Cervicitis of moderate activity. Cervicitis is an inflammatory process of the cervix. Are there risk groups?

Most women experience inflammatory diseases of the genital organs. The structural features of the female reproductive system are such that the infection quickly spreads from the vagina to the internal genital organs. Cervicitis develops into inflammation of the endometrium and ovaries. Often the consequences are pregnancy complications or even infertility. Chronic inflammation causes precancerous disease. It is important to strengthen your immune system, use contraception wisely, and be regularly examined by a doctor to protect yourself from such dangers.

The epithelium of the cervical canal (endocervix), connecting the uterine cavity with the vagina, differs in structure from the epithelium lining the part of the cervix that is located directly in the vagina (exocervix). Depending on which part of the cervix the inflammation occurs in, endocervicitis and exocervicitis are distinguished, respectively.

The age of women who are diagnosed with cervical cervicitis is 20-40 years old in 70% of cases, and only 30% of women are those who have reached menopause.

The disease must be treated, since when it passes into chronic form There is a thickening of the walls of the uterus, narrowing of the lumen of the cervical canal. This may cause infertility. The spread of inflammation into the tubes and ovaries also leads to the inability to conceive, the occurrence of ectopic pregnancy, and hormonal disorders.

The danger of cervicitis in pregnant women

Cervicitis is associated with the destruction of the mucous plug that protects the uterus from infection from the vagina. The likelihood of illness and the transition of the inflammatory process to a chronic form increases due to the inevitable decrease in immunity during this period (this prevents fetal rejection).

If pregnant women have cervicitis, the risk of complications such as miscarriage and premature birth increases. Infection of the fetus is possible, which leads to abnormal development, the appearance of deformities, intrauterine death, and death of the newborn in the first months of life.

Cervicitis poses a greater threat to early stages pregnancy, when the fetus's organs and systems are formed. Most often, a woman has a miscarriage. If acute cervicitis occurs in the middle or end of pregnancy, the child may develop hydrocephalus, kidney disease and other organs. Therefore, when planning a pregnancy, a woman should be cured of cervicitis in advance and strengthen her immune system. Treatment is mandatory, as the risk of complications is very high.

Video: The danger of sexually transmitted infections during pregnancy

Causes of cervicitis

The inflammatory process in the cervix can be of an infectious nature or occur for reasons not related to the penetration of microbes and viruses.

Infectious causes of infection

The cervix separates the sterile uterine cavity from the vagina, the microflora of which normally contains beneficial lactobacilli and opportunistic microorganisms. Beneficial lactic acid bacteria create a healthy environment that prevents the proliferation of pathogens. The causes of cervicitis of infectious origin are:

1. Reproduction of opportunistic bacteria. Opportunistic pathogens are microorganisms that are always present in the human intestines and genitourinary organs in small quantities without causing harm. But under certain conditions, they begin to multiply uncontrollably, which leads to disease. These include, for example, staphylococci, streptococci, E. coli, fungi, and gardnerella. They cause inflammation of the vulva and vagina, spreading to the cervix. The infection can enter the vagina directly from the rectum and urinary organs.
2. Infection with human papilloma viruses and genital herpes.
3. Infection with sexually transmitted infections (Trichomonas, gonorrhea pathogens, mycoplasmas, chlamydia and others).

Non-infectious causes of cervicitis

Such reasons include:

• prolapse of the cervix and vagina;
• cervical injuries (ruptures during childbirth or abortion, as well as damage during curettage and cauterization, causing scar formation);
• failure to comply with hygiene rules, use of inappropriate hygiene products;
• frequent douching with solutions that cause overdrying of the mucous membrane and disruption of the microflora;
• changes in the composition of the mucous membrane when using hormonal replacement therapy drugs or contraceptives;
• pseudo-erosion of the cervix, that is, the movement of columnar epithelial cells of the cervical canal into the area of ​​squamous epithelium of the vaginal cervix. This happens during abortion, childbirth or surgery.

Decreased immunity, the presence of tumor diseases, and uncontrolled use of antibiotics contribute to the occurrence of cervical inflammation.

Video: Diagnosis and treatment of cervicitis

Types and forms of cervicitis

There are different types of cervicitis of the cervix.

Purulent cervicitis. Sources of inflammation include gonococci, ureaplasma, and trachoma bacilli. The infection is sexually transmitted and affects the mucous membrane of the cervical canal (cylindrical epithelium). If columnar cells are displaced into the area of ​​squamous epithelium (cervical ectopia appears), then the purulent process spreads to the displaced areas. The process may also affect the stroma that separates the mucosa from the muscles. The infection spreads to other pelvic organs and causes inflammation.

