TL;DR:
- Cervical erythema (erosion) is a reddened epithelial defect on the cervix, caused by displacement of cylindrical epithelium. It occurs in 1 in 3-4 women.
- Types: True erosion (linked to advanced cervical cancer) and pseudo erosion (replacement of squamous epithelium with glandular epithelium).
- Causes: Ignored vaginal inflammation, postpartum recovery, multiple births, miscarriage, contraceptive use, mechanical trauma, and multiple sexual partners.
- Symptoms: Discharge, burning, itching, post-intercourse bleeding. Requires gynecological consultation.
- Diagnosis: Cytology, culture, colposcopy, and possibly biopsy.
- Treatment: Includes pharmacology, chemical coagulation, electrocoagulation, freezing, and photocoagulation, depending on lesion size.
- Post-treatment: Avoid intercourse for recovery.
- Prevention: Early treatment prevents complications like cervical cancer and infertility. Regular gynecological exams are crucial.
Cervical erythema occurs in the form of an epithelial defect. It is an irregular, reddened area (erythroplakia) that occurs on the cervix. Its formation occurs when the epithelium from the vaginal part causes the cylindrical epithelium to be displaced from the cervical canal. Erosion looks like a small wound with an uneven surface, which at first glance does not look like anything dangerous. A relatively large number of women struggle with erosion – it occurs in one in three or four patients. There are two types of erosion – true and pseudo erosion. True erosion is an area of markedly crater-like loss of the protective layer of the squamous multilayer epithelium. It is observed primarily in advanced cases of cervical cancer. In contrast, pseudo erosion is an area resulting from the replacement of the squamous multilayer epithelium by the glandular epithelium that lines the cervical canal. ** In order to distinguish one erosion from another, the doctor will refer the woman for additional cytology and colposcopy.** Once the results are properly identified, the history of past diseases is analyzed and a thorough clinical history is taken, the specialist can decide on the next stage of diagnosis – histopathological evaluation of the lesions.
Why is cervical erosion formed?
Erosion occurs in women who ignore vaginal inflammation and do not take the time to treat it. This problem also affects patients who are postpartum (in which case the cervix is weakened), who have undergone miscarriage, have given birth multiple times, use intrauterine contraception, have suffered mechanical trauma, and have multiple sexual partners.
How to know cervical erosion?
Erosion is not accompanied by specific symptoms that can clearly help in an accurate diagnosis. Frequently, unpleasant-smelling discharge is observed irritating the vulva and causing infection. A woman may also complain of burning and itching of the intimate parts. Bleeding that occurs during sexual intercourse is also a common reason that women report. Symptoms that may indicate erosion require urgent medical consultation. Admittedly, most ailments of this nature only need to be observed and not treated, but not all of the symptoms described are grounds for indicating the presence of erosion right away. Women should regularly examine themselves with a gynecologist to prevent the condition.
How does the diagnosis of cervical erosion proceed?
Before performing diagnostic tests, women should not have intercourse for 2 days beforehand, wait 3 – 4 days if they have taken vaginal agents. The most common tests that gynecologists use to diagnose erosion include:
- Cytology, during which the doctor takes material from the cervix for examination using a special brush. The material is then transferred to a slide, with which it is transferred to a laboratory. There, under a microscope, the cytologist observes what size, structure and shape the cells taken are. Cytology is a simple test in the diagnosis of erosion. With its help, the doctor can assess the condition of the cervix, detect inflammation and even cancer in its early stages.
- Culture, which is the collection of mucus from the cervix and vagina. For this purpose, a special spatula is used. The test makes it possible to assess the type of infections that cause inflammation.
- Colposcopy, during which a gynecologist applies an instrument similar to a microscope connected to a computer to the vagina. This allows the specialist to see everything on the monitor – the image is magnified several times, which in turn facilitates accurate analysis of the lesions. During the examination, the gynecologist can also perform a biopsy. It will allow to confirm or exclude the existence of cancer cells.
How is the treatment of cervical erosion carried out?
Treatment of cervical erosion depends on the diagnosis and result of cytology, colposcopy or histopathology, the extent of the lesion, as well as many other factors. For erosions of small size, treatment with pharmacological agents is used. Tabs in the form of anti-inflammatory drugs contribute to the healing of erosions. Small lesions are also treated with chemical coagulation. This is a painless treatment that does not cause scarring. Specialized agents are applied to small lesions to destroy the old epithelium.
One of the more effective treatment methods is electrocoagulation, which involves a series of electrical flashes that burn the erosion. This technique allows the specialist to reach each diseased area. During the procedure, a peculiar odor can be smelled, but it is nothing dangerous for the woman. When the lesions are small, the doctor may order treatment with chemical coagulation. This is a completely painless method and does not cause scarring. Appropriate agents are applied to the erosion to destroy the old epithelium, which is replaced by new epithelium over time. The gynecologist can also refer the patient to freezing treatment, which involves the use of a special electrode that freezes the cervical tissues. The procedure does not take long – from 4 to 6 minutes. In a situation where erosions are of considerable size, freezing is performed using several tips. Freezing is carried out after menstruation. Another way to remove erosions is photocoagulation, which uses a tip that emits light waves. Photocoagulation is painless and does not cause scarring. The technique is distinguished by its high effectiveness for small erosions, and healing after the procedure takes about 14 days.
What is the post-treatment management?
After the treatment of erosion, it is recommended that you refrain from intercourse, especially deep penetration. After the treatment is performed, the cervix needs time to fully recover, which can be difficult by constant irritation with the penis and semen. As a result, this can lead to further damage and bleeding.
Why is it worth treating cervical erosion?
Cervical erosion can develop into dangerous cervical cancer. A preventive measure that can prevent the development of cervical cancer is to treat early lesions. To this end, screening of healthy patients (allows identification of a group of women at risk of cancer), diagnosis of existing lesions on the cervix, and treatment of precancerous lesions are performed. Erosion of the cervix in an advanced form can also make it difficult to get pregnant. This causes diagnosed erosion to be treated before a planned pregnancy. When erosion is detected during pregnancy, pharmacology is used in most situations. Surgical procedures are postponed until after delivery. It is worth remembering that erosion is not a threat to pregnancy. The situation is different with the pathogens that are responsible for it. Erosion should always be consulted with a doctor, who will perform the appropriate tests. Each situation is different and requires careful diagnosis.
Conclusion
Cervical erosion may seem harmless at first but requires attention and care. It can lead to serious issues like cancer or fertility problems if ignored. Identifying symptoms early, consulting a doctor, and undergoing tests like cytology or colposcopy are crucial. Treatment options vary based on the severity, but early intervention can prevent complications. Remember, treating cervical erosion protects your health and future. Regular checkups with a trusted gynecologist make all the difference. Don't wait—take control of your reproductive health today.
