All You Need To Know About The Cervix, Cervical Screenings, And Cervical Disorder Prevention
What are the functions of the cervix? How often should you attend cervical screenings? How have new guidelines changed the frequency of recommended Pap tests? Learn all about the cervix, cervical health and disorders, and recommended cervical screenings.
The cervix is part of the female reproductive system. Positioned at the end of the vaginal canal, the cervix protects the uterus and plays an important role in pregnancy and vaginal delivery during childbirth. In this article, you'll find out more about:
- Anatomy and location of the cervix
- Common cervical disorders
- Cervical cancer risks
- Cervical screenings
- Ways to prevent cervical diseases
Cervical anatomy
The cervix is part of the female reproductive system. Although small, the organ plays an important role in pregnancy, vaginal delivery, fertility management, and menstruation.
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The cervix is a cylindrical organ located at the lower end of the uterus. It connects the uterus to the vagina. It's typically 4 centimeters long and 2-3 centimeters in diameter. The cervix is made of fibromuscular tissue and is divided into two main parts.
The ectocervix is the outer part at the end of the vagina. It has a small opening called the external os. The endocervix is the inner canal on the side of the uterus, ending at the internal os.
The cervical canal is lined with columnar epithelium, which produces mucus that changes in consistency throughout the menstrual cycle. The cervix has many glands and nerve endings. Its position changes, depending on the menstrual cycle phases, pregnancy, and menopause.
Cervical functions
The cervix produces mucus and allows fluids to travel from and to the uterus. However, this tiny organ is also responsible for the timing of vaginal delivery.
The main functions of the cervix are:
- Uterus protection: The cervix acts as a physical barrier between the vagina and the uterus. While it has a tiny opening, which fluctuates in size depending on the menstrual cycle and pregnancy, it's not wide enough to let foreign objects pass. Because of the cervix, you can use tampons, menstrual cups, and similar products without them getting lost in the vagina.
- Protection from infections: The cervix is usually the first organ to signal if there's an infection. The glands in the organ always produce mucus. When there's an infection, the mucus changes in color and odor. It also works as a physical barrier to protect the upper reproductive tract from potential infections and foreign substances. The mucus it releases is also slightly acidic, which creates conditions where bacteria can't proliferate.
- Sperm transport: During ovulation, the cervical mucus becomes thin and stretchy. This change, along with increased pH levels, creates conditions that allow sperm to pass more easily into the uterus to fertilize the mature egg.
- Menstrual flow: The cervix allows blood to flow from the uterus into the vagina during menstruation.
- Pregnancy: During pregnancy, the cervix forms a mucus plug that helps protect the developing fetus from infections. Right before labor, the plug drops, which is also one of the first signs of upcoming labor.
- Labor and delivery: The cervix dilates when a baby is ready to be born. Once the mucus plug dissolves, the cervix becomes softer and thinner. Cervix dilation can also indicate how long the delivery will take.
- Fertility indicator: Changes in the cervix's position and texture can indicate different phases of the menstrual cycle. For example, during ovulation, the cervix moves up, widens, and releases more mucus to allow sperm to pass more easily.
Cervical health and disorders
Cervical health is a complex subject. The cervix is susceptible to various infections and disorders caused by viruses, bacteria, fungi, and parasites.
A few reasons why the cervix is so susceptible to infections are its location, hormonal changes, and cellular structure.
Because of its location, the organ is exposed to potential sexually transmitted infections (STIs) and microorganisms in the vagina.
The cervix is also very reactive to hormonal changes in the body. Each time hormones fluctuate during the menstrual cycle, pregnancy, and menopause, cervical mucus changes in consistency and abundance, which can make the organ more vulnerable to pathogens.
Finally, the cervical cells are more sensitive to infections and cancerous changes compared to other parts of the female reproductive system.
Usually, the symptoms of an infection or illness in the cervix are:
- Abnormal vaginal bleeding (in between periods, after or during sex, after menopause)
- Bleeding heavily or for too long during a period
- Abnormal vaginal discharge (bloody, grey, green, watery, cottage cheese-like)
- Changes in odor
- Pain in the lower belly
- Discomfort during intercourse or while using menstrual products
- Painful urination and/or the need to urinate more often
Most common cervical disorders and diseases
Cervicitis
Cervicitis is an inflammation of the cervix, caused by infections or irritants. It causes abnormal discharge, pain during intercourse, and bleeding between periods.
Cervical ectropion
The condition happens when the cells from inside the cervix grow on the outside. It’s generally harmless but can cause increased discharge and spotting.
Cervical polyps
Cervical polyps are quite common. They’re small, benign growths on the cervix, but they can sometimes cause irregular bleeding or discharge.
Cervical dysplasia
Cervical dysplasia is when abnormal cells grow in the cervix. The condition is usually detected through Pap smears. If left untreated, dysplasia can progress to cervical cancer over time.
Cervical incompetence
The condition happens when the cervix begins to open prematurely during pregnancy. It can increase the risk of preterm birth.
