Even in 2020, there are large parts of Africa where a woman’s primary value is in her ability to bear children. Problems with the cervix can have a massive impact on being able to have children and overall health. It’s not a surprise then that they 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. The opening also allows menstrual blood from the uterus to flow out into the vagina. Sperm enters the womb through it from the vagina during sex.
Problems of the cervix are relatively common and cover three main areas – inflammation, issues with its function, and abnormal growths or changes in the cells. There are several things you can do, however, to prevent major cervical problems.
Inflammation of the cervix
Cervicitis is the inflammation of the cervix and is usually caused by infections. You may have no symptoms. However, in most cases, it 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:
- Sexually transmitted infections such as gonorrhea, chlamydia, genital herpes, and human papillomavirus (HPV).
- Bacterial vaginosis – an overgrowth of the healthy bacteria in the vagina. If you use vaginal douches frequently, you may be putting yourself at risk for this. It may clear up without the need for antibiotic treatment.
- Allergy to spermicides or condoms – not common but can occur.
Pelvic inflammatory disease (PID) develops when sexually transmitted infections spread from the cervix 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). Past damage to the cervix from an abortion or from previous difficult childbirth can cause an incompetent cervix . Untreated cervical infections 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 their 40s and 50s. It is not pre-cancerous and often has no symptoms. Slight bleeding during sex may occur. A simple surgical procedure removes it.
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. It’s done by gently scraping your cervix during a pelvic examination.
Paying attention to your cervical health can be a matter of life or death.
Like many conditions, most cervical problems are easy to treat if caught early, even cervical cancer! Some require no treatment at all. Others like untreated cervical infections, or cervical cancer, for example, can cause major complications.
Difficulty having a child often sets off a chain reaction involving emotional stress, relationship issues, additional healthcare costs, and financial strain. Even a minor cervical infection can affect your quality of life quite a bit. Infection with high-risk human papillomavirus can lead to cancer of the cervix.
The cervix is tucked away in a part of your body that you can’t see. It’s a good idea, therefore, to get yearly checkups by a gynecologist – beginning as early as twenty-one years old, all through your childbearing years, and even after menopause.
Don’t ever overlook any pain, unusual bleeding, or vaginal discharge. At best, it could affect your physical, reproductive, or emotional health. At worst, it could cost you your life. See a doctor immediately.
Toju Chike-Obi, MD