Viral cervicitis. Inflammation is caused by the human papillomavirus (HPV) or the causative agent of genital herpes (specific infections). Papillomas or herpes can occur both inside the cervical canal and on the vaginal surface of the cervix. A characteristic feature is severe itching in the cervix and pain in the lower abdomen. Most often, this type of cervicitis occurs in women of childbearing age who are sexually active.

Bacterial cervicitis. The process of inflammation spreads to all parts of the mucous membrane of the cervix: both internal and to its vaginal segment. The cause is bacterial vaginosis, that is, the development of opportunistic bacteria in the vagina due to a lack of beneficial lactic acid bacteria in the microflora. With this disease there is no danger of infecting a sexual partner. However, if a sexually transmitted infection also enters the vagina, the disease becomes purulent.

Atrophic cervicitis. This is the name for a type of disease in which there is a decrease in the thickness of the mucous membranes of the cervix (atrophy). The causes of this process can be both specific (gonococcus, trichomonas, herpes virus and HPV) and nonspecific infections (staphylococci, streptococci).

In addition, cervicitis of this type occurs due to traumatic damage to the mucous membrane during abortion or curettage.

Cystic cervicitis. Inflammation of the glands located in the cylindrical epithelium occurs, an increase in its volume, the formation of many cysts in the mucosa and damage to its surface. This type is an advanced stage of the disease, in which a combination of various types infections.

The disease often occurs in an acute form with pronounced symptoms. If left untreated, the inflammation becomes chronic, spreads to the glands and affects the mucous membrane deeper. However, treatment is complicated by the fact that external signs the diseases are smoothed out, it is more difficult to diagnose cervicitis. Often it can be detected only at a late stage, when the inflammation spreads to the uterine appendages.

Symptoms and signs of cervicitis

In some cases, even acute cervicitis is difficult to notice, since it occurs without pain or other obvious symptoms. However, in severe form, acute inflammation can cause the appearance of profuse purulent discharge with an unpleasant odor. There is a nagging pain in the lower abdomen, in the lower back. Bloody discharge appears, especially after sexual intercourse, which also becomes painful. Itching is felt in the genitals. Possible increased body temperature, nausea and dizziness. There is frequent painful urination.

Signs of the disease in acute stage are swelling and redness of the mucous membrane on the surface of the vaginal segment of the cervix. Upon examination, a protrusion of the mucous membrane of the cervical canal into the outer area is detected. There are small hemorrhages and ulcers on it.

When the disease becomes chronic, the discharge becomes less abundant, as the production of mucus by the glands of the cervical canal is disrupted. Cloudy discharge contains blood. A woman feels constant aching pain in her lower back.

The severity of the disease depends on the type of infection. When infected with gonococci, the manifestations, for example, are stronger than with chlamydia. If the occurrence of cervicitis is associated with the herpes virus, then on the mucous membrane there are individual ulcers, loose areas of bright red color.

In the presence of chronic cervicitis, swelling of the mucous membrane decreases. It is possible to move the outer epithelium of the cervix into the cervical canal. The color of the mucous membrane is bright pink. Cysts and blisters containing lymph and blood are detected. Inflammation spreads to neighboring tissues.

Diagnosis of cervicitis

Since obvious symptoms of cervicitis of the cervix may be absent, regular visits to the doctor for preventive purposes are of great importance for the timely detection and diagnosis of this disease.

The following methods are used for the examination:

1. Examination of the cervix using speculum. At the same time, they notice a change in the color of the vaginal segment of the cervix, the presence of purulent plaque, hemorrhages, ulcers, as well as the appearance of edema.
2. Tests of a smear from the cervix for examination under a microscope and detection of infectious agents in it.
3. Bacteriological culture of the contents of the smear, which allows you to determine the type of microbes and sensitivity to antibacterial drugs.
4. PCR and ELISA. These methods of smear examination can determine the presence of pathogens of specific infections and estimate their quantity.
5. Colposcopy. By optical magnification and illumination of the vagina and cervical canal using a colposcope, the condition of the mucous membranes is studied.
6. Laboratory analysis of a smear for the content of leukocytes, erythrocytes and lymphocytes allows us to assess the degree of inflammation of a non-infectious nature.

In the chronic stage of cervicitis, destroyed epithelial cells are found in the smear. Additionally, general blood tests and a smear for leukocytes, as well as an HIV test, are performed.

Video: In what cases are different smear tests used?

Treatment of cervicitis

Treatment of cervicitis consists of eliminating the causes of the disease, fighting inflammation and strengthening the body's defenses.

Antibiotics, antiviral and antifungal drugs are used to destroy pathogens. When a papilloma virus is detected in a woman’s body, special attention is paid to treatment, since damage to the genital organs is more likely to lead to the formation of malignant tumors. First of all, immunomodulator drugs (interferon, cycloferon, immunal) are prescribed.

