Treatment of chronic cervicitis. Cervicitis in women - signs and features of treatment. Infusion of wormwood, oak bark, bird cherry flowers

The vast majority of women who seek help from a gynecologist suffer from inflammatory diseases of the reproductive system. Such diseases, not identified and not treated in time, pass into the chronic stage, periodically reminding of themselves with exacerbations.

It is extremely difficult to cope with this form of inflammation, therefore it is important to consult a doctor for help at the first signs of an acute process. The inflammatory reaction that occurs in the cervix is \u200b\u200bcalled cervicitis and is often the result of sexually transmitted infections (STIs).

Causes and classification

The cervix is \u200b\u200bthe narrowest part of it, it communicates with the vagina. The cervix has the shape of a cylinder and is pierced through by a narrow cervical canal, which is, as it were, a continuation of the uterine cavity. Normally, it is closed with a dense mucous plug that protects the overlying genitals from the penetration of microorganisms from the external environment into them. It is produced by the cells of the mucous layer of the cervical canal.

The structure of the female reproductive system

They are hormone-dependent, so the viscosity of mucus depends on the phase of the menstrual cycle. During ovulation, their secretion liquefies so that it is easier for sperm to penetrate from the vagina into the uterus. Accordingly, at the same time, the risk of infection of the overlying female genital organs also increases.

Under the mucous layer is the muscular layer - it is quite powerful, since during pregnancy it has the task of keeping the growing fetus in the uterine cavity. A dense serous membrane separates the cervix from other organs. Two parts are distinguished in the cervix:

• Ectocervix - it is seen by the gynecologist in the vagina when viewed in the mirrors. This is the outer part of the neck, it looks like a dense disc with a hole in the middle. Covered with flat non-keratinizing epithelium, the same as the walls of the vagina.
• Endocervix - This is a part invisible to the eye during normal examination, directly passing into the uterus. From the inside, it is lined with a secretory columnar epithelium, into which microorganisms can easily penetrate with various kinds of infections.

The inflammatory process can be localized in:

1. Exocervix - exocervicitis;
2. Endocervix - endocervicitis;
3. In both parts of the cervix - cervicitis.

Since the cervix and vagina are closely related to each other, cervicitis rarely develops in isolation. As a rule, it is a consequence, or and easily turns into - inflammation of the mucous layer of the uterus.

Due to the inflammatory process, there are:

• Nonspecific cervicitis - it is caused by opportunistic bacteria that live on the skin and in the rectum (Escherichia coli, staphylococci and streptococci) when they enter the female genital tract. In addition, it develops in conditions of insufficient production of estrogens during menopause, ovarian hypofunction.
• Specific - it occurs when exposed to STI pathogens, most often it is a genital virus, a yeast-like fungus. There is also tuberculous cervicitis of the cervix, if the Koch's bacillus enters it with the flow of blood or lymph from the foci of tuberculosis.

By the duration of the course, there are:

1. Acute cervicitis - lasts up to 2 weeks;
2. Subacute - from 2 weeks to 6 months;
3. Chronic - over half a year. It is characterized by periods of remission - the subsiding of the symptoms of the disease and exacerbation, when they re-gain strength. The causes of chronic cervicitis are usually chlamydia, myco- and ureaplasma, as well as hormonal imbalance.

In a healthy woman, the cervical canal is reliably protected from infectious agents, since its mucus contains lysozyme, immunoglobulins - substances destructive for them. The normal microflora of the vagina also plays an important role: it prevents the reproduction of pathogenic microbes, acidifying the environment. Cervicitis develops under the influence of provoking factors, which include:

• Childbirth, abortion;
• Invasive interventions (hysteroscopy, IVF);
• Infectious diseases;
• Exacerbation of chronic diseases;
• Hormonal disorders;
• Metabolic diseases;
• Injuries to the pelvis and female genital organs;
• Lack of personal hygiene.

All of them lead to local and general immune disorders and create a favorable situation for the introduction of the pathogen into the epithelium of the cervical canal.

What happens in the body

Microorganisms enter the cervix through:

1. Vagina - during unprotected intercourse or with insufficient hygienic care;
2. Blood or lymph - from foci of chronic inflammation that are found in any part of the body.

Having penetrated into the mucous membrane of the cervical canal, the pathogen begins to actively multiply, releasing the products of its vital activity into the surrounding tissues. The latter cause cell death and a reaction of the immune system, in connection with which an inflammatory process develops. At the site of introduction, stagnation of blood occurs, expansion of blood vessels and an increase in their permeability. Liquid plasma, together with immune cells, enters the tissues and forms edema - this is how the focus of inflammation is localized. If the first reaction is adequate, then the pathogen cannot spread beyond the mucous membrane and the inflammation is limited only to it. After that, the destruction of foreign microflora and its removal from the cervical canal along with mucus occurs, and the damaged tissues are gradually restored.

With an insufficient immune response or certain characteristics of the pathogen, inflammation becomes chronic. The microorganism remains in the body for a long time, as it is able to penetrate cells or escape from the immune response and the action of antibiotics in other ways. From time to time, it is activated, destroys tissues, causes inflammation. As a rule, exacerbations are of low intensity, but prolonged damage to the mucous membrane and deeper layers leads to excessive proliferation of connective tissue. As a result, the cavity of the cervical canal narrows, deforms, or mucous cysts form in its thickness. They appear when the connective tissue elements close the excretory duct of the cervical gland. The cells of the latter continue to produce mucus, which accumulates inside the cavity, gradually stretching it. The cyst grows in size and can significantly disrupt the anatomy of the cervix. A chronic focus of inflammation is fraught with another danger. Damage to epithelial cells sooner or later leads to their degeneration - dysplasia with subsequent malignancy.

