Cervical erosion: what's behind it and how it's treated

A cervical sore ‒ known medically as cervicitis ‒ is an inflammation presenting as lesions on the cervix. It often goes unnoticed, as your body has very few pain receptors in the cervix. So there's every chance you'll have no idea at all that anything is amiss down there.

Your doctor's diagnosis may come as a complete surprise during a routine check-up, even if you have no other symptoms. And we're here to help you prepare for that. Read on to find out exactly what a cervical sore is, what causes it, how it presents and how it's treated.

 What is a cervical sore (cervicitis)?

Cervicitis, colloquially known as a cervical sore, is an inflammation of the cervix uteri. It may go unnoticed until a gynaecological examination, as symptoms such as pain or discomfort are often absent.

Depending on the cause of the inflammation and how it progresses, there are two forms of cervicitis:

• Acute cervicitis: when it's caused by an infection, the symptoms appear suddenly and are pronounced.
• Chronic cervicitis: when it's caused by irritation and the symptoms persist for several months or longer.

Your gynaecologist will spot it during a clinical examination in the form of small lesions, swollen or reddened areas on the cervix, with or without bleeding.

Cervical sore – causes

An inflamed cervix is usually the result of a sexually transmitted infection, but it can also have non-infectious causes. Whatever the cause, it needs to be correctly identified so that the right treatment can be chosen.

Here are the possible causes of a cervical sore:

• Bacterial vaginosis
• Bacteria that come into contact with the uterus: bacteria capable of triggering cervicitis include staphylococci (Staphylococcus) and streptococci (Streptococcus).
• Sexually transmitted infections: chlamydia (studies estimate that chlamydia infection is the cause of cervicitis in 40% of cases), gonorrhoea, genital herpes, trichomoniasis, infection with Mycoplasma genitalium or an HPV infection, which we've told you more about HERE.
• Chemical substances in certain menstrual products: such as synthetic fibres, fragrances or other hidden ingredients in conventional pads and tampons, which can irritate the cervix. You can easily avoid this by choosing pads and tampons made from 100% organic cotton with a neutral pH and hypoallergenic properties – like those from Enroush, which are made without any ingredient that could harm your intimate health.
• Irritation caused by inserting certain objects into the vagina: vaginal pessary, diaphragm, cervical cap, etc.
• Other allergic reactions: to spermicides, vaginal douches or the latex in condoms, for example.
• Radiotherapy.
• Systemic inflammatory conditions (autoimmune diseases).

Risk factors for a cervical sore

Since the cause of cervicitis can also be non-infectious – an allergic reaction, for instance – the risk factors also include vaginal douching, conventional tampons and the diaphragm. As a rule, however, a cervical sore is sexually transmitted or develops as a result of a sexually transmitted infection. The main risk factors for an inflamed cervix are therefore:

• Becoming sexually active at an early age.
• Risky sexual behaviour: unprotected intercourse or frequently changing partners, for example.

Medical history of sexually transmitted diseases: if you or your partner have had a sexually transmitted infection in the past, your susceptibility to a cervical sore increases. If you'd like to learn more about this topic, we've prepared a dedicated article on the Enroush blog with everything you need to know about sexually transmitted diseases.

Cervical sore – symptoms

The only way to know for certain whether you have cervicitis is through a clinical examination. Sometimes the inflammation is entirely symptom-free, because there are so few pain receptors in that area.

There are, however, a few symptoms that may raise the suspicion of a cervical sore. So do take note if you experience any of the following:

• Light, unusual vaginal bleeding
• Persistent vaginal discharge that is grey, yellow or white in colour, which may be accompanied by a distinctive, unpleasant odour (if you want to keep an eye on your vaginal discharge – while protecting your underwear at the same time – we recommend Enroush panty liners. They contain no fragrances, so they won't affect your vaginal pH, and you'll be able to tell whether the discharge has an unpleasant smell. They're hypoallergenic and made with no ingredients other than 100% organic cotton, to give you safe, reliable protection.)
• Purulent vaginal discharge
• Pain in the vagina
• Pain during intercourse (pain during sex isn't normal. You should see a doctor as soon as possible to establish the cause – whether cervicitis or something else. In another blog article we've told you more about the possible causes of painful sex and what you can do about it.)
• Bleeding outside your period or after intercourse
• A feeling of pressure in the pelvis
• Back pain
• Irritation in the area of the vulva or vagina
• Pain when passing urine or needing to urinate more frequently.

