected by infectious pathogens of cervicitis (ureoplasma, staphylococcus, gonococcus), the sluggish inflammatory process is asymptomatic and there are no complaints. If cervicitis lasts for a long time, discomfort in the lower abdomen, frequent and painful urination, discharge from the cervix, painful sexual intercourse and spotting after sex occur. When the vaginal mucosa is affected by pathogenic microorganisms (candidiasis, trichomoniasis), the clinical manifestations of the disease are diagnosed immediately.

Characteristic symptoms of cervicitis:

• Itching in the vagina.
• Bloody discharge in the middle of the cycle.
• Discomfort during sexual intercourse and urination.
• Cloudy vaginal discharge after menstruation.
• Swelling and discoloration of the mucous membrane on the surface of the cervix.

The mild form of cervicitis is practically asymptomatic, which makes early diagnosis and treatment difficult. When the disease becomes chronic, purulent vaginal discharge and dull nagging pain in the lower abdomen may appear.

Mechanism of disease development

The cervix acts as a physiological barrier that protects the upper reproductive system and the uterus from infection. The outer surface of a healthy cervix is ​​covered with several layers of squamous epithelial (mucous) cells.

Behind the pharynx in the inner part of the endocervical canal, the flat epithelium turns into a single-layer prismatic one. The function of prismatic cells is the secretion of mucus and the movement of sperm through the endocervical canal.

When the body malfunctions, the protective function is impaired, or foreign microflora penetrates the cervical canal and cervix, a pathological inflammatory process develops.

In the photo of the cervix affected by cervicitis, you can see a change in the color of the pharynx, a shift of the squamous epithelium to the prismatic area and thickening of the walls of the cervix. Infectious and non-infectious cervicitis is diagnosed.

Reasons for the development of infectious cervicitis:

• Viruses.
• Syphilis.
• Candidiasis.
• Chlamydia.
• Gonococci.
• Mycoplasmas.
• Trichomonas.
• Streptococci.
• Staphylococci.
• Escherichia coli.
• Parasitic and protozoal infections (amoebiasis).

Infection of the cervix can occur due to poor hygiene, sexually or contact (from the rectum). The development of non-infectious cervicitis is promoted by:

• Abortion.
• Installation of the IUD.
• Cervical injuries.
• Cicatricial deformities.
• Decreased immunity.
• Complicated colpitis.
• Hormonal contraceptives.
• Benign formations.

With late diagnosis or improper treatment, the disease cervicitis leads to thickening (hypertrophy) of the walls of the cervix and penetration of infection into the upper parts of the reproductive system.

Chronic and acute cervicitis

The disease chronic cervicitis is caused by damage to the mucous membranes of the endocervical canal of the cervix by viruses and bacteria. In rare cases, chronic cervicitis develops as a result of:

• Hygiene violations.
• Vaginal prolapse.
• Inflammation in the pelvic organs.
• Incorrect use of hormonal drugs.

Depending on the cause of the development of the infectious process, the condition of the mucous membranes, the presence of pathologies of the reproductive system and the reactivity of the body, the clinical manifestations of the disease can be different: minor mucous discharge, pus, bloody discharge.

Why is chronic cervicitis dangerous?

• The disease causes infertility.
• Provokes genital dysplasia.
• Increases the risk of cancer.
• Leads to thickening and hypertrophy of the walls of the cervix.

Acute cervicitis is an inflammatory process that causes swelling of the cervical mucosa, the formation of infiltrates and cysts in areas of squamous epithelium. The acute stage provokes a dystrophic change in the mucosa, rejection of the integumentary epithelium and replacement of columnar epithelium with flat epithelium in the endocervical canal of the cervix.

The acute course of cervicitis is characterized by:

• copious discharge (purulent or mucous);
• intense pain in the lower abdomen;
• hyperemia and swelling of the cervical canal;
• ulcerations and hemorrhages;
• pain when urinating;
• protrusion of the mucous membrane;
• itching of the genitals.

If you notice similar symptoms, consult a doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnosis of cervicitis

The disease cervicitis is dangerous because it can be asymptomatic for a long time. As a rule, a sluggish inflammatory process on the cervix is ​​diagnosed during a medical examination or treatment for other diseases.