Purulent cervicitis develops most often under the influence of nonspecific microflora - Escherichia coli, staphylococcus, proteus. They elicit a potent inflammatory response that involves neutrophils, a type of immune cell. Dead neutrophils and remnants of destroyed tissue form purulent detritus, which is secreted through the genital tract to the outside. This form of the disease usually proceeds with a violation of the general well-being and pronounced signs of intoxication, since the decay products are partially absorbed into the bloodstream and carried throughout the body.

Cervicitis during pregnancy is dangerous because it is fraught with intrauterine infection of the fetus and can cause miscarriage.

Symptoms

It is extremely rare that cervicitis develops separately, so its signs are usually combined with damage to the underlying parts of the genital tract. These include:

• in the external genital area, in the vagina;
• Redness and swelling of the labia;
• Unpleasant.

Symptoms of cervicitis of the cervix appear acutely, it is often possible to trace their relationship with the previous unprotected intercourse. A woman is worried about pulling, aching pains in the lower abdomen, fever, decreased appetite and general weakness. Discharge from the genital tract appears - from mucous membranes to yellow-green purulent, foul-smelling, sometimes frothy. With a pronounced inflammatory process, blood streaks can be observed in them. With fungal cervicitis, the discharge is cheesy, with a sour odor.

symptoms of cervicitis are redness of the cervix and discharge from the genital tract

In some cases, acute inflammation proceeds imperceptibly for a woman, with slight pain in the lower abdomen and discomfort during intercourse. In this case, there is a high risk of the infection becoming chronic. Outside of exacerbations, the disease does not manifest itself in anything, mucous or cloudy discharge from the vagina can only disturb. With a relapse, their volume increases, their character changes: color, smell, consistency. There is a slight aching pain in the suprapubic region, which intensifies during sex. A woman may not be aware of the presence of cervicitis for a long time until the serious consequences of the disease appear. Most often, exocervicitis is detected during a gynecological examination, and endocervicitis during examination for leucorrhoea, pain during intercourse, infertility.

Chronic atrophic cervicitis, which develops with insufficient production of estrogen, manifests itself gradually and is accompanied by other signs of hormonal imbalance. A woman is worried about dryness and itching in the vagina, deterioration in the quality of skin, hair, nails, and decreased libido. If the disease develops before menopause, then the leading symptoms are often menstrual irregularities and problems with conceiving a child.

Diagnostics

The diagnosis is established by a gynecologist based on the results of examination and additional research methods.
He collects anamnesis, examines complaints and symptoms. During the examination on the chair, the doctor sees foci of inflammation, punctate hemorrhages on the surface of the exocervix, an increase in its size due to edema, redness and edema of the walls of the vagina, external genital organs. Gynecologist takes from the surface of the cervix for further study under a microscope - cytology. The resulting material is also sown on nutrient media - the grown colonies of the pathogen make it possible to determine its type and sensitivity to antibiotics. Doctor if necessary measures the pH of vaginal discharge - its increase speaks of changes in its microflora.

Chronic cervicitis leads to the appearance of pathological foci on the cervix - they are detected when it is treated with an iodine solution. In this case, carry out colposcopy - study of the epithelium of the exocervix under high magnification in order to exclude malignant degeneration of its cells. For the diagnosis of chronic endocervicitis, curettage of the cervical canal is performed, followed by a study of the cellular composition of the material obtained. To exclude tumors of the female reproductive system, they are examined using ultrasound.

in the photo: a picture taken during colposcopy - an inflammatory process in the cervix

General clinical blood and urine tests are rarely performed, since changes in them are nonspecific or absent altogether. The biochemical composition of plasma also changes little. However, in the blood can be found specific to the causative agents of STIs - gonococcus, chlamydia, genital herpes virus. Such a diagnosis allows you not to wait for results to select the most effective therapy.

Treatment

As a rule, the treatment of cervicitis is performed on an outpatient basis, unless surgery is required. The main goal of therapy is to eliminate the pathogen and provoking factors of the disease. When identifying the causative agents of STIs, cervicitis must be treated with both partners, and for the duration of therapy, they are shown abstinence from sexual intercourse or the use of condoms.

The gynecologist selects drugs, taking into account the causative agent of the disease:

1. When non-specific microflora use broad-spectrum antibiotics, often combine two drugs (amoxiclav, ciprofloxacin), prescribe them inside in the form of tablets;
2. When fungal infection use vaginal suppositories with nystatin (fluconazole);
3. Herpesvirus infection are treated with acyclovir inside;
4. Atrophic cervicitis requires the appointment of hormone replacement therapy.

Additionally, drugs are prescribed that improve the immune response - polygynax, lycopid, thymalin. Patients are shown taking multivitamins, good nutrition, therapeutic exercises and physiotherapy.

It is most difficult to treat the disease during pregnancy, since most medications are contraindicated during this period of life. As a rule, the place of a candle with an antiseptic is prescribed - a geksikon.

Folk remedies for cervicitis should be used as an addition to the main therapy. You can irrigate the vagina with an infusion of chamomile, calendula, oak bark, and do sitz baths with the same herbs.

Surgical treatment of cervicitis is required with significant scar changes in the cervical canal or the formation of cysts in it. After the treatment, the woman is observed by a gynecologist at the place of residence, since there is a possibility of a relapse of the disease.

Video: G.R. Bayramova "Cervicitis and vulvovaginitis"

Diseases of the female reproductive system can hardly be considered a rarity. And quite often in modern gynecology, cervicitis is found. Treatment of this disease is, of course, possible. The sooner therapy is started, the faster recovery will occur, and the risk of complications will be minimized.

That is why today many women are interested in questions about what this disease is. What are the symptoms of cervicitis? How is it diagnosed? What are the complications of the disease? Are there effective treatments? The answers to these questions will be of interest to many of the fair sex.

What is cervicitis?

