Cervical ectropion: What you need to know

By Lana Burgess

Reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Cervical ectropion is a condition where cells from inside the cervix form a red, inflamed patch on the outside the cervix. What causes cervical ectropion, and does it require treatment?

Also known as cervical erosion, cervical ectropion is not usually a health concern. However, because of the way it looks, it can be hard to distinguish from the early stages of cervical cancer. For this reason, it is essential to understand the difference between the two conditions.

This article explores the causes, symptoms, and treatments for cervical ectropion. It also considers how it differs from cervical cancer and chlamydia.

What is cervical ectropion?

Cervical ectropion is a condition that affects cells in the cervix.

A woman's cervix has different sorts of cells on the outside (vaginal portion) than it does on the inside (the cervical canal).

The soft cells on the inside of the cervix are known as glandular cells, but the medical term for them is columnar epithelium. The hard cells on the outside of the cervix are known as squamous epithelial cells.

Most women only have glandular cells on the inside of their cervix. Cervical ectropion is when the glandular cells appear on the outside of the cervix.

The area on the outside of the cervix where glandular cells come into contact with squamous epithelial cells is called the transformation zone or the stratified squamous epithelium.

Symptoms

The primary symptom of cervical ectropion is a red, inflamed patch at the neck of the cervix — the transformation zone.

The transformation zone looks red and inflamed because the glandular cells are red, delicate, and easily irritated.

Other symptoms a woman may experience include:

• pain during sex
• bleeding during or after sex
• light discharge of mucus
• spotting between periods

Some women will only have mild symptoms, while others experience more severe discomfort.

It is important to note that cervical ectropion is not the only cause of symptoms such as these. If a woman has any of the above symptoms, it is a good idea to speak with a doctor to rule out more serious causes.

Causes

two packs of birth control pills

Cervical ectropion may be caused by taking the contraceptive pill.

Some women are born with cervical ectropion. It may also be caused by:

• Hormonal changes: Cervical ectropion may be caused by fluctuations in hormone levels and is most common in women who are of reproductive age. Women who have gone through menopause rarely get cervical ectropion.
• Taking the contraceptive pill: Taking birth control pills affects a person's hormone levels and may cause cervical ectropion.
• Pregnancy: Being pregnant may also cause cervical ectropion due to the changes in hormone levels.

The symptoms of cervical ectropion are caused by the delicate glandular cells that appear on the outside of the cervix. They produce mucus and bleed easily, which may lead to spotting and pain during or after sexual activity.

Other conditions of the cervix

Women may worry that cervical ectropion may be related to other conditions that affect the cervix. These include:

Cervical cancer

The red, inflamed appearance of the cervix in women who have cervical ectropion may look similar to early signs of cervical cancer. However, the two conditions are not related.

Cervical ectropion is not caused by cancer and is not an early symptom of cervical cancer.

If a woman is spotting or experiencing cervical pain and is unsure that cervical ectropion is the cause, a doctor can do a pelvic examination or recommend a Pap test.

Chlamydia

Having cervical ectropion does not mean a woman has chlamydia. However, a 2009 study found that women under 30 with cervical ectropion had a higher rate of chlamydial infection than those who did not.

It is a good idea for women to be tested regularly for sexually transmitted infections (STIs), particularly chlamydia and gonorrhea, which may not have any apparent symptoms.

Diagnosis

Most people with cervical ectropion are not aware they have it. It is usually diagnosed when a doctor carries out a routine pelvic examination.

Cervical ectropion and cervical cancer are not related. However, the cervix of a woman with cervical ectropion may look similar to that of a woman with early-stage cervical cancer.

For this reason, the doctor will need to rule out cervical cancer if a woman's cervix looks redder or more inflamed than usual. They may carry out the following tests:

• Pap test: Also known as a Pap smear, this involves a healthcare professional scraping a small sample of cells from the cervix to test for human papillomavirus (HPV) and cancerous or precancerous cell changes.
• Colposcopy: This is when a healthcare professional examines the cervix more closely with bright lighting and a magnifying instrument.
• Biopsy: This is when a small tissue sample is taken and tested for cancerous cells. A woman may experience cramping during the procedure.

Treatment

Cervical ectropion is not a harmful condition and does not usually require treatment.

In this 2008 review, researchers noted that there is no data to support routine treatment for cervical ectropion. However, doctors may recommend it if symptoms are bothersome.

If a woman is experiencing symptoms, such as pain or bleeding, a doctor may recommend cauterization. This is a painless method of removing the glandular cells on the outside of the cervix.

While cauterization usually resolves the symptoms of cervical ectropion, a doctor may need to repeat the procedure if the symptoms return.

There are three different versions of cauterization therapy:

• Diathermy: This uses heat to cauterize the affected area.
• Cryotherapy: This uses very cold carbon dioxide to freeze the affected area. A 2016 study found this to be an effective treatment for women with cervical ectropion who were experiencing a lot of discharge.
• Silver nitrate: This is another way to cauterize the glandular cells.

After the treatment, the doctor may recommend that a woman avoids some sexual activity and using tampons for up to 4 weeks. After this time, her cervix should have healed.

If a woman experiences any of the following after the treatment, she should go back to the doctor:

• discharge that smells bad
• heavy bleeding (more than a average period)
• ongoing bleeding

These symptoms may indicate an infection or another underlying condition, so a woman should not ignore them.

Outlook

Cervical ectropion is not a harmful condition and does not usually have any medical complications. It is not related to cancer and is not harmful to the baby or the woman if she is pregnant.

The condition typically resolves itself on its own, and many women may not even know they have it. If symptoms are bothersome, cauterization is usually an effective treatment.

If a woman has any concerns about cervical pain, bleeding during or after sex, or unusual discharge, it is a good idea to talk to a doctor.

SOURCE: MEDICAL NEWS TODAY