Cervical ectropion is a condition where the lining of the cervix protrudes into the vagina, often caused by hormonal changes. It is usually not serious, but can cause pain and discharge. Treatment options include hormone therapy, cryotherapy, and diathermy. It is important to screen for cervical cancer as symptoms can be similar.
A cervical ectropion, also sometimes called cervical erosion, is a medical condition in which the lining of a woman’s cervix protrudes into her vagina. Most of the time this isn’t apparent from the outside, but it’s usually easy enough for a doctor to diagnose during an exam. It can happen for a variety of reasons, but hormonal changes associated with puberty, pregnancy, and menopause are the most common; hormone-based oral birth control pills are also to blame in many cases. In most cases, the condition is not serious and no treatment may be needed. In rare cases, however, ectropion can cause pain, particularly during sexual intercourse, and can also contribute to foul-smelling discharge. Symptoms can often be relieved with medication or, in severe cases, surgery to remove the protruding tissue.
Basics of cervical cells
The cervix is the lower, narrower part similar to the neck of the uterus and forms a tube from the base of the uterus that opens into the vagina. A concentration of specialized cells called epithelial cells form epithelial tissue here, which creates part of the lining of the cervix; these cells help the tissues stretch and flex as needed for proper reproductive function. The formal name for the cervical lining is ‘central columnar epithelium’ and in rare cases this will actually start to detach from the cervix and slide into the vaginal cavity.
Subsequent erosion often creates a red, rough appearance near the top of the vaginal opening that healthcare professionals can see when performing an exam. In most cases the color is the natural color and texture of the epithelium and often looks much more alarming than it actually is. Tissue protrusions like this are usually quite problematic from a medical point of view, but the original color and appearance can make it look like a crisis when, in most cases, it will resolve itself with time.
Because it happens
Cervical ectropion is relatively common and usually develops during pregnancy, puberty, or when taking birth control pills. The cervix tends to widen due to the hormonal shifts that result from these events, and these fluctuations can cause the columnar epithelium to protrude from the cervical canal. Erosion can also be caused by congenital factors, infections or chemicals. Chemical exposure is more common in women who use douches or sperm contraceptives. Vaginal trauma from sexual intercourse or the insertion of a tampon or foreign object could also be a cause.
Primary symptoms
Many women experience no symptoms at all, but among those who experience pain during sex, thick, foul-smelling vaginal discharge is among the most common. Some people also report hard stools and mild constipation, although much depends on individual anatomy and the proximity of the intestines and reproductive organs. Bleeding after sex is also quite common. Protruding tissue can irritate the vaginal walls, and this, coupled with the friction of intercourse, can often lead to light bleeding as blood vessels burst.
Treatment
The condition does not usually require treatment and in most cases will gradually go away on its own. If things don’t improve after a few weeks, or if a woman is experiencing significant pain or lifestyle issues, there are usually a few options.
Hormone therapy or stopping oral contraceptives is often the first step. Cryotherapy, which freezes the area, and diathermy, which is cauterizing, may also be used. Cryotherapy and diathermy are usually painless and can be done as an outpatient procedure, although they are more or less permanent and are often considered surgical. However, even the most aggressive treatments aren’t always foolproof. The cellular tissues of the columnar epithelium can always regrow and stretch again, and women who take oral contraceptives tend to be more likely to recur.
Intersection with cervical cancer
Cervical ectropion is a non-cancerous condition in and of itself, but a cancer screen is usually performed on a woman who has this problem because many of the symptoms are the same. In fact, cervical cancer often looks almost like ectropia in its early stages. One of the only ways healthcare professionals can definitively tell whether the erosion is due to a problem with the cell lining or a cancerous growth elsewhere in the cervix is to take a sample and test it.
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