Diseases of the cervix are a common problem. Every year, thousands and even tens of thousands of women face similar ailments. And quite often, patients who come for a scheduled gynecological examination are diagnosed with cervicitis.

It is an inflammatory disease that affects the lining of the cervix (cervical canal). It's no secret that the cervix is \u200b\u200ba kind of barrier that protects the internal genital organs (uterus, ovaries) from infection. That is why its inflammation is a threat to the entire reproductive system.

According to statistics, cervicitis is most often diagnosed in women of childbearing age (in about 70% of cases). Much less often, inflammation develops in adolescent girls or women during menopause.

The main causes of occurrence

Today, many women are interested in questions about why cervicitis develops. After all, treatment directly depends on the source of the disease. Inflammation in this case develops under the influence of infection, which can be both specific and nonspecific.

Quite often, cervicitis develops when sexually transmitted bacteria enter the mucous membrane. Trichomonas, chlamydia, gonococcus, mycoplasma can act as a causative agent.

On the other hand, non-specific inflammation caused by increased activity of staphylococci, streptococci, Escherichia coli and other habitual “inhabitants” of the human body is diagnosed no less often. Such a phenomenon is usually considered the result of a sharp local or general decrease in immune defense.

Are there any risk groups?

It should be noted that in some women gynecological diseases, in particular, cervicitis, are diagnosed much more often, which is associated with the influence of certain factors of the internal or external environment.

For example, susceptibility to various kinds of infections increases with certain injuries of the cervix. First of all, such a disease occurs as a complication after childbirth, abortion, diagnostic curettage, etc. Risk factors include the use of certain methods of contraception. In particular, it is possible to damage the mucous membrane when installing or removing an intrauterine device, as well as with frequent use of chemical contraceptives or douching with acids.

On the other hand, cervicitis in most cases develops against the background of other diseases. For example, inflammation of the mucous membrane of the cervix is \u200b\u200boften diagnosed in women with ecropion, prolapse of the pelvic organs, as well as with vulvitis, bartholinitis and vaginitis.

Risk factors include hormonal imbalance, which often leads to a gradual thinning of the mucous membrane, making it more susceptible to the effects of pathogenic microorganisms. And, of course, do not forget about the state of the immune system, since the weakening of the body's defense contributes to the activation of conditionally pathogenic microflora.

Improper use of tampons, non-observance of personal hygiene rules, etc. also negatively affect the state of the reproductive system.

What are the symptoms of the disease?

Quite often, the first stages of the disease proceed unnoticed by a woman. In rare cases, the disease manifests itself as uncharacteristic discharge, especially if the patient has purulent cervicitis. The discharge is of a different nature depending on the pathogen, for example, it can be green, gray, yellow or whitish. It is very difficult to independently determine whether they are vaginal or are formed in the cervical region - this can only be done by a doctor during an examination.

Some forms of the disease (mainly acute purulent cervicitis) are accompanied by quite noticeable pain in the lower abdomen. Sometimes patients complain of a burning sensation in the vagina, as well as the presence of itching in the external genital area. There are other signs of cervicitis. In some women, pain occurs immediately during intercourse or after it ends and is accompanied by bloody discharge.

It is worth considering the fact that the inflammatory process in the cervical canal is often associated with other diseases of the genitourinary system. For example, with cervicitis complicated by cystitis, frequent painful urination is also observed. An extensive inflammatory process can be accompanied by an increase in temperature and symptoms of general intoxication - weakness, dizziness, drowsiness and chills.

Chronic cervicitis: symptoms

Since the initial stages of the development of the disease often go unnoticed, the chronic form of inflammation can hardly be considered a rarity. The clinical picture in this case is blurred - the symptoms remain the same as in acute cervicitis, but less intense.

For example, patients continue to have cloudy discharge, but they are not too profuse, so they rarely cause concern. From time to time, there is itching and burning in the external genital area. Dull pains often occur in the lower abdomen.

Treatment of chronic cervicitis is a long process. However, therapy is necessary, as the constantly progressive inflammation weakens the body and leads to a host of complications, including infertility.

Basic diagnostic methods

Since the symptoms of the disease are most often not very pronounced, cervicitis is discovered by chance during a routine gynecological examination or consultation for other diseases. The first step in the diagnosis is a standard mirror examination procedure. After that, as a rule, a colposcopy is performed - with the help of a special mechanism equipped with binocular optics, the doctor carefully examines the cervix. During the procedure, the gynecologist may notice significant changes. For example, such an examination allows you to notice redness and hyperemia of tissues, swelling of the mucous membrane of the cervix, an accumulation of purulent masses, the formation of characteristic vascular loops. In addition, the doctor will determine the nature of the inflammatory process - it can be diffuse or focal.

Naturally, further laboratory tests are prescribed. For example, microscopic examination of a smear can provide useful information. In the acute form of the disease, the samples show an increased number of leukocytes, as well as altered squamous epithelial cells, columnar epithelium with markedly hypertrophied nuclei. Chronic cervicitis is accompanied by other signs - during microscopic examination, one can notice the presence of cells of columnar epithelium of different sizes, sometimes with traces of destruction.

Bacteriological inoculation of samples is necessary. Such a procedure makes it possible to accurately determine the type of infection, as well as the sensitivity of bacteria to one or another antibiotic.

In the future, PCR studies can be carried out, which are indispensable for determining some types of infection. In particular, the causative agents of mycoplasmosis, gonorrhea, chlamydia, as well as some viruses (herpes, papilomatosis) can only be detected in this way.

Additionally, blood and urine tests, as well as ultrasound examination of the pelvic organs, are prescribed, especially if there is a suspicion of inflammation of the uterine appendages, adhesions and other complications.

Are complications possible?

Of course, such a disease in the absence of timely treatment can lead to a lot of complications. For example, often an acute form of the disease develops into chronic cervicitis of the cervix, which is much more difficult to treat.