The doctor makes a diagnosis of “acute” or “chronic cervicitis” based on colposcopy and examination of the patient in a gynecological chair. The disease is characterized by mucopurulent discharge, eroded surface and hyperemia of the external opening of the cervical canal. To diagnose cervicitis, the following studies are additionally carried out:

• Smear microscopy. In acute cervicitis, the level of leukocytes (over 30), histiocytes and lymphocytes is significantly increased. In the cylindrical epithelium, processes of hypertrophy of the nucleus are observed, and dystrophic changes in the squamous epithelium are diagnosed. Chronic cervicitis is accompanied by deformation and destruction of epithelial cells.
• PCR diagnostics and enzyme immunoassay. High-precision laboratory studies of RNA and DNA structures make it possible to identify infections such as mycoplasmosis, papillomavirus, gonorrhea, chlamydia, and herpes.
• Bacterial culture for microflora. After identifying the type and genus of pathogenic microorganisms in the cervix, an antibiotic test is performed for drug treatment of the disease.
• Examination of the cervix (with speculum). During the initial examination on the chair, a specialist can diagnose swelling of the mucous membrane, hyperemia, vascular loops, ectopia, and focal or diffuse inflammation characteristic of cervicitis.
• Cytomorphological study. High-precision diagnostics make it possible to determine damage to the cellular structure and the dynamics of recovery during the therapeutic intervention.

When selecting a treatment regimen for cervicitis, the primary task is to identify and eliminate the pathogenesis that provokes the development of the inflammatory process. If the main reason for the malfunction of the body's immune forces is metabolic or hormonal disorders, therapy should begin with the endocrine, digestive or reproductive systems.

Standard treatment regimen for cervicitis:

• Chlamydial infectious cervicitis is treated with tetracycline antibiotics (Doxycycline, Monomycin), azalides (Sumamed), quinolones (Tarivid, Maxaquin), macrolides (Erythromycin).
• For candidal cervicitis, suppositories are prescribed; Diflucan and analogues are effective.
• When treating fungal inflammatory processes on the cervix, combination drugs (Terzhinan) are prescribed.
• After the acute symptoms of cervicitis are relieved, the vagina and cervix are treated with local antibacterial agents: silver nitrate, Chlorophyllipt and Dimexide solution.
• Cervicitis caused by genital herpes is treated with antiviral drugs (Acyclovir, Valtrex), antiherpetic drugs and immunostimulants.
• For the treatment of cervicitis caused by human papillomavirus infection, cytostatics, interferons are prescribed, and outpatient removal of condylomas is performed.
• Therapy for atrophic cervicitis involves the use of estrogens, which help restore the mucosal epithelium and natural microflora.
• For chronic cervicitis with significant damage to the mucous membranes and systems, surgical techniques are used: cryotherapy, diathermocoagulation, laser therapy.

If the diagnosis confirms the diagnosis of “infectious cervicitis,” the sexual partner should undergo treatment along with the woman. During the course of therapy, control diagnostics are prescribed: laboratory tests and colposcopy.

What does traditional medicine offer for cervicitis?

Traditional methods for treating cervicitis are effective as maintenance therapy to relieve symptoms and improve vaginal hygiene. Traditional medicine should be used in parallel with drug treatment, after consultation with a treating specialist.

• Herbs. For douching, infusions of anti-inflammatory infusions are used: coltsfoot, willow bark, stinging nettle, birch leaves, juniper roots and bird cherry leaves.
• For infectious cervicitis, itching and burning in the vagina are relieved by baths of equal proportions of infusions: juniper berries, sage leaves, tansy flowers, yarrow and birch buds.
• Homeopathic ointments. Pharmacies make ointments from celandine, wormwood, dandelion roots, flax seeds, St. John's wort, sage, and lilac flowers. Honey or glycerin is used as a base in such medicinal compositions.
• For internal use, general strengthening and anti-inflammatory infusions are recommended: peppermint, horsetail, wormwood, St. John's wort.