Vaccines, tablets and ointments are used to clear the mucous membrane of papillomas. However, there is a risk of relapse, so women are advised to undergo regular gynecological examinations.

Often you can get rid of papillomas only surgically. This treatment is often used to eliminate chronic cervicitis of any nature. Methods such as laser destruction, cryotherapy, chemical cauterization, electrical destruction, and radio wave coagulation are used.

Sometimes the treatment of cervicitis requires simultaneous elimination of urological diseases.

Note: If the cause of inflammation of the mucous membrane is sexually transmitted infections, then the woman’s sexual partner should be treated at the same time.

In order to speed up the restoration of the mucous membrane and improve hormonal levels, estrogen and progesterone preparations are used.

After eliminating the inflammation, products containing beneficial bacteria necessary to maintain the normal composition of the vaginal microflora are prescribed. Lactobacterin, Kipferon suppositories, as well as gynoflor vaginal tablets are used.

Video: Cervical diseases in the presence of human papillomavirus. Cervical treatment methods

Prevention of cervicitis

The most important preventive measures to reduce the likelihood of cervicitis are proper hygienic care of the external genitalia and the use of condoms during sexual intercourse. Properly selected contraceptives help avoid abortion, possible injury to the cervix and infection. It is necessary to treat intestinal and urological diseases in a timely manner.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Cervicitis called an inflammatory process localized on the mucous membrane of the cervix.
Endocervicitis is an inflammatory process localized in the cervical canal.
Exocervicitis is an inflammation that develops on the vaginal segment of the cervix.

Reasons for development

• Inflammatory processes of reproductive organs ( endometritis, inflammation of the appendages, cervical erosion, colpitis, cystitis),
• STDs: chlamydia, trichomoniasis, gonorrhea, sexually transmitted viruses, fungi,
• Coccus infections of the genital tract,
• Prolapse of the cervix,
• Weak defense mechanisms
• Injuries to the cervical mucosa ( injuries during childbirth, abortion, and other manipulations),
• Illiterate use of local contraceptives, as well as the use of acids for these purposes,
• Violation hormonal levels during premenopause.

Diagnostics

The main way to determine cervicitis is an examination by a gynecologist using speculum. This method It’s simple and doesn’t cause any discomfort. When examined, the mucous membrane is swollen and may be covered with small hemorrhages and erosions. If the cause of inflammation is an infection, specific discharge is observed.

Signs of the chronic form:

• Swelling and redness of the cervical mucosa,
• Light discharge, in rare cases with the presence of pus.

In the treatment of the chronic form, along with antibiotics, an important place is occupied by physiotherapeutic methods, as well as exposure to liquid nitrogen, laser, diathermocoagulation ( cauterization).

Non-specific

The nonspecific form of the disease is provoked by opportunistic microflora: Candida, Gardnerella, Enterococcus, Escherichia coli, Proteus, Streptococcus, Staphylococcus, Pseudomonas aeruginosa.

The signs of this form of the disease practically do not differ from the signs of the typical form: pain can be observed less frequently and is not too acute, itching is not uncommon, as well as fairly copious discharge, the nature of which is determined by the pathogen.

Atrophic

Atrophic cervicitis develops during the period of physiological aging against the background of a decrease in the production of female sex hormones.
Lack of estrogen leads to changes in the processes occurring in the vaginal epithelium. In addition, the protective functions of the vaginal microflora and the acidity of the environment decrease. Conditions are more conducive to the development of pathogenic and conditionally pathogenic microbes. Therefore, cervicitis is the most common age-related disease of the cervix.
The mucous membrane becomes thinner, ulcers and foci of inflammation appear on it.
To diagnose the atrophic form, the patient is examined and a smear is taken from the vagina. By the nature of the smear, you can accurately determine the form of inflammation.

Treatment:
Most effective method– hormone replacement therapy. It allows you to normalize the functions of the mucous membrane and stop the process of cell atrophy.
The best method of treatment is local action: suppositories, creams, vaginal tablets with female sex hormones will help normalize blood circulation, microflora and improve muscle tone.

Treatment

1. Elimination of the pathogen ( acyclovir, metronidazole, diflucan, terzhinan, doxycycline),
2. Hormonal drugs ( more often prescribed for chronic forms). Most often prescribed - Ovestin in the form of vaginal suppositories, creams or tablets. The drug normalizes the condition of the tissue of the cervical mucosa; it is used according to the following scheme: Ovestin 0.5 mg once a day for 21 days in a row. Then 0.5 mg once every 3 days for 21 days, then 0.5 mg once every 7 days,
3. Correction of vaginal microflora using eubiotics and immunocorrectors ( hilak-forte and imudon ).
4. If erosion is present, cryotherapy, laser therapy, or another method of treating erosion is indicated. But this stage is started only after the inflammatory process has been completely suppressed.