According to statistics, in about 10% of cases, the infection spreads higher, affecting other organs of the reproductive system and small pelvis, including the uterus, ovaries, bladder, peritoneum, etc.

In some cases, cervicitis leads to the development of adhesions in the abdominal cavity and small pelvis, which, in turn, can cause infertility. Studies have also demonstrated that inflammation of the tissues of the cervical canal increases the risk of malignant degeneration of tissues in patients infected with the oncogenic papillomavirus.

Cervicitis: conservative treatment

It should be noted right away that therapy in this case is selected individually, since it depends on the causes of the development of the disease, as well as on the type of pathogen and the patient's health status. For example, antibiotic treatment of cervicitis is appropriate only if pathogenic bacteria act as the causative agent. In this case, the choice of the drug depends on the type of bacteria. Chlamydial cervicitis is treated with macrolides and tetracycline antibiotics. If the cause of inflammation is fungal microorganisms, then therapy includes antifungal agents, for example, "Flucostat", "Diflucan".

In acute stages, the use of topical preparations (ointments, douching solutions, etc.) is not recommended, as this can provoke the spread of infection to the internal genital organs. But as the main symptoms disappear, doctors prescribe various antibacterial and antiseptic medications. For example, patients are treated with the treatment of the vagina and cervix with a solution of silver nitrate or "Dimexid". Do not forget that antibiotics affect not only pathogenic, but also beneficial microflora. To restore it, you need to take drugs containing live strains of beneficial bacteria.

Viral cervicitis requires a completely different therapy. How to treat this form of the disease? Patients are prescribed antiviral and immunomodulatory drugs. But therapy in this case lasts much longer.

If the cause of the infection is hormonal imbalance, women are prescribed hormonal medications that can stop the process of further atrophy of the mucous membranes.

In cases where the cause of the inflammatory process is a specific infection, both sexual partners must undergo treatment, since the likelihood of re-infection is high. Gynecological diseases can be extremely dangerous. Therefore, in this case, you should not ignore the doctor's recommendations or self-medicate.

Cervicitis: surgical treatment

Drug therapy can not always solve the problem. For example, conservative treatment of chronic cervicitis quite often turns out to be simply ineffective. The indication for surgical intervention is the presence of erosions on the tissues of the cervix.

The appropriate procedure is selected individually. So what kind of therapy does chronic cervicitis require? How to treat such a disease? In most cases, patients are freezing the affected areas with liquid nitrogen. Methods of laser surgery are considered quite effective. Sometimes electrosurgical treatment is used to eliminate areas of erosion and chronic inflammation using a special device "Surgitron".

This is how cervicitis is treated today. Patient reviews indicate that the rehabilitation period is fast and is not accompanied by so much discomfort. By the way, after the operation, women are prescribed anti-inflammatory and immunomodulatory medications that help prevent the development of complications.

Basic preventive measures

Unfortunately, cervicitis in women is quite common. And since the disease often turns into a chronic form and entails a lot of complications, gynecologists recommend that every woman follow some preventive measures.

Naturally, first of all it is worth trying to prevent the ingress and development of infection in the genital tissues. That is why you should not lead a promiscuous sex life and be sure to protect yourself with condoms when in contact with an unverified person. Since the infection can be nonspecific, it is imperative to strengthen the immune system. Hormone therapy is prescribed for women during menopause, if necessary, which also prevents a number of complications.

Do not forget about the timely treatment of various infectious diseases of the genitourinary system. It is necessary to regularly undergo scheduled gynecological examinations (twice a year), because the earlier the disease is detected, the easier the treatment will be. Kegel exercises, which prevent the prolapse of the pelvic organs, will have a positive effect on health.

Cervicitis -this is an inflammation of the tissues of the vaginal part of the cervix.

The main function of the mucous membrane of the cervix is \u200b\u200bto protect the uterine cavity from pathogenic microorganisms. Cervical mucus consists of immunoglobulins, enzymes and various substances that have antibacterial effects. The cervix and cervical mucus are a natural filter that protects a woman from adverse environmental conditions. The main reasons for the development of cervicitis include:

• sexually transmitted infections;
• violation of the microflora of the vagina;
• various injuries of the cervical canal, for example, during childbirth, installation of uterine contraceptives, artificial termination of pregnancy;
• chemical burns of the cervix during douching;
• hormonal disorders.

Predisposing factors of the disease include earlier onset of sexual activity, promiscuous sexual relations, early childbirth (up to 18 years of age), allergic reactions to latex or condom components, the use of hormonal drugs, and smoking.

Cervicitis rarely occurs in isolation, most often it is accompanied by other diseases of the genital organs, for example, vulvitis, bartholinitis, vaginitis, ectropion, etc.

There are 2 forms of cervicitis:

• specific, which is caused by pathogenic microflora (gonococcus, mycoplasma, Trichomonas, chlamydia);
• nonspecific - caused by opportunistic microflora, which, under certain conditions, leads to the development of cervicitis (streptococci, staphylococci, Escherichia coli, enterococci, fungi of the genus Candida, and others).

Depending on the localization of inflammation, exocervicitis and endocervicitis are isolated. Exocervicitis means inflammation of the vaginal segment of the cervix, while endocervicitis means inflammation of the cervical canal of the cervix.

By the nature of the course, cervicitis is divided into:

• acute. In this case, the inflammatory process lasts less than 6 weeks;
• chronic, which proceeds with periodic exacerbations of the process.

With timely referral to a specialist, the prognosis of the disease is favorable. In case of late seeking help from a doctor or insufficient treatment, acute cervicitis can become chronic, which has certain consequences. In addition, cervicitis may result in polyps and erosion of the cervix, inflammation of the upper genital tract. That is why it is recommended to immediately contact a medical institution when the first symptoms of the disease appear, and also to undergo preventive gynecological examinations annually.