Surgical operations for cervicitis

With a high degree of damage to the cervical mucosa, the development of side anomalies in the reproductive system and the absence of an appropriate response of the body to drug therapy, surgical correction of cervicitis is indicated. The operation is performed only after the infectious source of inflammation has been cured.

The surgical method for treating cervicitis is based on exposing the affected tissue to liquid nitrogen, followed by electrosurgical treatment or laser therapy. Rehabilitation time after surgery can range from 2 weeks to 1.5 months.

Diet for cervicitis

For cervicitis, drug therapy should be supplemented with a competent, balanced diet. During the treatment of the inflammatory process, the body urgently needs a sufficient amount of microelements, polyunsaturated fatty acids, protein, vitamins and carbohydrates.

The patient's diet should include:

• Cereals: buckwheat, barley, oatmeal.
• Meat: beef, turkey, lamb, liver, pigeon meat.
• Dairy products: cheese, sour cream, cream, butter, cottage cheese.
• Fermented milk products: starter cultures, yoghurts, kefir, yogurt, ayran.
• Products rich in iodine, fiber and starch: seaweed, spinach, corn, feijoa, porcini mushrooms.
• Nuts and beans: beans, peas, pumpkin seeds, hazelnuts, almonds, pistachios, walnuts, cashews.
• Products that contain copper, zinc, iron, vitamin B12 and PP: squid, shrimp, oysters, eel.
• Fish rich in phosphorus, chromium, Omega-3 and Omega-6: pink salmon, mackerel, catfish, hake, tuna, flounder, salmon, capelin.
• Dried fruits and oils: prunes, raisins, dried apricots, dates, olive and corn oil.
• Foods rich in vitamin C: citrus fruits, currants, lentils, rose hips, broccoli, sweet peppers, dogwoods.
• In case of cervicitis, smoking, large portions of caffeine and alcoholic beverages are strictly contraindicated.

It is recommended to limit consumption:

• Kvass.
• Canned food.
• Fatty dishes.
• Sweet pastries.
• Yeast dough.
• Spicy and smoked dishes.
• Pickled products.

Complications of cervicitis

Chronic cervicitis can be asymptomatic for a long time and not cause any obvious dysfunction in the body.

Over time, the growth of the inflammatory process leads to differentiation and disruption in the epithelial cells of the endocervical canal and the vaginal part of the cervix.

As a result of changes in the mucosa, an erosive process and dysplasia develop. Compaction of the cervix and displacement of the mucous membrane disrupt the patency of the canal and lead to infertility, adnexitis and endometritis.

After suffering from cervicitis, the following appear in the uterine cavity and cervix:

• Polyps.
• Pseudo-erosions.
• Cervical inversion.
• Pathologies of the upper genital tract.

The main danger of late diagnosis of cervicitis is the development of erosion with subsequent development into cervical cancer.

Risk group for cervicitis

In most cases, cervicitis is diagnosed in women whose sexual activity began too early. The presence of several sexual partners and the lack of barrier protection also entails inflammatory processes in the cervix. A severe form of cervicitis can cause infertility in women of reproductive age.

As a result of hormonal changes during menopause, all women are at risk for diseases of the ovaries and cervix. Therefore, it is important to undergo regular diagnosis and, if necessary, take prescribed hormonal treatment.

Cervicitis during pregnancy

During pregnancy, cervicitis can cause infection of the fetus, miscarriage or premature birth.

In late pregnancy, the inflammatory process in the cervix spreads to the entire reproductive system and inhibits the development of the fetus.

For the treatment of cervicitis in pregnant women, the antibacterial Summamed, local antiseptics and immunomodulators are prescribed. As maintenance therapy when the symptoms of acute cervicitis subside, the vagina and cervix are treated with solutions of Dimexide and Chlorophyllipt. For infectious cervicitis, antiviral and antibacterial agents are prescribed to the woman and sexual partner.

Prevention of cervicitis

In 90% of cases, the etiology of cervicitis in women is sexually transmitted infection or gross violation of hygiene rules.

The most effective method of preventing infection is barrier contraceptives (condoms).

