Update: October 2018
In the structure of gynecological diseases, cervicitis takes far
not the last place. According to statistics, the disease is detected
70% of women who applied to the gynecologist. Most common cervicitis
diagnosed in women of childbearing age. And although this
the disease does not lead to the death of the patient, but may cause
significant damage to health due to the development of complications. 55%
patients are diagnosed with ectopia of the cervix on the background of chronic
cervicitis. Cervicitis rarely acts as a separate disease, as
правило, ему сопутствуют кольпиты и вульвовагиниты.
The cervix is the anatomical continuation of the lower
uterine segment. It is presented in the form of a tube up to 4 cm in length,
and its width is 2.5 cm. Only its part is visible outside (in the vagina).
– vaginal. The cervix is covered with epithelium, which gives it
pale pink color. The neck is the junction
vagina and uterine cavity that provides the cervical canal.
The cervix acts as an anatomical and biological barrier,
which prevents the penetration of infectious agents into the cavity
uterus, fallopian tubes and ovaries. Protection is provided by
the narrowness of the cervical canal, the mucous plug, which is located in it, and
secretion of protective secretion by the cervical glands. With воздействии
certain factors, the protective function of the cervix is impaired, in
the cervical canal penetrates an alien microflora and starts
inflammatory process – cervicitis.
Definition of concepts
If a воспаляется влагалищная часть шейки, говорят об
exocervicitis. TOогда воспаление развивается в эпителии шеечного
Canal – This is called endocervicitis.
You can often hear from a woman that she has found signs
cervicitis cervix. This is the wrong phrase, because
the word cervicitis refers to inflammation of the cervix, and
It turns out “oil oil”. Correct expression would be without any
дополнений, «cervicitis. “
Depending on the course of the disease, acute cervicitis and
chronic. Depending on the prevalence of cervicitis process
may be focal or diffuse. Also cervicitis can be
specific and non-specific, which is determined by the pathogen
Etiology of cervicitis
Cervicitis is caused by infectious causes, that is,
under certain conditions, the mucous membrane of the cervix and cervical canal
attacks pathogens, causing an inflammatory response.
The disease can cause as nonspecific microflora
(conditionally pathogenic microbes) and specific, which
Conditionally pathogenic microbes enter the neck through the blood and lymph
or from the rectum:
- E. coli;
- грибы рода TOандида;
- Klebsiella and others.
Specific infectious agents enter the body, causing
inflammation of the neck, only through sex:
- pale treponema (syphilis);
- miko – and ureaplasma;
- protozoal infections (amebiasis).
The inflammation of the cervical mucous is provoked by the following
- associated genital diseases (erosion and pseudo-erosion
cervix, colpitis, inflammation of the uterus or appendages);
- genital infections (chlamydia and mycoplasmosis, gonorrhea and
trichomoniasis, thrush, genital herpes, papillomavirus
person); most often (in 25%) neck inflammation occurs on the background
gonorrhea and trichomoniasis;
- non-specific vulvovaginitis, enterocolitis, sore throat and other
diseases caused by nonspecific microflora;
- prolapse of the genital organs (cervix, vagina);
- weakening of the immune defense;
- frequent change of sexual partners or promiscuous
- endocrine pathology (metabolic disease, diseases
thyroid, diabetes mellitus);
- ovarian dysfunction (the balance of sex hormones is disturbed, which
causes a disorder in the protective function of the cervix);
- hormonal changes in premenopausal and menopausal
period (reduction of estrogen leads to thinning and vulnerability
cervical mucosa – atrophic cervicitis);
- irrational use of local contraception (spermicides,
douching with acids);
- cervical injury (tears, cracks or abrasions) in
the process of childbirth, abortion,
diagnostic curettage or with the introduction / removal
- vaginal dysbacteriosis (bacterial vaginosis).
With цервиците симптомы обусловлены течением болезни (хроническое
or spicy). Symptoms may be pronounced or erased,
what depends on the causative agent of the disease. Expressed cervicitis
usually observed with gonococcal infection, and asymptomatic or
the erased course is characteristic of chlamydia. Inflammation is usually
arises first in the cervical canal (endocervicitis). As
disease progression (intensive secretion of mucus cervical
glands, loosening of underlying tissues), infectious agents
penetrate deep layers and affect the vaginal part of the neck. TO
this time in the cervical canal begins regeneration (healing),
which gives a false view of recovery. In fact
the inflammatory process “went” into the deep layers and became
Acute inflammation of the neck
Manifestations of the acute form of the disease are expressed significantly.
The patient is worried about purulent or abundant mucous whites,
vaginal itching and burning, which increase with urination.
May also cause pain when cervicitis. Usually it is stupid or
aching pain in lower abdomen, painful intercourse. Other symptoms
diseases caused by comorbidities. If a
inflammatory process of the cervix occurred against the background of cystitis,
worried about frequent and painful urination. With adnexitis and
inflammation in the cervix increases
temperatures from subfebrile (above 37) to febrile numbers (38 and
above). With a combination of pseudo-erosion and cervicitis,
spotting after coitus. Distinctive feature
disease is aggravation of all clinical symptoms after
Features of some cervicitis:
- Herpetic cervical disease
The neck has a bright red color, very loose, has foci
- Trichomonas cervical lesion
On the neck are determined (colposcopically) small
hemorrhage, which is called “strawberry cerviks”.
