Endocervicitis (cervicitis) is the term used to describe inflammation of the mucosal lining of the cervix.
The cervix is the lower, neck-like portion of the uterus that opens into the vagina. The endocervix is the cervical canal that leads into the uterus from the vagina. The mucous membranes of the cervix produce mucous and serous secretions that protect and lubricate the cervix. As progesterone levels increase at mid-cycle, cervical secretions become thinner to allow entry of sperm. At other times mucous is thicker to prevent microorganisms from gaining entry and causing infection, and perhaps to prevent the entry of sperm at times other than ovulation.
Cervical function:
- allow passage of menstrual blood from the uterus to the vagina,
- direct sperm into the uterus during intercourse,
- serve as a portal for delivery of the fetus.
Cervicitis may be caused by infection or as a result of cervical irritation resulting from frequent douching, exposure to chemical irritants, or other unknown factors.
The two most common infectious causes of cervicitis are C. trachomatis and N. gonorrhoeae, although other sexually transmitted organisms have also been implicated – Trichomonas vaginalis and genital herpes. Infection with Mycoplasma genitalium and bacterial vaginosis have also been implicated as causes of cervicitis. However, in the majority of cases of cervicitis, organisms are not isolated.
Cervicitis is characterized by one or both of the following:
- purulent or mucopurulent exudates from the endocervix,
- bleeding occurring when a cotton swab is passed through the cervical opening.
Symptoms, when present, include abnormal vaginal discharge and vaginal bleeding that occurs between menstrual cycles: bleeding may be noted after sexual intercourse due to irritation of the cervix. However, cervicitis is often asymptomatic.
Additional symptoms associated with sexually transmitted infection may also be present:
- unusual sore in the genital area,
- discharge with foul odor,
- burning during urination,
- pain during or following sexual intercourse.
Infectious cervicitis, especially cases involving chlamydia or gonorrhea is often associated with the presence of increased numbers of polymorphonuclear white blood cells (leukocytes) on microscopic examination of vaginal fluids or samples collected by swab from the cervix.
Although the presence of polymorphs (polymorphonuclear leukocytes) is often used as an indicator of chlamydia and gonorrhea infections, it is an unreliable indicator of infection. Samples should be obtained to test for testing for chlamydia, gonorrhea, trichomonas, bacterial vaginosis, and other sexually transmitted infections, as appropriate.
Cervicitis may be a sign of upper genital tract infection, most commonly endometritis involving the uterus, and/or salpingitis involving the fallopian tubes. Women who have symptoms of cervicitis should seek medical attention and abstain from sexual activity until testing for sexually transmitted infections is completed. If sexually transmitted infection is detected, appropriate antibiotic treatment should be obtained, and sexual partners should also be treated.
Read more articles on sexually transmitted infection:
Sexually Transmitted Infection: STI and STD
PID: Risk Factors and Prevention
