What are other Names for this Condition? (Also known as/Synonyms)

• Chronic Cervical Inflammation
• Chronic Inflammation of the Cervix

What is Chronic Cervicitis? (Definition/Background Information)

• Chronic Cervicitis is the chronic or persistent inflammation of the cervix, which is the lower portion of the uterus. This condition occurs only in women
• If acute cervicitis is left untreated, it may persist resulting in Chronic Cervicitis. Chronic conditions may lead to several complications
• Even though there may be multiple causes for cervical inflammation, non-infectious causative factors are common and may include birth control agents (such as contraceptive creams, cervical caps) and chemicals that induce allergy
• The signs and symptoms of Chronic Cervicitis include redness and inflammation of the cervix, abnormal discharge from the vagina, or itching around the genitalia. The condition can be diagnosed by a Pap smear and tissue culture studies
• The treatment of Chronic Cervicitis depends on the cause of the condition. The prognosis of Chronic Cervicitis with adequate treatment is generally good. However, the condition may recur

Cervicitis, which indicates an inflammation of the cervix, is classified according to the following types:

• Acute Cervicitis
• Chronic Cervicitis
• Follicular Cervicitis

Who gets Chronic Cervicitis? (Age and Sex Distribution)

• Chronic Cervicitis is commonly observed in women who have children or are in their child-bearing phase
• It may affect females of any age group, although the risk is higher in older women
• The condition is known to occur in all races, ethnic groups, and across all geographic regions

What are the Risk Factors for Chronic Cervicitis? (Predisposing Factors)

The risk factors for Chronic Cervicitis may include:

• Longstanding acute cervicitis that is left untreated or is not treated adequately
• Advancing age; older women are at a higher risk
• Regular use of vaginal douches: Douching changes the chemical balance in the vaginal area causing different bacteria to grow and thrive in the altered environment
• Past history of sexually-transmitted diseases
• Regular use of certain contraceptives that irritate the cervix
• Engaging in unprotected sex; sex with multiple partners
• Surgery or radiation therapy to the cervical region

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Chronic Cervicitis? (Etiology)

Even though Chronic Cervicitis can be caused by many factors, the majority are due to a non-infectious cause. Acute cervicitis that is left untreated or treated inappropriately for a long period of time can also result in chronic condition. In some cases, the cause of the condition may not be determined.

• Non-infectious etiology:
  • Allergies to condoms, vaginal douches, contraceptive creams (spermicides), etc. 
  • Irritation, due to the insertion of a device, such as a cervical cap or tampon
  • Use of chemicals (allergic reactions)
  • Iatrogenic cause including recent surgeries and radiation therapy involving the cervix
  • Injury to the vagina
  • Cervical polyps
  • Presence of Nabothian cysts: If these cyst openings get blocked, then the cyst may be infected resulting in Chronic Cervicitis
• Chronic bacterial infections due to staphylococcus, streptococcus, E coli, anaerobic bacteria,
• Sexually transmitted infection (STIs) such as due to Neisseria gonorrhoeae bacterium
• Sometimes, Chronic Cervicitis can occur due to Follicular Cervicitis, which is usually due to chlamydial (bacterial) infection
• Other infections:
  • Viral infections such as due to herpes simplex virus
  • Parasitic infections such as caused by Trichomona vaginalis

What are the Signs and Symptoms of Chronic Cervicitis?

In a majority of women, no signs and symptoms of Chronic Cervicitis are noted. In other women with signs and symptoms, the following may be seen:

• Swelling and redness of the cervix
• Ulceration
• Some women can have abnormal vaginal discharge
• Increased frequency of urination
• Itching in the genital area
• Pain during intercourse
• Pressure in the pelvis

Since many women do not show any indication of the condition, annual well-being checkups are important in diagnosing Chronic Cervicitis.

How is Chronic Cervicitis Diagnosed?

Chronic Cervicitis may be diagnosed through the following exams and tests:

• Physical examination and comprehensive medical history evaluation
• A visual examination by a healthcare provider: When the cervical area is examined during a pelvic exam, there may be redness and ulceration seen. In some women, vaginal discharge may be present
• Urine test and analysis
• Pap smear exam, where a small swab of cells from the cervix are collected and examined under the microscope
• A culture of tissue or discharge
• Tissue biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are possible Complications of Chronic Cervicitis?

The complications from Chronic Cervicitis could include:

• Spread of infection to the uterus, urinary bladder (cystitis), endometrium (endometritis), ovaries and fallopian tube leading to pelvic inflammatory disease (PID)
• Pelvic inflammatory disease can lead to infertility and ectopic pregnancy
• Increased susceptibility to HIV infection
• Individuals, who are pregnant, are at additional risk for complications, such as miscarriage and premature labor, if cervicitis is left untreated
• Recurrence of the condition even after treatment

How is Chronic Cervicitis Treated?

The treatment of Chronic Cervicitis depends on the cause of the inflammation. The treatments may include:

• Symptomatic treatment of the signs and symptoms, if the cause is due to a non-infectious agent
• Surgical treatment for Chronic Cervicitis may include laser therapy and cryotherapy
• Antibiotic medication, if bacteria are the cause of the condition
• Antiviral medication, if viruses are the cause of the condition
• Avoiding sexual intercourse until the treatment is completed may be necessary; generally, treating the partner is also important (when the cause is from a sexually-transmitted infection)

How can Chronic Cervicitis be Prevented?

Chronic Cervicitis may be prevented by reducing the risk for developing acute cervicitis. This may be achieved by:

• Avoiding potential allergens and irritants such a douche, spermicidal creams, or cervical caps
• In general, leaving a foreign body or chemical within the cervix for prolonged periods must be avoided
• Practicing safe sex; avoiding sex with multiple partners
• Changing birth control forms: Switching from oral contraceptives to vaginal douches or spermicidal solutions, etc. may help
• Emptying the bladder after intercourse
• Maintain cleanliness and hygiene, especially before and after sexual activities
• Sexual partners may also have to be treated for infections
• Get Pap smears done regularly as recommended by the healthcare provider
• Immediate and adequate treatment of acute cervicitis

What is the Prognosis of Chronic Cervicitis? (Outcomes/Resolutions)

• Chronic Cervicitis usually subsides, if the source of inflammation is identified and treated appropriately. The prognosis is good, if the underlying condition can be treated adequately
• However, inadequate treatment, unprotected sex, or the use of known irritants and chemicals again, may cause the condition to recur

Additional and Relevant Useful Information for Chronic Cervicitis:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/sexual-health/

http://www.dovemed.com/healthy-living/womens-health/