Symptoms

Acute cervicitis is manifested by the appearance of abundant discharge from the genital tract of a mucous or mucopurulent nature. In addition, pain syndrome may be present in the clinic of the disease. However, dull pain in the lower abdomen is not a permanent sign of the disease, that is, acute cervicitis can occur without pain.

Chronic cervicitis is characterized by an erased clinical picture. In the chronic form of the disease, there are periodic pains in the lower abdomen, mainly of an aching nature, as well as cloudy mucous discharge from the genital tract.

Depending on the type of causative agent of cervicitis, the clinical picture of the disease may vary slightly. So, for example, cervicitis, caused by a gonorrheal infection, proceeds acutely and rapidly, the symptoms are pronounced, often with pain. With chlamydial infection, the symptoms of the disease are less pronounced, which is why the patients do not seek help from a specialist for a long time.

Diagnostics

A gynecologist can diagnose cervicitis not only when a patient comes with characteristic complaints, but also during a routine examination, when the patient was not bothered by anything.

The examination begins with an examination of the cervix using a gynecological speculum. Depending on the causative agent of the disease, the cervix looks like this:

• with cervicitis of gonorrheal etiology, the vaginal part of the cervix has a bright red color, it is edematous, loose, with areas of ulceration (a symptom of "continuous erosion");
• with cervicitis caused by Trichomonas, the cervix is \u200b\u200bhyperemic, edematous, loose, small hemorrhages are detected ("strawberry cervix");
• with chlamydial infection, which can also cause the development of cervicitis, the mucous membrane of the vaginal part of the cervix is \u200b\u200bslightly hyperemic, edematous.

Next, colposcopy is performed - a diagnostic method that allows you to assess the condition of the mucous membrane of the vaginal part of the cervix using a special optical device (colposcope). In the course of this study, the nature of the pathological changes in the cervix is \u200b\u200bclarified. In addition, colposcopy allows you to determine the location of the pathological focus, which is necessary for targeted biopsy of the cervix. There are 2 types of colposcopy:

1. Simple colposcopy, during which the cervix is \u200b\u200bexamined with a colposcope, without any medical tests.
2. Extended colposcopy, in which the mucous membrane of the cervix is \u200b\u200bpretreated with a 3% solution of acetic acid (or 0.5% salicylic acid) and an aqueous solution of Lugol (the so-called Schiller test), after which the cervix is \u200b\u200bexamined using a colposcope ...

The procedure is absolutely painless and does not require preliminary preparation on the part of the patient. It is believed that colposcopy must be performed only if any changes in the mucous membrane of the cervix are detected during examination using a gynecological mirror. However, at present, it is recommended to perform this study for women who are sexually active at least once a year for prophylactic purposes.

Next, a smear is taken from the cervical canal, which is sent for microscopic and bacteriological examination. Microscopic examination allows us to determine the number and ratio of normal, pathogenic and opportunistic microorganisms, as well as cellular elements, which allows us to conclude about the presence of an inflammatory process, the degree of its severity and the nature of the microflora that populates the vaginal part of the cervix. In acute cervicitis, a large number of leukocytes (30 or more), lymphocytes and pathogenic microorganisms are found. Bacteriological research allows you to identify the type of pathogen that caused the development of cervicitis, as well as to determine the sensitivity of the microorganism to the spectrum of antibiotics, which will help in choosing a specific antibiotic for treatment. It is far from always possible to identify the causative agent of the disease with the help of bacteriological examination of a smear; in such cases, PCR diagnostics is performed. This is, of course, a fairly powerful and effective modern diagnostic method that allows you to quickly and accurately determine the causative agent of an infectious disease. It is also worth noting that PCR diagnostics has high specificity and sensitivity. Due to the numerous advantages of this diagnostic method, an existing disease in a person can be detected even at the stage of the incubation period, when there are no clinical and laboratory signs of the disease.

Treatment

Treatment of cervicitis is aimed at eliminating the cause and predisposing factors for the onset of the disease. For this, antibacterial, antiviral or pro-fungal drugs are prescribed, depending on the causative agent of the disease.

Local treatment is carried out only after the acute process of the disease subsides. It includes douching, the introduction of vaginal creams, suppositories, treatment of the cervix with a 3% solution of dimethyl sulfoxide, a solution of silver nitrate. It is important to emphasize that the use of local therapy in the acute period of cervicitis is strictly prohibited due to the risk of developing an ascending infection.

Physiotherapeutic treatment is also used, which is prescribed after stopping the acute period of the disease. For example, vaginal laser therapy, magnetotherapy, darsonvalization, and the like can be used.

Chronic cervicitis responds poorly to drug treatment. Therefore, the following surgical options are used:

• diathermocoagulation is a method of treatment, the action of which is to burn tissues with high-frequency current;
• cryotherapy is a method of treatment based on exposure to cold tissue;
• laser therapy is a method of treatment based on exposure of tissues to a concentrated beam of light.

Preventive measures aimed at preventing the development of cervicitis include following the rules of personal hygiene, avoiding sexually transmitted infections, their timely treatment, and treatment of endocrine disorders. An important condition for preventing cervicitis is the timely treatment of thrush.