To prevent inflammatory processes in the cervix, it is necessary to undergo regular examination in a gynecologist's chair, take smears and conduct a cytological examination.

The impetus for the development of cervicitis is a decrease in immunity after an illness or seasonal exhaustion of the body. Taking vitamins, hardening and an active lifestyle will be the best prevention of the disease. For pathological prolapse of the genital organs, it is recommended to regularly perform exercises to strengthen the vaginal muscles (wumbuilding) and not wear compressive underwear.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

Source: https://illness.DocDoc.ru/cervicit

Cervicitis: causes, signs and symptoms, treatment of inflammation

Cervicitis is an inflammatory process, localized in the vaginal segment of the cervix.

Cervicitis, the symptoms of which are characterized by cloudy discharge, pain in the lower abdomen (pulling or dull), painful sexual intercourse and urination, in its protracted chronic form can lead to erosion.

In addition, such a course can provoke thickening (i.e. hypertrophy) or thinning of the cervix, as well as cause the spread of infection to the upper genital organs.

Online consultation on the disease “Cervicitis”.

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general description

The cervix itself acts as a barrier that prevents infection from entering the uterus, as well as the upper genital tract (in the form of protective secretion, mucus plug and cervical canal).

Exposure to certain factors provokes a disruption in its protective functions, which leads to the entry of foreign microflora into this area, thereby contributing to the development of the inflammatory process.

Cervicitis is precisely such a process, which also includes exocervicitis (inflammation of the exocervix, or vaginal segment in the uterus) and endocervicitis (inflammation of the endocervix, or inflammation in the area of ​​the inner lining belonging to the cervical canal of the cervix).

The vaginal part of the cervix: how the doctor sees it during examination

Cervicitis can appear as a result of exposure to a nonspecific infection, which occurs due to opportunistic microflora.

In particular, these include staphylococcus and streptococcus, E. coli and fungi. In addition, the disease also occurs due to exposure to specific viruses: chlamydia, gonococci, Trichomonas, etc.

d. The impact of protozoal infections and parasitic infections cannot be excluded.

The specified opportunistic microflora, which provokes cervicitis, appears in the uterus through contact through the lymph and blood, as well as through the rectum. As for specific viruses, they enter the uterus through sexual contact.

It should be noted that cervicitis can develop under the influence of certain factors, which include birth injuries affecting the cervix, diagnostic curettage and termination of pregnancy, as well as the use of contraceptives (in particular, we are talking about the installation and removal of the intrauterine device). Various types of cicatricial deformities, as well as formations in the cervix of the uterus of a benign type, are identified as factors provoking cervicitis. A decrease in immunity is also not excluded when considering the actual factors leading to the development of cervicitis.

Features of the development of cervicitis indicate that this disease extremely rarely occurs in isolation - mainly its “companions” are certain diseases relating to the reproductive system: vaginitis, vulvitis, pseudo-erosions or inversion of the cervix, bartholinitis.

As for the age category, the disease we are considering most often occurs among women of reproductive age (about 70% of morbidity cases); cervicitis occurs less frequently during menopause.

As a consequence of this disease, polyps are formed, as well as erosion in the cervix and inflammation in the upper genital tract. Cervicitis occurs in acute or chronic form, in addition to its other varieties, which we will also consider below.

Acute cervicitis

Acute cervicitis is, accordingly, an acute inflammation that occurs in the cervix. In this case, inflammation mainly affects only the endocervical glands, while in rare cases, damage to the squamous epithelium may also occur.

Some researchers are of the opinion that the nature of inflammation (that is, its persistence, area of ​​localization, route of spread) is directly determined based on the specific type of pathogen.

Gonococci, for example, infect exclusively epithelial cells belonging to the endocervical glands, and their spread occurs along the surface of the mucosa.

If we are talking about inflammation provoked by staphylococci or streptococci, then their localization is concentrated directly in the endocervical glands, affecting the stroma of the cervix. The lymph flow ensures that pathogens reach other organs in the pelvis, which, accordingly, leads to their infection.