Candles

The most preferred dosage form of drugs for the treatment of cervicitis are suppositories or vaginal creams. Used as antibiotics or combination drugs ( metronidazole, terzhinan), and hormonal drugs including estrogens.
If inflammation is caused by a viral infection, antiviral drugs are used in the form of suppositories.

Traditional treatment

1. For candidiasis: take 20 grams of juniper, sage, tansy, birch buds, 10 grams of yarrow, eucalyptus, alder cones. Brew two tablespoons of the mixture with 200 ml of boiling water, steam in a sealed container for 10 minutes, set aside from heat for half an hour, pass through a sieve and consume 70 ml in the morning, at lunch and in the evening after a meal. Duration of treatment is 4 – 12 weeks. For douching at night, add 10 ml of an alcohol preparation of eucalyptus or calendula to the prepared decoction. Do the procedure every day for 14–21 days.

2. For viral etiology: take 20 grams of mint, thyme, raspberry leaf, juniper cones, 10 grams of wormwood and adonis. Brew 2 tablespoons of the collection into 400 ml of boiling water, keep covered for 60 minutes, pass through a sieve and consume orally the day before. Can be combined with oral tincture of Eleutherococcus 40 drops twice a day ( not overnight) for a month.

3. Take the same amount of wormwood, oak bark, bird cherry flowers, twice as much strawberry leaf and three times as much rose hips. Grind everything in a coffee grinder, take 1 liter of boiling water for 2 tablespoons of the mixture, and leave in a thermos for 8 hours. Drink 100 ml three times a day on an empty stomach. Duration of treatment is 12 – 16 weeks.

Pregnancy and cervicitis

Pregnancy against the background of cervicitis threatens premature birth or miscarriage, infection has not yet born child, as well as severe complications after childbirth.

The most common and dangerous is the ascending route of infection, when it enters the body through the vagina. This is how amniotic fluid can become infected. If fetal infection occurs during early stages development, there is a possibility of the formation of congenital defects, as well as placental insufficiency.

If infection occurs later, fetal development may be delayed.
When the fetus becomes infected in the first three months of pregnancy, the infection covers the entire body of the unborn child.

During pregnancy, cervicitis often occurs in a latent form, which complicates its detection.

Sumamed is used as the main drug in the treatment of an atypical form of inflammation in pregnant women ( azithromycin) in the form of tablets and topical preparations.

Sex with cervicitis

Often, sexual intercourse with cervicitis causes inconvenience and discomfort. If this is not observed and if the inflammation is not associated with the presence of a sexually transmitted infection in the body, sexual intercourse is not prohibited.

Inflammation of the cervix is ​​a well-known gynecological problem. Most often, cervicitis is detected in women of childbearing age, but sometimes this diagnosis is made on the eve of and even during menopause. The complexity of the disease is that it contributes to the appearance of various pathologies of the reproductive sphere, and during pregnancy it threatens the abortion or intrauterine infection of the child.

In the body of a healthy woman, the cervix acts as a filter that protects the genitals from invasion of pathogenic microorganisms. The mucous membrane of its canal contains special bactericidal enzymes that can neutralize most pathogenic agents. And the narrow channel prevents mechanical penetration.

However, under unfavorable factors, the function of the vaginal cervix and cervical canal is impaired. This part of the organ remains defenseless against infection and is the first to take the blow. Its tissue is affected by an acute inflammatory process - cervicitis, which can last up to one and a half months and then become chronic.

Depending on which part of the organ is affected - internal or external, the disease is divided into endocervicitis and exocervicitis, respectively.

The reasons that cause such a disease in the female body can be of a different nature. Most often, doctors identify the following situations.

Infectious diseases

The most common provocateurs of cervicitis are pathogens for which the cervix is ​​a favorable environment. They can get to this area in the following ways:

• during unprotected sexual intercourse;
• through blood;
• by contact, for example, from the intestines if the rules of intimate hygiene are not observed.

When treating cervicitis, gynecologists have to deal with:

• cocci;
• coli;
• chlamydia;
• plasmas;
• trichomonas;
• viral microorganisms (herpes, HPV, CMV and others);
• fungi (candida and the like).

Often, cervicitis is a secondary disease, that is, it occurs as a consequence of the inflammatory process in adjacent structures, as well as in other parts of the genital organs (for example, with colpitis, adnexitis).