Medicines

The appointment of antibacterial drugs is necessary for the bacterial etiology of cervicitis. The following groups of antibiotics are used:

1. Tetracyclines. One of the representatives of this group of antibacterial agents is doxycycline, which is active against both gram-positive and gram-negative microorganisms. Contraindicated in children under 8 years of age, pregnant and breastfeeding women, people with hepatic insufficiency, as well as with myasthenia gravis (in the case of intravenous administration of the drug).
2. Macrolides. The most common macrolide is azithromycin. This antibiotic has a wide spectrum of antibacterial action, which makes it possible to use it in case of damage to various gram-negative and gram-positive microorganisms. The mechanism of action of the drug is to slow down the growth and reproduction of bacteria. Azithromycin is well tolerated, side effects rarely occur while taking the drug, it is contraindicated only if the patient has an allergic reaction to any of the components of the drug, pregnancy and lactation, as well as children under 12 years of age.
3. Fluoroquinolones:
   • moxifloxacin. Possesses bactericidal action, covering a wide range of microorganisms. The drug is well tolerated among representatives of different ages. If necessary, it is allowed to prescribe to pregnant women, since during the study on animals, no teratogenic effect was detected, which means the occurrence of malformations due to the use of the drug. It is worth refraining from using children under 18 years of age, since clinical trials of the drug have not been carried out, indicating the safety of using moxifloxacin in childhood;
   • levofloxacin. The drug has a bactericidal effect, is active against both gram-negative and gram-positive microorganisms. Levofloxacin is well tolerated, the following side reactions rarely occur: nausea, diarrhea, discomfort in the epigastric region (upper abdomen), muscle weakness.

Antiviral drugs are used, for example, for herpes infection. In this case, acyclovir is often prescribed. The dosage of the drug and the frequency of administration is determined by the attending physician, based on the severity of the process and the severity of clinical manifestations. Adverse reactions while taking the drug are rare. Most often, you can face abdominal discomfort, nausea, vomiting, diarrhea, headache. Detection of an allergic reaction is an indication for discontinuation of the drug. While taking acyclovir, it is recommended to monitor kidney function, that is, to monitor changes in the biochemical blood test of such indicators as creatinine and urea.

In case of detection of candidal cervicitis, antifungal drugs are prescribed. The most common drug in this group is fluconazole. The tolerance of this drug is very good, side effects are extremely rare. Of the side reactions, the most common are abdominal pain, nausea, flatulence, dryness of the oral mucosa, upset stool in the form of constipation.

Folk remedies

Cervicitis should be treated by a specialist in the field of medicine. Self-medication at home is not encouraged, since the lack of timely qualified treatment of acute cervicitis can lead to a chronic course of the process.

As you know, in some cases, cervicitis has an erased clinical picture, which is why a woman does not seek timely help from a specialist. To avoid such situations, it is recommended not to forget about preventive examinations by a gynecologist, which should be carried out at least 2 times a year. In addition, it is important to follow the rules of personal hygiene in order to eliminate the appearance of favorable conditions for infection. The number of sexual partners in a woman plays an important role in the possibility of developing cervicitis. Therefore, you should limit the number of sexual partners, as well as exclude casual sex. To prevent the occurrence of a sexually transmitted infection, it is necessary to use a barrier method of contraception (condom) during intercourse. In case of neglect of this method of protection, it is strongly recommended to be screened for the presence of sexually transmitted diseases, especially if there is no permanent sexual partner. In addition, it is necessary to promptly treat infectious and inflammatory diseases of the internal genital organs, as well as prevent oneself from provoking factors leading to an exacerbation of chronic diseases. To do this, you should avoid hypothermia, various injuries, psycho-emotional stress. It is also important to take care of your diet, special attention should be paid to the use of vegetables and fruits that are rich in various vitamins and minerals, dairy products, cereals. Particular attention is paid to the regime of sleep and rest, the observance of which helps to strengthen the general condition of the body.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, see your doctor.

Inflammation of the cervix, or chronic cervicitis, is a serious disease of the female genital organs that can be complicated by erosion, dysplasia or cancer of the cervix and lead to impaired female fertility or its complete destruction.

The cause of cervical inflammation is the presence of an infection in the cervix, which can occur through unprotected intercourse or poor personal hygiene. Cervicitis is always accompanied by another inflammatory disease - colpitis, that is, inflammation of the vagina. The causative agents can be bacteria, viruses or fungi and protozoa (chlamydia). Inflammation of the cervix is \u200b\u200boften one of the manifestations of sexually transmitted diseases.

Promiscuous sex life, neglect of personal hygiene, hypothermia of the groin area, colds, the presence of chronic diseases and foci of infection in the body contribute to the occurrence of colpitis and cervicitis.

Along the course, cervicitis is classified as acute and chronic. Acute cervicitis often occurs after unprotected intercourse with a partner suffering from sexually transmitted diseases or, less often, when an infection is brought in from another focus with blood flow. If acute cervicitis is not cured in time, then the disease can turn into chronic, with a constant alternation of exacerbations and remissions and a very high risk of complications from the reproductive system. So it is imperative to treat acute cervicitis.

Endo- and exocervicitis is isolated on the affected area. Endocervicitis affects only the mucous membrane of the cervix (endocervix), and exocervicitis also affects the deeper layers, which significantly increases the risk of complications.

Symptomatic manifestations

Chronic cervicitis is a disease that can be asymptomatic for a long time, and a woman will consider herself perfectly healthy. Its first symptoms may appear several months or years after infection. As a rule, cervicitis is manifested by pulling pains in the lower abdomen, soreness during intercourse, and after it - smearing discharge of a dark color or bloody.

Yellowish mucous or yellowish-green purulent discharge from the vagina appears, they can be scanty or profuse, usually do not depend on the menstrual cycle. Since the symptoms are not pronounced, a woman may consider them a normal feature of her body and not take any measures to treat them. Cervicitis can be accompanied by cystitis, with it there are violations of urination, which usually makes a woman see a doctor. Chronic cervicitis and colpitis are usually identified on examination due to cystitis.

Effects on pregnancy

During pregnancy, the cervix acts as a barrier - it is tightly closed and does not allow infections to enter the uterus. But with inflammation, its barrier function is disrupted, in addition, it can itself become a source of infection. The opening of the cervix is \u200b\u200balso a signal for the beginning of labor, but if, due to inflammation, it cannot close tightly, this also leads to a disruption in the course of pregnancy.