Dwelling specifically on the symptoms, it should be noted that the first of them, at the initial stage of the disease, manifests itself in the form of discharge, and the nature of this discharge may be different. Meanwhile, most often it is noted that they contain an admixture of pus and at the same time their profuse nature, which is especially true in the case of the relevance of such a disease as gonorrhea.

Comparison of normal and diseased cervix

In addition, the acute course of the disease is often accompanied by a slight increase in temperature and dull pain in the lower abdomen. Often there are sensations of hot flashes concentrated in the pelvic organs.

In addition, patients often experience lower back pain, disorders associated with urination (polyuria or dysuria, an increase in the volume of urine excreted or a decrease in the volume of urine excreted, respectively) and pain that occurs in the external genitalia and pelvic organs during sexual intercourse.

When diagnosing acute cervicitis, in addition to a gynecological examination, microscopic examination of smears is used, as well as inoculation of cervical canal secretions directly onto a nutrient medium.

If we are talking about diagnosing gonorrheal cervicitis in an acute form, then, as a rule, it is done extremely rarely due to patients turning to a doctor only in those cases in which the inflammatory process passes to the uterine appendages.

Taking this into account, if there is pain in the adnexal region in the acute form of gonorrheal cervicitis, it is necessary to use a slightly different treatment than with ordinary acute cervicitis, because in this case the inflammatory process is quite specific.

Chronic cervicitis

Chronic cervicitis is formed when the genital organs are affected by various bacteria, as well as when they are affected by fungi and viruses.

The onset of the infectious process in this case can occur with prolapse of the cervix or vagina, as well as with improper use of hormonal and contraceptive drugs.

In addition, concomitant factors in the development of chronic cervicitis are promiscuous sex life, poor hygiene and inflammatory diseases in the pelvic organs.

Redness of the uterine mucosa and swelling are also noted. The acute form of manifestation of the chronic form of pathology manifests itself, accordingly, in greater severity of symptoms.

Again, there is a dull pain that occurs in the lower abdomen, itching, pain and burning during urination, bleeding that occurs after sexual intercourse.

The disease is more than serious for a woman, because untimely treatment leads to thickening of the walls of the cervix with subsequent hypertrophy, which contributes to the formation of another type of pathology. Due to this, the risk of possible cancer, infertility and dysplasia in the genital area in question also increases.

To make a diagnosis, the uterus is examined using a colposcope and speculum. Blood and urine are tested for sexually transmitted infections. An ultrasound is also performed with subsequent examination of the condition of the pelvic organs.

Purulent cervicitis

Purulent mucous cervicitis involves the presence of an inflammatory process in the area of ​​the cylindrical layer of epithelial cells, as well as the relevance of subepithelial damage to the cervical area.

In addition, damage may also occur in all simultaneously areas of the columnar epithelium, which is ectopically concentrated on the outside of the cervix (that is, there is an unnatural displacement of the epithelium).

What is noteworthy is that if a woman has purulent cervicitis, it can almost certainly be said that her partner has urethritis, which is caused by a similar type of pathogen, but is difficult to diagnose.

In the presence of symptoms of purulent cervicitis among expectant mothers, the risk of disruption of the normal course of the entire pregnancy, as well as subsequent childbirth, increases significantly.

As a rule, the cause of the formation of pathology is gonococci or trachoma bacillus. Unofficial statistics indicate that one out of three cases is due to the occurrence of the disease due to exposure to ureaplasma. The symptoms in this case are similar to diseases caused by the herpes virus and Trichomonas. In general, purulent cervicitis forms against the background of gonorrhea.

Viral cervicitis

Viral cervicitis with its characteristic inflammatory process occurs when the infection is transmitted through sexual contact. The localization of the inflammatory infectious process determines such forms of the disease as exocervicitis and endocervicitis, with damage to the external tissues of the cervix and damage to its internal part, respectively.

The generally accepted classification defines the division of the inflammatory process into a specific form of its course and a nonspecific one. The specific form is a concomitant manifestation of viral cervicitis; accordingly, we are talking about a viral etiology with actual transmission of the virus through sexual contact (genital herpes, HPV).

As a rule, women of childbearing age are affected.

The main symptoms include pain in the lower abdomen, general discomfort and severe itching that occurs on the outside of the genitals.