- Cervical lesions with actinomycetes
TOольпоскопически определяется признак «желтое зернистое
- Gonorrheal cervical disease
The reddened “crimson”, edematous neck with
loosened mucous membranes, which bleed easily on contact.
Purulent, copious, yellow or green discharges – “purulent
- Human papillomavirus infection
На шейке образуются кондиломы и участки ulcerations.
Chronic inflammation of the neck
A disease that was not adequate and timely treated in
acute stage, chronic. Signs of Chronic Cervicitis
less pronounced or practically absent. Allocations acquire
dull-slimy character, squamous epithelium of the vaginal part of the cervix
replaced by a cylindrical cervical canal formed
pseudo cervix. Inflammation (redness and
puffiness) are mild. When inflammation spreads to
surrounding tissue and deep down, the neck is compacted, it is possible to replace it again
cylindrical epithelium flat ectopia that is accompanied
nabot cyst formation and infiltrates.
Inflammation of the cervix during pregnancy
Cervicitis during pregnancy is rarely diagnosed. Since the treatment
diseases many women go through at the planning stage
of pregnancy. Acute inflammation of the neck матки, вызванное
specific microflora in the early stages can lead to
penetration of the infection into the uterine cavity, infection of fetal
shells and cause miscarriage or gross malformations
fetus. In the later stages, the inflammatory process in the neck can also
provoke anomalies of fetal development, intrauterine delay
fetal growth and hypotrophy, preterm labor and infectious
maternal complications in the postpartum period. TOроме того, при
passing a child through an infected birth can
contribute to the development of his infectious diseases.
Untreated, timely and adequate disease threatens
- the development of a chronic inflammatory process in the neck;
- ascending infection when the inflammatory process
spreads to the uterus and appendages, affects the peritoneum and urinary
bladder (in 10 patients out of 100 with chlamydial or gonorrheal
cervicitis is diagnosed with adnexitis, endometritis and
- the occurrence of Bartholinitis with specific inflammation of the neck
- inflammation of the appendages and the development of adhesive pelvic disease,
leading to infertility;
- malignant lesion of the cervix.
Most cases of the disease are detected either by planned
honey. examination, or when the patient turns to a gynecologist in another
about The doctor examines the neck in the mirrors and determines:
- swollen and hyperemic neck;
- eroded zones around the circumference of the external pharynx;
- copious purulent or mucopurulent discharge from the cervical
canal, in the chronic process of isolation scanty or moderate and
- petechiae (dot hemorrhages) on the mucous neck;
- in postmenopausal disease in addition to the thinned mucous neck
thinning of the mucous membranes of the external genitalia.
After a pelvic exam, a colposcopy is performed, which
allows you to identify structural changes in the neck, chronic
process and various complications of the disease (nabotovy cysts,
pseudo-erosion or erosion).
From laboratory research methods are applied:
- smear microscopy (vaginal, cervical and urethral)
to determine the microflora;
- study by PCR for detection of genital infections
(chlamydia, mycoplasma, cytomegalovirus, genital herpes virus,
Trichomonas and others);
- cytology smear from the cervix (definition of precancerous
processes or malignant degeneration);
- tank. seeding vaginal discharge for identification
- blood test for HIV and syphilis.
If a установлен хронический процесс, выполняется биопсия шейки в
first phase of the cycle. If necessary, appoint a pelvic ultrasound. With
concomitant cystitis is prescribed by OAM.
With цервиците и фоновых заболеваниях шейки матки назначается
comprehensive treatment that includes anti-inflammatory and
antimicrobial drugs, fortifying therapy,
physiotherapy, immunomodulating agents and drugs,
restoring the normal vaginal biocenosis. According to testimony
surgical treatment is carried out.
Antimicrobial and Antiviral Agents
The purpose of one or another group of drugs is determined
isolated pathogen and given its sensitivity to
antibiotic / antiviral drug.
- chlamydial cervical lesion – antibiotic treatment recommended
from a number of tetracyclines (doxycycline), quinolones (tarivid),
macrolides (erythromycin) and azalides (azithromycin);
- cervical fungal infection – antifungal agents are prescribed
drugs inside (flukostat) and place in the form of candles and vaginal
tablets (clotrimazole, isoconazole);
- treatment of atrophic cervicitis is performed by suppositories with hormones
- cervical lesion – the treatment is very time consuming and
prolonged, in the case of genital herpes prescribed
antiviral drugs (acyclovir and zovirax), immunomodulators
and multivitamins, as well as antiherpetic immunoglobulin;
- cervical lesion with specific microbes (gonococci,
Trichomonas) – treatment is prescribed to both sexual partners;
- cervical papillomavirus infection – appointed
Local therapy is prescribed for relieving acute events.