With untreated chronic cervicitis during pregnancy, there is a high risk of intrauterine infection of the fetus with various infections, congenital fetal abnormalities, early and late miscarriages, premature birth and recurrent miscarriage. Therefore, a woman planning a pregnancy must be examined for the presence of cervicitis, and if it is detected, cure it before she becomes pregnant.

Possible complications

In chronic cervicitis, especially if it occurs in the form of exocervicitis, there is always a risk of ascending infection, with damage to the uterus and fallopian tubes.

Endometritis (inflammation of the lining of the uterus) disrupts the cyclical processes in the endometrium that underlie the menstrual cycle. At the same time, the amount and nature of discharge during menstruation may change, and soreness may appear before and during menstruation. More dangerous signs of endometritis appear only during pregnancy - this is a violation of the formation of the placenta and, as a consequence, the inability to become pregnant, the threat of termination of pregnancy and early miscarriages, habitual miscarriage. Endometritis can lead to congenital diseases and malformations in the fetus due to the malformed placenta.

Salpingitis is an inflammation of the fallopian tubes that can lead to the formation of adhesions in them. Adhesions prevent the passage of the egg, both fertilized and unfertilized, from the ovary into the uterus. If adhesions have formed in the initial section of the tube, then the egg cannot meet with the sperm, and adhesive obstruction of the fallopian tubes becomes the cause of infertility, and if fertilization does occur, but due to adhesions of the zygote cannot enter the uterus, an ectopic pregnancy is formed, which threatens death for a woman.

More rare diseases to which an ascending infection of the female genital tract can occur are oophoritis and peritonitis. Oophoritis - inflammation of the ovary, accompanied by a violation of the menstrual cycle, coarsening of the voice, the appearance of excessive hair growth, decreased sex drive, infertility. Peritonitis is an inflammation of the peritoneum with a high probability of death. Due to the structural features of the female body, the peritoneal cavity communicates with the fallopian tubes, so infections of the female genital organs can have quite serious consequences not only for a woman's reproductive health, but also for her life.

Diagnostic measures

Since the symptoms of the disease are rather blurred, an accurate diagnosis can be made clinically, i.e. based on the patient's complaints, it is impossible and necessary laboratory and instrumental research methods (after all, perhaps this is acute cervicitis).

The very first of these is a gynecological examination, which every woman must undergo annually. With a digital examination, soreness will be felt, when examined in the mirrors, the cervix is \u200b\u200bswollen, possibly redness. When pulling on the mucous probe, pain occurs, depending on the severity of the process - sharp or pulling. If the doctor notices signs of inflammation, vaginal and cervical swabs should be taken to determine the causative agent of the infection, and a biopsy should be taken to look for possible signs of dysplasia or cervical cancer.

Colposcopy is an examination of the vagina and cervix using a special magnifying device. This allows you to see micro-erosion and other signs of inflammation that are invisible to the naked eye. It is carried out if, upon examination, in the mirrors, unambiguous signs of inflammation of the cervix are not found, but there are symptoms and signs of colpitis or endometritis.

The bacteriological analysis of the smear determines the presence in the cervix of any of the types of microorganisms that could cause the disease. If necessary, an antibiotic susceptibility test is performed to decide which drug will be more effective for treating chronic cervicitis. In addition, vaginal and urethral discharge is cultured.

PCR is performed if there is a suspicion of the viral nature of the disease. This analysis allows you to determine the type and number of pathogens in the tissues of the cervix and suggest which of them is most likely the causative agent of the disease. Another method that allows you to identify some sexually transmitted diseases is RIF (immunofluorescence reaction).

A biopsy of the cervical tissue is necessary in order to timely identify signs of cervical dysplasia (precancerous condition), which can lead to a prolonged course of the inflammatory process.

An ultrasound of the pelvic organs is prescribed in order to detect signs of inflammation in neighboring organs, as well as to see adhesions if they have formed.

All patients who are examined for chronic cervicitis are tested for HIV and hepatitis B and C, as these diseases can be sexually transmitted and turn out to be an extremely unpleasant “attachment” to cervicitis.

Curative tactics

Perhaps medical and surgical treatment of chronic cervicitis. First of all, it is necessary to eliminate the cause of the inflammation, that is, its causative agent. After its type and sensitivity to drugs is determined, a course of treatment is prescribed. If antibiotics are needed, then it is worth remembering to take them for at least five days. If necessary, a longer admission is possible, but in no case should the course of treatment be shortened - this will lead to the fact that the microflora will lose sensitivity to the prescribed drug. If the patient's condition is very serious, there is purulent discharge from the vagina, suggesting the bacterial nature of the inflammation, and the test results are not yet ready, then empirical antibiotic therapy is prescribed - drugs of the widest spectrum of action are used. After receiving the result of bacteriological analysis, it is possible to replace the drug.

With viral cervicitis, Acyclovir, Podofilin and other antiviral drugs are prescribed. Also, in this case, immunomodulatory and immunostimulating drugs are required, because the activity of the virus is often associated with insufficient function of the immune system.

Antifungal drugs for fungal infection of the cervix in no case can be combined with antibiotics or hormonal drugs - this will cause an even greater increase in the growth of the fungus.

Pathogenetic therapy is aimed at eliminating inflammation and involves the appointment of non-steroidal and hormonal anti-inflammatory drugs in the form of tablets, vaginal suppositories, and in severe cases, intravenous injections. Vaginal suppositories with drugs that allow restoring the normal microflora of the vagina also occupy a very important place, because the normal microflora displaces the disease-causing one and does not allow it to develop. Immunomodulators and immunostimulants are especially important for viral and fungal infections of the cervix - they restore the activity of the immune system so that it can effectively fight the pathogen.