In addition, there is a discharge with impurities in the form of pus or mucus. In the acute stage of viral cervicitis, the discharge is characterized by abundance, in the chronic stage - by scarcity.

Bacterial cervicitis

Bacterial cervicitis is also quite common when patients visit a gynecologist. The disease is infectious, and its localization is concentrated in the cervical canal or in the vagina in the area bordering the cervix. Accompanying its course is a disturbance of the vaginal microflora; there is no strong inflammatory reaction.

Cervicitis occurs exogenously, and its development occurs against the background of mucous membranes affected by viruses such as herpes, papillomavirus, trichomoniasis or syphilis, but in this case there is no connection with sexually transmitted infections themselves.

In addition to the listed causes of bacterial cervicitis, genitourinary tuberculosis is also isolated. Bacterial vaginosis is the most common cause for the formation of nonspecific chronic cervicitis.

The most common symptoms of this form of the disease are dysuria (i.e.

urination disorders), dull nagging pain that occurs in the lower abdomen, as well as painful sensations accompanying sexual intercourse.

In addition, patients experience vaginal discharge of varying consistency while simultaneously being abundant or, conversely, scarce. The presence of impurities in the form of mucus or pus is also noted.

Atrophic cervicitis

Atrophic cervicitis has a number of features, but its development proceeds in accordance with the general principles relevant for cervicitis. The reasons that provoke the occurrence of this form of cervicitis can be various types of diseases that form in the genitourinary system (cervical erosion, cystitis, endometritis, inflammation of the appendages).

In addition, the development of the atrophic form of cervicitis is also possible during unprotected sexual contact, in particular when pathogens of one or another type of sexually transmitted disease enter the body. Infectious agents include gonorrhea, trichomoniasis, chlamydia, mycoplasmosis, and viral diseases.

In addition, nonspecific infections (staphylococci, streptococci) are also isolated.

The development of atrophic cervicitis also occurs in the area of ​​the damaged area. The cause of injury in this case may be curettage, abortion, or rupture of the uterus during labor.

As a rule, this form of the disease becomes the result of a chronic course of cervicitis.

Cystic cervicitis

In this case, the cause of the disease is a combination of infections (chlamydia, gonococci, streptococci, fungi, staphylococci, gardnerella, trichomonas, etc.), which leads to the proliferation of columnar epithelium along the surface of the uterus. This, in turn, leads to a gradual and continuous overgrowth with cysts. Often cysts are combined with manifestations in the form of erosions.

Diagnosis of cervicitis

Quite often, as we have already noted, cervicitis occurs without any symptoms, which, accordingly, leads to untimely contact with a specialist. As a rule, the disease is discovered accidentally during a routine medical examination or when visiting a doctor with suspicion of another disease.

Diagnosis of cervicitis is based on data such as:

• examination of the cervix using mirrors;
• upon receipt of colposcopy results, which make it possible to detail pathological changes in the epithelium in the case of actual cervicitis;
• based on the results of laboratory tests (smear microscopy, microflora culture, PCR).

Treatment of cervicitis

In modern conditions, gynecology has many different methodological options that make it possible to treat cervicitis. Meanwhile, the first thing that needs to be done in this treatment is to eliminate the factors predisposing to the development of the disease in question.

In the treatment of cervicitis, antiviral, antibacterial and other agents are used, which is determined based on the specifically identified pathogen and its characteristic sensitivity to the selected drug. The stage at which the inflammatory process occurs is also taken into account. Local combination medications, as well as creams and suppositories, are widely used in the treatment of cervicitis.

Specific infections require parallel treatment of the partner.

The chronic stage of the disease is characterized by less success of conservative treatment, which, accordingly, determines the need for the use of surgical methods (cryotherapy, diathermocoagulation, laser therapy) for preliminary disposal of infections.

If you suspect cervicitis, as well as the presence of symptoms corresponding to this disease in one form or another, you should consult a gynecologist. Additionally, you may also need to be examined by a urologist.

Source: https://SimptoMer.ru/bolezni/zhenskie-zabolevaniya/81-tservitsit-simptomy

Cervicitis

Cervicitis is a pathological inflammatory process that affects the mucous membrane of the cervix.