Cervical stenosis
Cervical stenosis indicates a narrowing of the cervical opening. This can make it more difficult to pass menstrual blood, increase cramping, and impact fertility.
Cervical cancer
Cervical cancer is a malignant growth in the cervix linked to HPV (Human Papillomavirus) infection.
Nabothian cysts
Cervical cysts are small, harmless fluid-filled bumps on the cervix. These cysts are typically discovered during routine pelvic exams and rarely require treatment. If they cause pain or abnormal bleeding, your doctor can surgically remove them.
Cervical erosion
It happens when the protective outer cell layer on the cervix is lost. Cervical erosion can expose the cervix to infections and cause spotting or discharge.
Cervical fibroids
Benign tumors that can grow on or near the cervix. Large fibroids may cause pelvic pressure, pain, or abnormal bleeding.
Cervical infections
Chlamydia, gonorrhea, herpes, and other infections can affect the cervix and cause various symptoms.
Risk factors for cervical disorders
- Unprotected sex and sex with many partners: As the cervix is the organ most exposed to STIs such as HPV, having unprotected sex increases your risk of infections. They not only lead to cancer but also inflammation.
- Smoking: Tobacco use weakens your immune system, damages cervical cells, and makes it more difficult to clear HPV if you get it.
- Weak immune system: Poor habits, HIV/AIDS, chronic illness, or immunosuppressive medications can make you more likely to develop cervical disorders.
- Long-term use of oral contraceptives: Particularly for 5 or more years, but the risk decreases once you stop taking them.
- Multiple pregnancies: Having given birth to 3 or more children can make your cervix more prone to cancer.
- Genetics: If your mother, grandmother, or other close relatives had cervical cancer, you have a slightly higher chance of developing it in the future.
- Age: Cervical cancer is more common in women between 35 and 44.
Cervical screening
Cervical screening, also called a Pap smear, is a test during which your OB-GYN collects cervical cells using a swab. These cells are then analyzed to see if there are any abnormalities that could indicate cervical cancer or an HPV infection, which is the leading cause of cervical cancer.
It's a routine procedure, usually done together with a regular pelvic exam. It's recommended to have a Pap smear test every 3 years between the ages of 21 to 65, either with an HPV test or alone. The HPV test can be done alone every 5 years for those 30-65 years old. You might need to be tested more frequently if you've previously been diagnosed with HPV, have many different sex partners, or have cell abnormalities.
Previously, it used to be recommended to perform the test every year, but the current guidelines state that every 3-5 years is enough, as it usually takes a lot of time for abnormal cells to develop into cancer.
Follow-up procedures for abnormal results
If the test shows that you have an HPV strain linked to cancer or abnormal cells in the cervix, you’ll need to undergo follow-up procedures.
Colposcopy
A colposcopy is a diagnostic procedure where a healthcare provider uses a special magnifying device called a colposcope to closely examine the cervix, vagina, and vulva. During the procedure, they apply a solution to highlight abnormal cells and get a more detailed view of the areas that might require a biopsy.
Biopsy
A cervical biopsy involves removing a small sample of tissue from the cervix for laboratory examination under a microscope. It can show if the cells in the cervix have become cancerous.
Is there a way to prevent cervical cancer and other cervical disorders?
Cervical cancer is one of the most preventable cancers. Not only can you limit your risk of getting it in the future by vaccinating against the cancer-causing HPV strains, but you can also treat it rather easily when it’s found in the early stages.
Here’s how to prevent it:
- Get vaccinated against HPV, ideally before becoming sexually active
- Have regular Pap smears and/or HPV tests as recommended by your healthcare provider
- Use condoms consistently to reduce the risk of HPV transmission
- Limit the number of sexual partners to reduce exposure risk
- Don't smoke
- Eat a balanced diet to support your immune system
- Exercise regularly and maintain a healthy weight
- Get adequate sleep and manage stress
- You might want to limit long-term use of oral contraceptives
However, cervical cancer is only one of the possible cervical disorders. Exposure to infections can lead to chronic inflammation and fertility issues.
Here’s how you can limit your risk of catching cervical infections:
- Practice safe sex – use condoms and change them after every use
- Attend routine gynecological exams and screenings
- Clean the genital area properly, wiping from front to back
- Avoid douching
- Wear cotton or other natural fabric underwear
- Urinate after sex and masturbation
- Keep diabetes and other conditions that affect your immune system under control
- Use antibiotics responsibly – only take antibiotics when prescribed and complete the full course
- Use unscented, gentle soaps, and avoid products that irritate the genital area
- Change tampons and pads regularly
Healthy cervix
While the cervix is a small organ, it plays an important role in many reproductive processes and events. However, try not to panic if you test positive for HPV or an infection or show signs of cell abnormality. Nowadays, medical care is so advanced that most cervical cancers are treated quickly and have great recovery rates. The most important thing is to get vaccinated, practice safe sex, and attend your regular checkups.
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