What causes a friable cervix?

By Soccy Ponsford 

Reviewed by Holly Ernst, PA-C

A friable cervix occurs when a person's cervix, which is the opening between the vagina and uterus, becomes more sensitive than usual.

The term "friable" refers to tissue that is easily irritated, which makes it more prone to inflammation, bleeding, or tearing. A person with a friable cervix may notice pain or bleeding after intercourse.

There are several reasons why a person may have an overly sensitive cervix, including sexually transmitted infections (STIs) or physical irritation. The treatment will depend on the cause.

In this article, we explore the symptoms, causes, diagnosis, treatment, and outlook for a friable cervix.

Symptoms

The symptoms of a friable cervix may vary depending on its cause. Common symptoms that indicate a person has a friable cervix include:

• bleeding between periods or after intercourse
• pain or discomfort during sex
• unusual vaginal discharge
• irritation that is felt inside the vagina

In some cases, a person may have a friable cervix without having any symptoms, which means it can go undetected.

If a person notices the symptoms of a friable cervix, they should speak with their doctor to rule out other causes that have similar symptoms, such as pregnancy, infection, or growths in the uterus or cervix.

Causes

There are several factors that can cause an overly sensitive cervix. These include:

Cervicitis

Cervicitis is the name given to any inflammation of the cervix. It can be caused by various kinds of infection, including:

• Sexually transmitted infections (STIs). STIs can cause irritation and inflammation in the cervix. STIs include chlamydia, gonorrhea, trichomoniasis, and genital herpes.
• Bacterial vaginosis. Bacterial vaginosis is a condition that occurs when there is an imbalance in the bacteria of the vagina. It can affect the cervix.

Physical irritation

A friable cervix can also be caused by physical irritation or an allergic reaction. For instance, an adverse reaction in the cervix can be caused by spermicides, latex condoms, or female contraceptives devices such as diaphragms and pessaries.

Pregnancy

Pregnancy hormones can cause the cervix to become more sensitive than usual. This is because of the increased blood supply in the tissues surrounding the cervix.

This increased sensitivity means that any irritation to the cervix, such as intercourse or an internal examination, can result in spotting or bleeding.

A friable or sensitive cervix on its own is not a risk to pregnancy. However, a woman should consult her doctor immediately if any bleeding occurs during pregnancy.

Cervical polyps

Cervical polyps are small growths that develop on the cervix. Most are benign but could cause bleeding after intercourse or between periods.

Cervical ectropion

Cervical ectropion occurs when the thin layer of glandular cells that are normally found inside the cervical canal extend to the outside of the cervix. This is a benign condition.

Symptoms include vaginal discharge and bleeding after intercourse. They normally do not need to be treated.

Cervical intraepithelial neoplasia (CIN)

This condition occurs when cells in the cervix undergo abnormal changes over time and could potentially turn cancerous if not treated.

Cervical cancer

Cervical cancer is a type of cancer that affects the cells of the cervix. In its early stages, cancer of the cervix often has no visible symptoms.

If there are signs, the most common one is vaginal bleeding, which a person may notice after intercourse or between periods.

Most cases of cervical cancer are caused by the human papilloma virus (HPV), a virus that can be passed on through sexual contact.

Treatment

The treatments for conditions that cause a friable cervix can vary depending on the underlying causes.

Cervicitis can be treated once the cause of the infection, usually an STI, is identified. If left untreated, cervicitis can cause pelvic inflammatory disease (PID), which can, in turn, cause fertility problems.

STIs such as chlamydia, gonorrhea, and trichomoniasis can be treated with antibiotics.

While there is no cure for viral infections such as herpes and HPV, there are treatments that can ease its symptoms.

Doctors can remove cervical polyps with an instrument called polyp forceps. They can also remove CIN tissue using a small, electrically charged wire loop called LEEP.

Cervical ectropion usually clears up on its own without need for treatment. But if it causes problems, a doctor can cauterize or burn it off.

Treatment for cervical cancer will depend on how far the cancer has spread. They would include:

• removal of abnormal cells using cone biopsy or laser therapy
• surgery
• radiotherapy
• chemotherapy

Some studies suggest that drinking green tea and eating yogurt or taking probiotic supplements can ease gynecological disorders. However, these should only be used to supplement and not replace medical treatments.

Diagnosis

There are several ways to diagnose conditions that cause a friable cervix:

• STI tests. These tests normally require a swab from the infected area or a urine sample.
• A pap test. A pap test, also called a smear test, involves gathering cells from the surface of the cervix to detect abnormal cells or identify the HPV types that could lead to cancer.
• A biopsy. A biopsy involves removing a small sample of tissue from the cervix and testing it for abnormal or precancerous cells, or cervical cancer.
• Colposcopy. A colposcopy is an examination of the cervix using a magnifying device called a colposcope.

Prevention

There are several ways to reduce the risk of developing conditions that cause a friable cervix in the first place. These include:

• Having a HPV shot. This vaccination protects against infection by the HPV strains that cause cervical cancer, other genital cancers, and most genital warts. The vaccines may be given to from the age of 11 up to 45 years.
• Attending regular cervical screenings. Also called pap smears, cervical screenings are the best way to detect abnormal changes in cervical cells at an early stage.
• Using barrier protection during sex. The use of condoms during intercourse to lower the chances of developing an STD.
• Having regular STI tests. These tests are recommended for people who are sexually active, especially since many symptoms are not immediately visible.
• Avoiding smoking. People who smoke are less likely to get rid of the HPV infection, which can progress and develop into cancer.

Outlook

It is possible for a friable cervix to clear up on its own. Many of the conditions that cause its symptoms can be treated easily, especially if detected early.

However, if left untreated, some infections, such as chlamydia, can result in infertility or pelvic inflammatory disease (PID). An HPV infection can lead to cervical cancer if not treated early.

If a person experiences the symptoms of a friable cervix, they should visit their doctor for an accurate diagnosis and treatment.

SOURCE: MEDICAL NEWS TODAY