For severe pain, pain relievers are prescribed, douching with solutions of various antiseptic and soothing herbs. They allow you to remove the manifestations of the disease and restore good health.

Surgical treatment is the use of liquid nitrogen and a surgical laser to remove cervical erosions. After its application, the endocervix recovers on its own in a few days. There is no pain or other discomfort. After such an operation, it is advisable to abstain from sexual activity for a week in order to avoid damage to the tissues of the cervix.

Necessary prevention

First of all, the prevention of infection - the use of a condom during sex, loyalty to your sexual partner, personal hygiene, timely treatment of foci of infection and gynecological diseases.

In addition, it is important to undergo regular examinations by a gynecologist, and if unpleasant symptoms appear during and after intercourse, consult a doctor. It is necessary to treat diseases of the genitourinary system, such as cystitis, on time, and it is not necessary to use folk remedies, but be sure to be treated with antibiotics in order to eliminate the focus of infection.

The penetration of infection is also possible during abortion, since during this manipulation and for some time after it, the cervical canal gapes and becomes an entrance gate for infection. For this reason, it is necessary to carefully choose effective methods of contraception so that pregnancy is only desired and not accompanied by illness.

Untreated acute inflammation of the cervix (CM) often leads to a chronic stage of the pathology. For this reason, changes occur in the body, which are the starting conditions for many undesirable phenomena.

It is chronic cervicitis that is dangerous due to the absence of symptoms, an imperceptible expansion of the inflammatory process to muscle and connective tissues. As a result, a woman may develop cysts, seals, infiltrates and a relapse of the acute form against the background of a sluggish one.

Signs of a chronic stage

Symptoms of the chronic stage can be mild and it is important to recognize them, pay attention to them and, therefore, see a doctor. Signs depend on the cause that caused the acute stage even earlier. If these are infections from the group of sexually transmitted infections, they manifest themselves as symptoms that can be noticed:

- increased discharge (white, purulent, cheesy)

- discomfort, burning sensation when urinating, itching

- mild pain in the projection area of \u200b\u200bthe cervix (in the pubic region).

Consequences of a sluggish state

A dangerous consequence of the chronic stage is the thickening of the epithelium of the cervix. As a result, hypertrophy develops, which becomes the cause of the subsequent stages of cell change. If there is a pregnancy, pathology leads to the following consequences:

- fetal infection

- spontaneous abortion

- postpartum complications.

Secondary states of the chronic process

The long course of chronic inflammation of the cervix is \u200b\u200bsupported by secondary diseases that often accompany this pathology:

- ectopia of CM

- cervical neoplasia

- violations of the normal blood supply to the CM epithelium.

Features of a sluggish form

Thus, in the chronic stage, a vicious circle is observed when treatment may not give an effect due to the appearance of a number of other diseases. The systemic nature is also explained by the fact that in the chronic form of cervicitis, developed ectopia and other conditions, a general decrease in immunity is observed.

A common cause of decreased immunity is self-medication with antibiotics in the acute phase of the disease. As a result, drug-resistant microorganisms are formed, and treatment of the chronic stage becomes difficult. As a result, there are problems with pregnancy: if a woman plans to conceive, it does not occur due to a change in the chemical composition of the cervical mucosa. You should not get carried away with self-medication, medication should be prescribed by a doctor.

Dangerous effects of papillomavirus

In addition to infections from the PPP group, the human papillomavirus plays a decisive role in the development of the chronic form of cervical inflammation. It is he who leads to metaplasia - a change in cells of a benign nature against the background of this pathology. Since the inflammation is not treated for a long time due to weak or completely hidden symptoms, the situation worsens imperceptibly.

As a result, chronic cervicitis with squamous cell metaplasia is diagnosed during colposcopy, which requires urgent treatment, since the condition leads to precancer. And without treatment of this stage - to cancer. This is because with ectopia against the background of inflammation, the squamous epithelium is replaced by a cylindrical epithelium originating from the cervical canal. In the case of overlap of this columnar epithelium with a stratified squamous epithelium, dysplasia (precancer) is formed. The same process is a determining condition for the development of CM cancer.

How to recognize the chronic stage?

Sluggish pathology is diagnosed using the following manipulations:

- colposcopy

- biopsy.

The best option from the above is to treat the disease at the stage of inflammation. That is why it is extremely important to be examined by a gynecologist even in the absence of unpleasant symptoms in the genitals. However, sometimes leucorrhoea, minor contact bleeding may appear and should be taken seriously.

Self-medication or early termination of treatment for chronic forms of cervicitis is dangerous with the described consequences. That is why gynecologists strongly advise women to come for an examination at least once a year.

How to treat pathology?

Purpose of treatment

Treatment for a chronic condition should begin immediately, as soon as it is detected. The purpose of the impact is reduced to the following steps:

- stop the process

- eliminate causal factors

- restore normal epithelium

- to carry out the prevention of relapse.

Medicine methods

For this, modern medicine offers to treat patients with three main methods:

1. Antibiotic therapy (internally and locally). The drugs are selected on the basis of smear responses about the type of microorganisms that caused the pathology.

2. Immunocorrection with the aim of raising and restoring immunity of the whole organism and at the local level.

3. Restoration of the normal microflora of the genitals: the vagina, cervix, the uterus itself and its appendages.

Options for removing altered epithelium

It should be noted that pregnancy requires special attention when the doctor selects drugs and methods of treatment for the chronic stage. Insufficiently effective treatment can cause a reverse reaction in the form of an exacerbation of the disease. Depending on the cause of the pathology and the state of the epithelium of the cervical pharynx, treatment is possible by removing the altered tissue.

There are many ways to do this: radio wave or laser exposure, cryodestruction, electrosurgical, knife or ultrasonic conization. It should be noted that after the operation, you will need to undergo a recovery course and always follow the rules for the prevention of cervicitis in order to exclude a relapse.