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

• Chronic Follicular Cervicitis
• Chronic Lymphocytic Cervicitis
• Chronic Lymphofollicular Cervicitis

What is Follicular Cervicitis? (Definition/Background Information)

• Follicular Cervicitis (or Chronic Lymphofollicular Cervicitis) is the chronic inflammation of the cervix, which is the lower portion of the uterus. This condition occurs only in women
• The condition is caused by chlamydial infections that are transmitted sexually, in about two-thirds of the cases. In the remaining cases, the cause of Follicular Cervicitis generally remains unidentified
• In a majority of women, no signs and symptoms of Follicular Cervicitis are observed. In some women, there may be 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 or a tissue biopsy
• The treatment of Follicular Cervicitis depends on the cause of the condition. It is treated using antibiotics, when Chlamydia is the causative organism. The prognosis 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 Follicular Cervicitis? (Age and Sex Distribution)

• Follicular Cervicitis is only observed in females and may be observed in any age group
• However, the risk is higher in older and sexually-active women
• The condition is known to occur in all races, ethnic groups, and across all geographic regions

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

The risk factors for Follicular Cervicitis may include:

• Advancing age; older women are at a higher risk
• Past history of sexually-transmitted diseases
• Engaging in unprotected sex; sex with multiple partners

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 Follicular Cervicitis? (Etiology)

• Follicular Cervicitis is associated with chlamydial infections (caused by the bacterium Chlamydia trachomatis) in 50-67% of the cases
• In between 33-50% of the cases, the cause of the condition is unknown. Hence, Follicular Cervicitis is not always sexually transmitted

What are the Signs and Symptoms of Follicular Cervicitis?

In a majority of women, no signs and symptoms of Follicular Cervicitis is noted. In some women, the following may be observed:

• Swelling and redness of the cervix
• Some women can have abnormal vaginal discharge
• Itching in the genital area
• Increased frequency of urination
• 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 Follicular Cervicitis.

How is Follicular Cervicitis Diagnosed?

Follicular 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 of the area. 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 to detect the causative organism
• 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

Note: The pathologist may observe the presence of abundant lymphocytes on a tissue biopsy, which may cause a concern for a lymphoma.

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 Follicular Cervicitis?

The complications from Follicular Cervicitis could include:

• Spread of infection to the uterus, urinary bladder (cystitis), endometrium (endometritis), ovaries and fallopian tube leading to pelvic inflammatory disease (PID)
• If Follicular Cervicitis due to Chlamydia is not treated, then in about 33% of the women, it may result in endometritis; and in about 10% cases, inflammation of the fallopian tubes, or salpingitis, may occur
• Pelvic inflammatory disease can lead to infertility and ectopic pregnancy
• Increased susceptibility to HIV infection
• Women, who are pregnant, are at additional risk for complications, such as miscarriage and premature labor, if cervicitis is left untreated
• Pregnant women with Chronic Lymphofollicular Cervicitis caused by Chlamydia can cause chlamydial conjunctivitis in the newborn with signs and symptoms that include redness, inflammation, and tenderness of the eye; discharge of pus-like fluid; and inflammation of nasal mucous membranes. This can be a serious infection in the neonates
• Recurrence of the condition even after treatment; development of chronic cervicitis

How is Follicular Cervicitis Treated?

The treatment of Follicular Cervicitis may include:

• Treating chlamydial infections using antibiotic medication, after a diagnosis is confirmed
• Symptomatic treatment of the signs and symptoms, if the cause is unknown
• Avoiding sexual intercourse until the treatment is completed may be necessary; generally, treating the partner is also important

How can Follicular Cervicitis be Prevented?

Infectious cases of Follicular Cervicitis may be prevented by reducing the risk of sexually-transmitted diseases. This may be achieved by:

• Practicing safe sex; avoiding sex with multiple partners
• 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

It may not be possible to prevent Follicular Cervicitis, when the causative agent is unknown.

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

• Follicular Cervicitis usually subsides upon adequate treatment and the prognosis is good in a majority of women
• However, inadequate treatment or practicing unprotected sex may cause the condition to recur

Additional and Relevant Useful Information for Follicular 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/