(prevention of ascending infection). Vagina and cervix
I process with 3% dimexide, silver nitrate solution or 2%
chlorophyllipt. Douching with a weak solution is also shown.
manganese, aqueous chlorhexidine, soda or boric acid.
Cervicitis remedies such as
vaginal suppositories and tablets (Betadine, Terzhinan),
which have antimicrobial and anti-inflammatory
To stimulate the immune system (especially in viral etiology
diseases) is recommended to receive immunomodulatory drugs
(Genferon, Izoprinozin). Vitamin intake shown
Restoration of vaginal microbiocenosis
It is carried out at the second stage of treatment, when acute
manifestations of the disease. Assigned (intravaginally) eubiotics
(bifidumbacterin, lactobacterin, acylact) course 10 – 14
From physiotherapy to the acute phase of the disease
UFO or UHF is assigned to the lower abdomen, in a course of 5 to 8 sessions. With
subacute and chronic course shows SMT, electrophoresis with
magnesium, vaginal laser therapy, intravaginal mud
Elimination of the chronic process
With хроническом цервиците, как правило, проводят хирургическое
treatment. Mandatory surgical treatment is carried out at
combination of the disease with another pathology of the cervix (ectropion,
pseudo-erosion). Surgical intervention is performed only after
prior anti-inflammatory treatment. From surgical
methods are applied:
- cryodestruction (freezing with liquid nitrogen);
- laser therapy;
- diathermocoagulation (cauterization by electric current);
- moxibustion apparatus Surgitron (radio wave treatment);
- photodynamic therapy.
After surgical treatment of the cervix is administered introduction
intravaginal anti-inflammatory suppository (Terzhinan, Polizhinaks)
and immunostimulating drugs (Genferon). Physiotherapy
held by an electrode inserted into the vagina (electrophoresis
At the same time, the treatment of comorbidities
(endometritis, adnexitis) to exclude relapses.
Treatment цервицита народными средствами применяется как
supplementary to drug or surgical therapy:
Oak bark decoction
A tablespoon of raw material pour half a liter of boiling water and boil for
low heat for 15 minutes. Broth is filtered and cooled.
to room temperature and use for douching (three times per
Pour 2 tablespoons of chamomile pharmaceutical 0.5 liter of boiling water
and insist for 20 minutes. Infusion strain, blot them
тампон и ввести во влагалище на 15 минут (не чаще трех раз в day).
Chamomile infusion is effective in the purulent form of the disease.
Pour 2 tablespoons of dry grass 2 cups of boiling water and
boil on low heat for 20 minutes. Decoction insist
thermos night, strain, dissolve half liter of warm boiled water
and douche 4 times a day.
The mixture of herbs №1
Mix the herb adonis, wormwood, thyme mint in equal parts.
Add 2 lobes of juniper berries and raspberry leaves. Pour 2
tablespoons of raw half a liter of boiling water. Leave insist
within an hour and strain. Consume 1/3 cup for
of the day
The mixture of herbs №2
Equally mix oak bark, cherry blossom and sagebrush. TO
mixes add 3 shares of hips and 2 shares of a strawberry leaf.
Two tablespoons of vegetable raw materials is poured with a liter of boiling water and
insisted night in a thermos. Drink an infusion of ½ cup three times a day
The mixture of herbs №3
Mix in two lobes of sage leaves, juniper fruits and
flower tansy. Add one lobe of eucalyptus leaves, herbs
yarrow and alder cones. Pour 2 столовые ложки смеси
a glass of boiling water, boil for a couple of 8 – 10 minutes. Insist
half an hour, strain. Consume three times a day for 1/3 cup.
The disease is easier to prevent than to treat. Prevention
inflammatory lesion of the cervix is:
- regular gynecological examination (every six months);
- colposcopy annually;
- preventing unwanted pregnancies and abortions;
- having a regular partner;
- condom use for casual sex;
- strengthening immunity (physical education classes, full
- prevention of genital prolapse (refusal to
тяжестей и тяжелой физической нагрузки, упражнения TOегеля);
- the appointment of hormone replacement therapy in menopause;
- timely and adequate treatment of urogenital infections
Вопрос: Можно ли забеременеть при цервиците?
Yes. By and large, the disease does not affect the process of conception.
Difficulties with conception may occur with concomitant diseases.
(inflammation of the fallopian tubes and ovaries, endometritis, background pathology
Вопрос: Проводится ли лечение заболевания во время
During the period of gestation, only local
conservative therapy. Treatment хронического процесса откладывается
for the postpartum period.
Вопрос: Запрещается ли при воспалении шейки
No, having sex with cervicitis is not contraindicated. Ban on
sexual activity is only imposed when sex is detected
infections and for the period of treatment and the postoperative period.
Вопрос: Можно ли установить спираль при частых
exacerbations of chronic cervicitis?
Не рекомендуется, так как внутриматочный TOонтрацептив усугубляет
inflammatory process, contributes to the development of ascending infection and
increases the frequency of exacerbations of the disease.
Вопрос: TOак лечить хронический цервицит?
Before starting treatment, you should consult with your doctor and go through
gynecological examination examination for infection. After
anti-inflammatory therapy gynecologist will choose the best method