Mechanical damage

Another cause of inflammation in the cervical area is trauma. A hastily placed contraceptive (cap or ring) or too deep insertion of a hygienic tampon can damage the delicate mucous membrane and make it vulnerable to any bacteria. The same can be observed after the installation of an intrauterine device and after injuries during childbirth.

Mechanical damage can occur after artificial termination of pregnancy. Even if we omit the negative consequences of the procedure for reproductive function and psychological state, the technique of its implementation itself remains very traumatic. Therefore, even under sterile conditions, the body is not protected from complications, among which cervicitis is often encountered.

The mucous membrane of the vaginal part of the cervix can also be damaged when douching with potent solutions. Concentrated liquids can not only leave a burn, but also “wash out” all the beneficial microflora that protects against infections.

Women with allergies have a particular predisposition to cervicitis. An unsuccessfully selected lubricant, spermicidal lubricant or contraceptive material (barrier) can cause an inflammatory process after sexual intercourse, even if the partner is not a carrier of the infection.

Other factors

Girls who began to have an active sex life before reaching adulthood have an additional risk of getting cervicitis. The fact is that the microflora of young representatives of the fair sex is not yet able to adequately respond to the changes taking place.

Therefore, any interventions quickly lead to imbalance and disrupt the maturation process. This makes the genitals accessible to infections, which are more intense than in older women.

Women during menopause also remain vulnerable to cervicitis. Due to decreased estrogen production, the entire reproductive system suffers. The mucous membranes of the reproductive organs become more vulnerable, the epithelium becomes thinner, so the protective forces weaken.

Symptoms of the disease

The insidiousness of cervicitis is that it occurs on its own without noticeable symptoms. A woman can assume that something is going wrong by the “unusual” lack of orgasm, pain during intimacy and spotting after it, not related to menstruation. However, this situation occurs rarely.

Basically, cervicitis becomes a companion to another disease, which is provoked by the same pathogen. That is, it is not inflammation of the cervix or its canal that manifests itself, but another pathology, for example, colpitis or adnexitis.

Complaints are varied and can be as follows:

• pain in the lower abdomen, may radiate to the lower back;
• pain when urinating;
• frequent “unreasonable” urge to go to the toilet;
• unpleasant odor of intimate parts of the body;
• unusual discharge (cloudy, curdled, foamy, etc.);
• irritation or itching in the genital area.

Symptoms of vaginitis and cervicitis caused by various microbes

If treatment is not started during the acute period of cervicitis, it becomes chronic. At this stage the disease affects inner fabrics organs, changing their structure. Adnexitis and other forms of the inflammatory process occur. This happens almost asymptomatically.

Diagnostic methods

The disease can only be detected by examination in a gynecological chair. Since acute cervicitis shows little sign of itself, it is most often discovered by chance. Visually, inflammation confirms swelling of the surface of the vaginal part of the cervix, which bleeds when touched. Often ulcerations are noticeable on it. The cervical canal can also be filled with ichor or other biological fluid that should not normally be there.

In fact, one gynecological examination in the speculum is enough for the doctor to diagnose cervicitis. Much more difficulties arise when establishing the cause of this disease. The exception is sexually transmitted infections, which have a specific pathogen and clear symptoms.

To choose the right treatment tactics, the gynecologist prescribes special manipulations and tests. Most often, the list of diagnostic procedures looks like this:

During the examination, the specialist may take a small piece of inflamed tissue for further examination - a biopsy is performed.

• Cytological examination. These are smears for oncocytology. Cells are collected from the cervical canal and the vaginal part of the cervix, after which they are examined under magnification. This makes it possible to assess the risk of oncological processes and the severity of inflammation.
• Bac sowing. He will determine the causative agent of the disease (if it is a bacterium) and a group of drugs that can be used to eliminate it.
• PCR research(polymerase chain reaction). It allows you to identify viruses and sexually transmitted infections.
• . With its help, the doctor will get an idea of ​​the composition of the vaginal microflora.

Treatment of acute cervicitis

After receiving the results of all tests, the doctor determines the necessary therapy. In a situation where the cause of cervicitis is an infection, the main efforts are aimed at sanitizing the cervix and its canal in order to prevent the spread of the inflammatory process to other parts of the genital organs, and if a woman is “pregnant,” to her baby. Depending on the pathogen, you will have to treat:

• (pregnant women are mainly prescribed Erythromycin or Ceftriaxone);
• antiviral agents containing acyclovir or other substances;
• drugs that suppress fungi (in the form of suppositories or vaginal tablets).

Vaginal suppositories in the treatment of cervicitis

In addition, it is additionally necessary to adjust the composition of the microflora to prevent the recurrence of cervicitis. To do this, the doctor prescribes medications or dietary supplements containing the necessary strains of lactobacilli.