Rarely develops as an independent disease. As a rule, it is a consequence of vulvitis and other inflammatory processes in the reproductive system. Most often diagnosed in patients of reproductive age. The lack of therapeutic effects leads to the development of erosive lesions of the uterine mucosa and spontaneous termination of pregnancy in its early stages.  

What causes cervicitis 

The causes of cervicitis are an inflammatory process caused by pathogenic microflora (staphylococcus, viruses, escherichiosis, mycoplasma, bacteria, STIs).

Main risk factors

The risk of developing cervicitis is increased by the following factors: injury to the pelvic organs during labor, curettage during diagnosis or abortion, taking COCs (long period), development of scar tissue on the surface of the mucosa, neoplasms of various etiologies, disruption of the immune system. 

Symptoms and clinical picture of cervicitis  

The clinical picture of the pathology is characterized by various manifestations and depends on the root cause, the main pathogen, and the general condition of the patient. 

Symptoms of cervicitis:

• itching, burning in the vagina;
• pain syndrome in the pelvis;
• pain when urinating;
• discomfort during sexual intercourse;
• discharge mixed with blood or pus;
• spotting, bloody discharge in the middle of the menstrual cycle;
• slight increase in body temperature. 
• Diagnosis of cervicitis 

Diagnosis of cervicitis includes identifying the root cause of the pathology, identifying the main pathogen and provoking factors.

Methods for diagnosing cervicitis 

To make an accurate diagnosis, a comprehensive examination is carried out. Appointed:  

• bacterioscopy;
• PCR analysis;
• cytological examination;
• Ultrasound of the genitourinary system;
• colposcopy;
• detailed urine analysis;
• biopsy of the focal area (for chronic cervicitis). 

Which doctor treats cervicitis?

Treatment of cervicitis is carried out under the supervision of a gynecologist, endocrinologist, and surgeon. 

Treatment regimen for cervicitis 

The doctor decides how to treat cervicitis after receiving the results of a full examination. The treatment regimen solves the problem of eliminating the root cause of the pathology and factors that aggravate the course of the disease.  

Basic treatment methods and contraindications 

• How to treat cervicitis is determined by its etiology. 
• For cervicitis caused by an STD, antibiotics are prescribed: tetracyclines (Acromycin, Monomycin, Cyclomycin); macrolides (Macropen, Klacid); fluoroquinolones (Ofloxacin, Tarivid); azalides (Sumamed, Azithromycin).
• For cervicitis of fungal etiology, antifungal drugs (Fluzon, Diflucan) are used.
• Local treatment is also carried out: treatment of the vagina with a weak solution of Dimexide (prescribed after stopping the acute process), estrogen-based drugs (for atrophic forms of the pathology). 
• Contraindications to the use of tetracycline antibiotics: fungal diseases, renal failure, neutropenia, pregnancy. 

Possible complications 

During treatment or in its absence, the following complications may develop:

• transition of pathology to a chronic form;
• transition of the inflammatory process to nearby organs;
• inflammation of the Bartholin glands;
• venereal perihepatitis;
• transition of the disease to an atypical form. 

Chronic cervicitis 

Diagnosed in the presence of a chronic inflammatory process localized on the mucous membrane of the cervix. Signs of cervicitis in chronic form are mild; the first symptoms appear when inflammation worsens.

The main provoking factors and causes: incorrect use of various types of contraception, their illiterate combination; vaginal douching using acid solutions; sexually transmitted diseases; hormonal imbalances; chronic forms of urethritis, cystitis, colpitis; injury to the uterus during abortion or childbirth.  

Treatment of the chronic form of cervicitis involves the use of radical methods (laser exposure, cryodestruction) while simultaneously eliminating the underlying cause. 

Measures to prevent cervicitis  

Prevention measures include:

• examination by a gynecologist every six months;
• exclusion of artificial termination of pregnancy;
• high-quality treatment of infectious and inflammatory processes;
• control of sex hormone levels;
• having a permanent sexual partner. 

Source: https://meds.ru/illness/tservitsit