Complications of a cervical sore

If a cervical sore is left untreated, it can lead to various complications affecting your intimate and reproductive health. Your cervix acts as a barrier, preventing bacteria and viruses from reaching the uterus. When the cervix becomes infected, it can no longer perform this function, which allows the infection to spread further towards the uterus. In practical terms, this means:

• Gonorrhoea and chlamydia (where these are the cause of the cervicitis) can reach the uterine lining and the fallopian tubes and trigger pelvic inflammatory disease.
• Untreated pelvic inflammatory disease can result in infertility or peritonitis (inflammation of the abdominal lining).
• There's an increased risk of catching further sexually transmitted infections from your partner (HIV, for example).
• There's an increased risk of passing the infection on to your partner.
• The risk of cervical cancer may increase.

Cervical sore (cervicitis) – diagnosis

As it only becomes visible during a physical examination, a cervical sore can only be diagnosed by a gynaecologist. To make the diagnosis as accurate as possible, the following examinations may be carried out:

• Gynaecological examination: to identify swollen, reddened or inflamed areas on both the cervix and the vaginal walls
• Examination of vaginal secretions: to establish whether there's a sexually transmitted infection (gonorrhoea, chlamydia, trichomoniasis) or bacterial vaginitis
• Pap test (cervical smear)
• Urine test

Your doctor may also ask questions about your medical history, so that other past or current health problems can be taken into account in the diagnosis. Below, we explain in more detail how each of these examination methods works.

 The bimanual examination

This is precisely the gynaecological examination we mentioned earlier. Wearing gloves, the gynaecologist inserts a finger into the vagina with one hand while applying gentle pressure to the abdomen and pelvis with the other, to determine whether palpation causes any pain.

Also as part of the gynaecological examination, a speculum may be used to check the vaginal walls above, below and to the sides, as well as the appearance of the cervix. This makes it possible to identify any inflamed areas or areas affected by redness, swelling or bleeding.

The Pap test

The Pap test is the key screening examination for the early detection of cervical or bowel cancer, which is why it's recommended at regular intervals. We've told you more about it in a dedicated blog article, where you'll find everything you need to know about the Pap test and why it's so important for your health.

During this examination, the doctor takes a sample of cells from the cervix and the vagina; the laboratory results then show whether there are any abnormalities.

The cervical biopsy

A cervical biopsy, or colposcopy, is only carried out if the Pap test results show an abnormality and further investigation is needed. The doctor inserts a speculum into the vagina in order to examine the cervix with a colposcope (a type of microscope). This allows additional samples to be taken precisely from the areas of the cervix that appear abnormal.

Culture of cervical secretions

Once collected, the cervical secretions are examined under the microscope. This makes it possible to identify the infections that have caused the cervical sore – from bacterial vaginosis and Candida infections through to sexually transmitted infections.

 Treating a cervical sore

Treatment for cervicitis depends on the cause, and healing can take up to two weeks (which is exactly why we told you at the outset how important it is to know the cause of the cervical sore in order to heal it). Medical recommendations are generally as follows:

• If the cervical sore is an allergic reaction to hygiene products or spermicides, no treatment is usually prescribed. The irritation clears up on its own once contact with the allergens ends (for example, if you stop using spermicides or switch to pads made from 100% organic cotton).
• If the cervicitis is the result of a sexually transmitted disease, it's recommended that you abstain from intercourse for the entire duration of treatment and that both partners are treated.
• In most cases of infection, antibiotics are prescribed, whether the infection is bacterial (bacterial vaginosis) or sexually transmitted (gonorrhoea, chlamydia, etc.).
• If the inflammation is caused by genital herpes, antiviral medication may be prescribed, which only reduces how often symptoms occur (as genital herpes cannot be cured).
• Once treatment is complete, it's recommended that the cervicitis tests be repeated.

Before we wrap up, a word about natural remedies: even if they appear to work, there's no guarantee that they genuinely help. They aren't based on a diagnosis or on a doctor's expertise – which means they may do you more harm than good if you misidentify the cause or the remedy isn't suitable.

We'd always recommend following the treatment prescribed after your examinations, which takes your history and medical situation into account – that way you'll recover more quickly and may avoid complications. And if you really do want to try a natural remedy, seek your doctor's advice and supervision beforehand, just to be on the safe side.