The treatment of cervicitis in women during menopause includes the use of hormonal agents. Regardless of the form (tablets or cream), they must be used regularly and in accordance with the regimen determined by the gynecologist.

After finishing taking all medications, you need to visit the gynecologist again and take control tests. If conservative methods of combating acute cervicitis are ineffective, the inflamed tissue of the cervix will have to be removed. For this purpose, cryotherapy, electrocoagulation or cauterization with a laser are prescribed. Radio wave treatment of cervicitis using the Surgitron device

At the same time as a woman, her sexual partner also needs to sanitize her genitals. This is important because the pathogen can circulate from one organism to another without giving medicines perform its function efficiently. In general, it is better to abstain from sexual relations during treatment.

If left untreated

Any disease of the genital organs should not be ignored. A frivolous attitude towards acute cervicitis can lead to changes in the cervix and the appearance of erosions on it. This will become a serious obstacle if a woman wants to become a mother, or even deprive her of such an opportunity.

This condition is especially dangerous if the lady is already “in position.” Cervicitis allows infection to reach the child, even in a situation where the disease is caused by another cause. If left untreated, the result can be very tragic.

For information on the diagnosis and treatment of cervical diseases, watch this video:

Prevention

The main way to protect against cervicitis is considered to be that every woman takes care of her health. Since this disease is often caused by infection, it is important to avoid factors that lead to its acquisition. Ideally before you start intimate relationships a man and a woman should check whether they are carriers of a disease that can be transmitted to their partner.

But such consciousness does not occur very often. Therefore, in order to protect yourself from cervicitis and other problems, it is important:

• do not have casual sex;
• insist on correct use condom (before sexual intercourse);
• strengthen immunity;
• fully treat all diseases (especially infectious ones);
• monitor intimate hygiene;
• Visit your gynecologist regularly.

No matter in what life situation a woman encounters cervicitis, it is important to understand that successful relief from this disease is possible only under the supervision of a doctor. If his recommendations are strictly followed, the prognosis is positive in most cases. But from use traditional methods for the treatment of cervical inflammation, it is better to refuse, they will not have a therapeutic effect to the required extent or, even worse, will aggravate the disease.

Useful video

About prevention and treatment options gynecological diseases watch in this video:

A long-term inflammatory process in the mucous membrane of the vaginal and supravaginal part of the cervix, which in some cases spreads to its connective tissue and muscle layer. During remission, symptoms are limited to an increase in the number vaginal discharge. During exacerbation, the volume of discharge increases, it becomes mucopurulent, and the patient notes pain in the lower abdomen. When making a diagnosis, data from extended colposcopy, bacteriological, serological and cytological tests, and gynecological ultrasound are taken into account. Antibiotics, hormonal drugs, eubiotics, and immune agents are used for treatment.

General information

Diagnostics

Since clinical manifestations chronic cervicitis are nonspecific and usually mild, the leading role in diagnosis is played by physical, instrumental and laboratory research. The most informative for making a diagnosis are:

• Inspection on the chair. Slight swelling of the mucous membrane is detected, the cervix looks thickened and somewhat enlarged. In the area of ​​the exocervix, eroded areas and papillomatous growths are detected.
• Extended colposcopy. Examination under a microscope allows you to clarify the condition of the mucosa and timely identify precancerous changes and malignant degeneration of the epithelium.
• Laboratory etiological studies. A flora smear and culture with an antibiogram are aimed at detecting the pathogen and assessing its sensitivity to etiotropic drugs. Using PCR, RIF, ELISA, you can reliably determine the type of specific infectious agent.
• Cytomorphological diagnostics. When examining a scraping of the cervix, the nature of the changes and the condition of the cells of the exo- and endocervix are assessed. Histology of the biopsy is carried out according to indications for the timely detection of signs of malignancy.
• 1. Etiotropic drug treatment . For infectious genesis of cervicitis, antibacterial and antiviral drugs are used. When selecting an antimicrobial agent, the sensitivity of the pathogen is taken into account. Hormonal drugs (estrogens) are used in the treatment of atrophic cervicitis in women during menopause.
  2. Restoration of vaginal microflora. After a course of antibiotic therapy, eubiotics are recommended topically (in the form of suppositories, tampons, vaginal irrigations) and orally.
  3. Adjuvant therapy. To speed up the processes of mucosal regeneration, strengthen the immune system and prevent possible relapses, immunotherapy, herbal medicine, and physiotherapeutic procedures are indicated.

  In the presence of retention cysts, radio wave diathermopuncture is prescribed. In cases where conservative treatment is ineffective, or chronic cervicitis is combined with dysplasia, elongation, cicatricial deformation and other diseases of the cervix, surgical techniques are used - cryo- or laser therapy, tracheloplasty, etc.

