cervical ectropion
Cervical ectropion, also called cervical erosion, is typically caused by high estrogen levels.

The cervix is the lower portion of the uterus and the “neck” that connects to the vagina. It has two parts: the inner of the endocervical canal and the outer of the ectocervix.

The causes of cervical ectropion include:

  • High estrogen levels: The cervix is highly responsive to estrogen, which is responsible for the formation of the cervical cells. With the increase in estrogen, the cervical cells grow in number and spread to the outer part of the cervix. Cervical ectropion is usually seen in conditions when the estrogen levels are high, such as:
    • Adolescent girls and young women
    • Pregnant women
    • Use of hormonal contraceptives
    • During menstruation, mostly during the ovulatory phase
  • Congenital: In some cases, during fetal development, the squamocolumnar junction (the transitional zone of the inner columnar cells and outer squamous cells) remains in its original neonatal position. It may also occur when the fetus is exposed to maternal hormones, which leads to endocervical columnar epithelial hyperactivity and causes cervical ectropion during late fetal development and the first month of life.
  • Diseases: Studies have suggested that women suffering from chlamydia are more likely to have cervical ectropion. However, further study is needed to confirm this link.

Cervical ectropion is rare in postmenopausal women. In the postmenopausal period, the estrogen levels fall, causing the cervix to shrink and invert, pushing the ectocervical squamous cell epithelium into the endocervical canal.

What is cervical ectropion?

Cervical ectropion, also called cervical erosion or cervical ectopy, occurs when the cells (columnar glandular cells) that line the inner part (endocervical canal) of the cervix spread to the outer surface (ectocervix) of the cervix, which normally has different types of cells (called the squamous epithelium).

Cervical ectropion is a benign (noncancerous) gynecological condition that is pretty common among women of childbearing age and is typically nothing to be concerned about. It is not a symptom of another health issue, such as cervical cancer, and it doesn’t cause infertility. However, in cases with symptoms, doctors may advise some treatment.

What are cervical ectropion symptoms?

Cervical ectropion is mostly asymptomatic and is usually diagnosed by a doctor during a pelvic examination. However, the affected women may experience some symptoms, which include:

  • Mucus discharge
  • Spotting between periods
  • Pain and bleeding during or after intercourse

There may be pain and bleeding during or after a pelvic examination. The most prevalent cause of bleeding in the latter months of pregnancy is cervical ectropion. As the columnar glandular cells are more delicate than the squamous epithelial cells, they produce more mucus and bleed easily.

Even if the symptoms are mild, consulting a doctor for appropriate examination is necessary because similar symptoms are seen in other gynecological problems. Thus, the cause should be ruled out to get proper treatment.

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How do you diagnose cervical ectropion?

Cervical ectropion is usually diagnosed during a pelvic examination where the cervix appears red and rougher than normal. Some bleeding may be seen during the examination.

A Pap smear is done to confirm the diagnosis, and it helps rule out cervical cancer or sexually transmitted diseases because they appear similar.

If the symptoms are severe, a colposcopy is done by the doctor to study the cervix closely, and even sample tissue could be taken (biopsy) to test for possible cancer cells.

What are the treatment options for cervical ectropion?

Cervical ectropion may not need any treatment and symptoms resolve by themselves. If the symptoms start during pregnancy, they resolve three to six months post-delivery. If it is caused by birth control pills, the doctor may prescribe other contraceptive pills.

If the symptoms are severe, the doctor may treat the patient with:

  • Cryotherapy: Cryotherapy, also called cryosurgery, is where a doctor uses a probe to freeze the cervical cells to stop the symptoms. Studies suggest that this treatment works effectively for women who have a lot of vaginal discharge from cervical ectropion.
  • Diathermy: The doctor applies intense heat to the cells to remove them by using a tiny instrument. The patient will be given medication to numb the region first.
  • Silver nitrate: Silver nitrate is a chemical that is applied to the cervix by the doctor to seal off the cells that cause bleeding. There would not be any necessity of numbing medication beforehand.

These are small procedures that may be done at the doctor’s office, and people may continue with normal daily activities. However, people may feel some discomfort for a few hours to days, and some patients may have spotting or vaginal discharge for a few weeks.

To prevent infections and to provide time to heal, it is advised to avoid intercourse and using tampons for a few weeks.

Follow-up with the doctor according to their recommendation to check the healing progress or if any possible infections may require immediate medical attention.

Immediate medical attention is required if there are any symptoms, such as:

  • Severe pain
  • Heavy bleeding
  • Smelly vaginal discharge

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Medically Reviewed on 10/14/2021
References
Aggarwal P, Ben Amor A. Cervical Ectropion. [Updated 2020 Nov 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560709/

Columbia Shores Sexual Health. What Is Cervical Ectropion? https://www.columbiashoresobgyn.org/blog/251232-what-is-cervical-ectropion

The Gynaecology Collaborative. What Is Cervical Ectropion? https://www.islingtongpfederation.org/cervical-ectropion