The everted or inside-out parts of the endocervix appear red, raw, and are often covered with a yellow discharge—this can be visualized by a doctor during a pelvic exam using a speculum.
You may have heard cervical ectropion being called cervical erosion. Despite its name, the cervix is not actually eroding. Instead, those “eroded-looking” areas are parts of the cervix where the normal squamous cells of the outer cervix (ectocervix) are replaced by columnar cells of the inner cervix (endocervix).
This article discusses the causes, symptoms, diagnosis, and treatment of cervical ectropion,
Causes
In the past, it was thought that various types of physical trauma that caused infection might eventually lead to cervical ectropion. Such sources of trauma included sexual intercourse, the use of tampons, the insertion of a speculum, or the insertion of other objects into the vagina.
Other assumed causes included sexually transmitted infections (STI) such as herpes or early syphilis. It was also thought that vaginal douches or other chemicals, such as contraceptive creams or foams, might cause cervical erosion.
Today, these theories have lost ground as experts now believe that cervical ectropion is a normal anatomic phenomenon that some women are born with.
Researchers have also found that it can be caused by hormonal changes, making it more prevalent among adolescent women, pregnant women, or women who are taking an estrogen-containing contraceptive like the pill.
The presence of ectropion is also influenced by estrogens and can often be seen in postmenopausal women. The common denominator here is an increase in estrogen levels in the body, which can change or remodel the cervix.
Symptoms
While there are generally no symptoms associated with cervical ectropion, some women may experience light bleeding that is not part of menstruation, such as bleeding after sexual intercourse.
Bleeding after a pelvic exam when a cervical speculum is inserted into the vagina or during a bimanual examination may also occur. This is because the exposed columnar tissue has blood vessels that are fragile and bleed easily when even lightly touched.
Some women with cervical ectropion also experience a clear or yellowish vaginal discharge that has no odor. This discharge does not resemble pus, which would indicate an infection.
Treatment
The good news is that for the majority of women, cervical ectropion is not bothersome. In fact, experts do not recommend treatment unless a woman experiences excessive discharge or spotting, which is rare.
This is because treatment can be invasive, may lead to worsening of discharge (although this is temporary until healing is complete), and can cause cervical stenosis, a condition in which the endocervical canal, or the tunnel within the lower part of the uterus, is narrowed.
Cervical stenosis may lead to fertility problems, as well as menstrual problems like painful periods (called dysmenorrhea) or no periods (called amenorrhea).
If therapy is decided upon, a doctor will first need to rule out cervical cancer, as it can mimic cervical ectropion. This requires a Pap smear and potentially a colposcopy and/or cervical biopsy. Cervical cancer is obviously a very serious medical condition, unlike cervical ectropion, which is not pathologic.
Treatment options should be discussed in detail with your physician and can include electrocautery, cryosurgery, microwave tissue coagulation, laser cauterization, or boric acid vaginal suppositories.
A Word From Verywell
While the term cervical ectropion or erosion sounds worrisome, it’s not. That being said, it can only be diagnosed by a doctor.
If you are experiencing bleeding with intercourse or new vaginal discharge, it’s important to get it checked out. A number of conditions can mimic the symptoms and/or experience of cervical erosion like an infection of the cervix or vagina or cervical cancer.