  Prognosis and prevention

  The prognosis of the disease is favorable. For timely detection of possible cervical dysplasia, after a course of treatment, the patient must undergo colposcopy twice a year, undergo cytological smears and bacterial cultures. Prevention of chronic cervicitis includes regular examinations by a gynecologist, adequate treatment of inflammatory diseases of the female genital area, and justified prescription of invasive procedures. It is recommended to follow the rules of intimate hygiene, organize sex life, use condoms (especially during sexual contacts with unfamiliar partners), avoid sex during menstruation. To prevent relapses, courses of general strengthening and immunotherapy, adherence to sleep and rest, and protection from hypothermia in the legs and pelvic area are effective.

Cervicitis, what is it? How to treat cervicitis of the cervix

Cervicitis is classified as an inflammatory pathology of the female genital area. It is an inflammation of the mucous membrane of the cervix (vaginal part) and its cervical canal. Very often it accompanies more extensive pathological processes (vulvovaginitis, colpitis), and is rarely an independent disease.

The cervix is ​​a kind of barrier, the task of which is to prevent the spread of infection through the ascending route into the uterus and its appendages. If its protective function is impaired, then pathogenic microorganisms penetrate the upper parts of the woman’s internal genital organs, provoking the development of cervicitis. The woman begins to be bothered by atypical discharge, periodic or constant pain localized in the lower abdomen, which intensifies during sexual intercourse or urination.

What is it?

Cervicitis is an inflammation of the cervix, in short in simple language. But, not everything is so simple - let's look at the issue in detail.

Causes of cervicitis

The main cause of cervicitis are diseases that are sexually transmitted. With the development of a certain sexually transmitted disease, thick mucus gradually liquefies, resulting in inflammation of the mucous membrane. After this, the infection begins to spread to the base of the cervix. Due to such changes, microbes gradually enter the uterus, appendages, and later spread into bladder, kidneys and other organs. As a result, pathological phenomena develop in the woman’s pelvic cavity, including peritonitis.

If sexually transmitted diseases are considered the main cause of the development of cervicitis in a woman, then doctors also identify a number of factors that contribute to the development of this disease. The risk of developing cervicitis increases significantly if a woman has been infected with the herpes virus or. Cervicitis can overtake a girl at a time when she is just beginning to have an active sexual life. Also, cervicitis of the cervix can manifest itself as a consequence of mechanical or chemical irritation (we are talking about contraceptives or hygiene products). In some cases, the inflammatory process occurs as a consequence allergic reaction the body to latex, other components of contraceptives or personal hygiene products.

A factor that provokes the disease is also weakened immunity due to other somatic diseases. In addition, cervicitis can develop as a result of injuries caused during abortion or childbirth (in in this case it is important to qualitatively suture all ruptures of the perineum and cervix obtained during the birth process), with. The disease also often affects women who have entered menopause.

All the reasons described above contribute to the active reproduction of microorganisms classified as opportunistic (staphylococci, streptococci, enterococci, E. coli). In a woman’s normal health, such microorganisms are present in the vaginal microflora.

Symptoms of cervicitis

Manifestations of the acute form of the disease are significantly pronounced. The patient is bothered by purulent or profuse mucous leucorrhoea, vaginal itching and burning, which intensifies with urination. Pain due to cervicitis may also be bothersome. Usually these are dull or aching pain in the lower abdomen, painful sexual intercourse. Other signs of the disease are due to concomitant pathology.

If the inflammatory process of the cervix occurs against the background, frequent and painful urination is a concern. With the inflammatory process in the cervix, there is an increase in temperature from subfebrile (above 37) to febrile numbers (38 and above). When pseudoerosion and cervicitis are combined, spotting may appear spotting after coitus. A distinctive feature of the disease is the exacerbation of all clinical symptoms after menstruation.

Chronic inflammation of the cervix

A disease that was not adequately and timely treated in the acute stage becomes chronic. Signs of chronic cervicitis are less pronounced or practically absent. The discharge becomes cloudy and mucous in nature, the flat epithelium of the vaginal part of the cervix is ​​replaced by cylindrical epithelium from the cervical canal, and pseudo-erosion of the cervix is ​​formed.

Inflammatory phenomena (redness and swelling) are mild. When inflammation spreads to the surrounding tissues and deeper, the cervix becomes denser, and it is possible again to replace the columnar epithelium with flat epithelium during ectopia, which is accompanied by the formation of nabothian cysts and infiltrates.

Lymphocytic cervicitis

The disease is also called follicular cervicitis. This form of inflammation is asymptomatic and occurs in menopausal women. The process is a lymphoid “impregnation” of the walls of the cervix, resulting in the formation of follicular benign formations. If this form of inflammation is detected, the doctor will definitely conduct differential diagnosis with malignant lymphosarcoma.

