Sadly in many parts of Africa, a woman’s primary value comes from her ability to bear children. As a result, problems with the cervix not only have a significant impact on the reproductive life and overall health of a woman but can also damage her social acceptance and self-worth.
The cervix is at the lower end of your womb (uterus) and connects it to the vagina. It has a narrow opening that stretches to accommodate a baby’s head and body during childbirth.
Common problems of the cervix are inflammation, problems with its function, and abnormal growths or changes in the cells.
Inflammation of the cervix
Cervicitis is the inflammation of the cervix and is usually caused by infections. You may have no symptoms. However it often causes foul-smelling vaginal discharge, pain in your lower abdomen or during sex, unexpected bleeding in between menstrual periods, painful urination and feeling the need to urinate more than usual.
Several things can cause inflammation:
- Bacterial vaginosis – an overgrowth of the healthy bacteria in the vagina. If you use vaginal douches frequently, you may be setting yourself up for this. It may clear up without the need for treatment.
- Allergy to spermicides or condoms – not common but can occur.
- Sexually transmitted infections such as gonorrhea, chlamydia, genital herpes, human papillomavirus (HPV).
Pelvic inflammatory disease (PID) develops when sexually transmitted infections spread to the uterus and fallopian tubes. It is severe and if untreated, PID can lead to infertility. Antibiotics are the treatment for cervicitis due to a bacterial infection.
Problems with the function of the cervix
In pregnancy, the cervix is thick, rigid and closed to protect the baby in the womb. During labor, the cervix shortens, softens, gets thinner and opens so your baby can pass through the birth canal. Sometimes, the cervix is abnormally short or opens too early during pregnancy. Both conditions can lead to miscarriage or premature birth.
When your cervix opens too early in pregnancy, you have an incompetent cervix (also called cervical insufficiency). An incompetent cervix may be caused by past damage to the cervix such as dilatation and curettage (D&C) or a cervical tear from previous difficult childbirth. Untreated cervicitis can also result in an incompetent cervix.
Treatment is usually a cerclage, which is a large stitch the doctor puts in your cervix to help keep it closed. A cerclage is put in at about 13 to 14 weeks of pregnancy and is removed at about 37 weeks of pregnancy when it is safe for the baby. Hormonal treatment may also help.
Abnormal growths or changes in the cells of the cervix
A Cervical polyp is a small growth on the surface or inside of the cervix. It affects about 4 in 100 women usually in the 40s and 50s. It is not pre-cancerous and often has no symptoms. Slight bleeding during sex may occur. Treatment is surgical removal by a simple procedure.
Cervical cancer and HPV
Cervical cancer is the leading cause of cancer deaths in African women. Human papillomavirus (HPV), a sexually transmitted infection causes 99% of all cervical cancer. The virus creates changes in the cells of the cervix that develop into cancer. Regular screening for cervical cancer is crucial because early detection is the key to saving lives.
There are two screening tests for cervical cancer:
- Pap test or Liquid-based cytology test to see if there are any abnormal changes in cells of the cervix
- Human Papilloma Virus (HPV) test to see if cancer-causing HPV is present in the cervix.
They help to find changes to the cells of the cervix early. You can do both tests at the same time (Co-testing) from a sample of cells your doctor collects by gently scraping your cervix during a pelvic examination.
Cervical Cancer Screening Guidelines:
If you have a weakened immune system or are HIV positive, a previous abnormal Pap or HPV test or cervical cancer, you’ll need more frequent screening. If you have had your uterus removed surgically (Hysterectomy), you don’t need screening.
Common sense sexual practices can help lower your risk for cervical cancer and inflammation of the cervix:
- Sexual abstinence outside of marriage
- Limiting the number of sexual partners
- HPV vaccination before start of sexual activity (recommended from 9yrs – 26yrs old)
- Proper and consistent use of condoms