Candidiasis cervicitis

Occurs in a situation where there is already a fungal infection in the vagina (). When examining the cervix in the speculum, white deposits are detected, which are easily scraped off, resulting in exposure of the inflamed red mucosa.

Viral cervicitis

The disease appears as a result of infection with the herpes simplex virus, human papilloma,. It is somewhat difficult to recognize because it has no specific features. During the examination, the doctor may see blisters characteristic of a herpes infection, or only a laboratory will confirm the diagnosis.

Cystic cervicitis

It is a form of the disease in which benign formation occurs. As a result of the inflammatory process, blockage of the glands that secrete mucus occurs and their subsequent proliferation, which the gynecologist will detect during examination or colposcopy.

Atrophic cervicitis

Most often this is a chronic and nonspecific form of the disease. Common reasons atrophic inflammation - traumatic manipulations associated with disruption of the integrity of the cervical canal of the uterus or childbirth.

Diagnostics

The diagnosis is made by a gynecologist based on the results of examination and additional research methods. He collects anamnesis, studies complaints and symptoms. During the examination on the chair, the doctor sees foci of inflammation, pinpoint hemorrhages on the surface of the exocervix, an increase in its size due to swelling, redness and swelling of the walls of the vagina and external genitalia.

The gynecologist takes a smear from the surface of the cervix for further examination under a microscope - cytology. The resulting material is also sown on nutrient media - the grown colonies of the pathogen make it possible to determine its type and sensitivity to antibiotics. If necessary, the doctor measures the pH of vaginal discharge - its increase indicates changes in its microflora.

Chronic cervicitis leads to the appearance of pathological foci on the cervix - they are detected when it is treated with iodine solution. In this case, colposcopy is performed - studying the epithelium of the exocervix under high magnification to exclude malignant degeneration of its cells. To diagnose chronic endocervicitis, curettage of the cervical canal is performed, followed by studying the cellular composition of the resulting material. To exclude tumors of the female reproductive system, they are examined using ultrasound.

Treatment of cervicitis

First of all, it is necessary to identify and eliminate factors that could cause cervicitis. It is worth noting that if sexually transmitted infections are detected, the woman’s sexual partner must also undergo treatment.

The treatment strategy for cervicitis depends on the identified cause of the disease. Treatment regimen for different types cervicitis:

1. In case of fungal infection, antimycotics are used: Fluconazole orally, Natamycin tablets, suppositories with econazole in the vagina;
2. For chlamydial infection, a combination of several antibiotics (Tetracycline + Azithromycin) is prescribed for a period of at least 21 days;
3. With atrophic inflammation, the introduction of suppositories, creams, gels containing estriol (Divigel) into the vagina helps;
4. For bacterial infections - treatment with antibiotics (Neomycin, Metronidazole suppositories), combined anti-inflammatory and antibacterial drugs (Terzhinan). After sanitation, suppositories with beneficial lactobacilli are prescribed to restore normal microflora (Acilact).

After the acute stage of the disease subsides, local treatment methods can be used. The use of creams and suppositories (terzhinan) is effective. It is recommended to treat the mucous membranes of the vagina and cervix with solutions of silver nitrate, chlorophyllipt or dimexide.

In advanced cases of the disease, when atrophic changes are observed in the mucous membrane of the cervix, local hormonal therapy (ovestin) is indicated, which promotes the regeneration of the epithelium and the restoration of normal vaginal microflora.

Conservative treatment may not give the desired results in the chronic stage of cervicitis. In such cases, the doctor may recommend surgical treatment (cryotherapy, laser therapy, diathermocoagulation).

To assess the effectiveness of treatment, a control colposcopy and laboratory tests are performed.

The danger of cervicitis in pregnant women

Cervicitis is associated with the destruction of the mucous plug that protects the uterus from infection from the vagina. The likelihood of illness and the transition of the inflammatory process to a chronic form increases due to the inevitable decrease in immunity during this period (this prevents fetal rejection).

If pregnant women have cervicitis, the risk of complications such as miscarriage and premature birth increases. Infection of the fetus is possible, which leads to abnormal development, the appearance of deformities, intrauterine death, and death of the newborn in the first months of life.

Cervicitis poses a greater threat in the early stages of pregnancy, when the fetus’s organs and systems are forming. Most often, a woman has a miscarriage. If acute cervicitis occurs in the middle or end of pregnancy, the child may develop hydrocephalus, kidney disease and other organs. Therefore, when planning a pregnancy, a woman should be cured of cervicitis in advance and strengthen her immune system. Treatment is mandatory, as the risk of complications is very high.