Enlarged uterus, reddened papillae in gynecology. Precancerous conditions of the cervix. Cervical diseases: causes, symptoms, diagnosis and treatment. Acute inflammation of the cervix: symptoms

Gynecologists classify cervicitis, an inflammatory process that affects the cervix, as a fairly common disease of the female genital area, because 50% of women experience it at least once throughout their lives.

The cervix, which serves as a protective barrier for infectious microorganisms, becomes infected, and inflammation occurs, which is divided into several stages. Moreover, in two thirds of cases, this disease occurs during reproductive age.

Causes of inflammation

Based on the fact that the disease occurs quite often, it can be caused by many reasons.

We list the main ones:

• vaginal infections or sexually transmitted diseases- (chlamydia, gonorrhea, trichomoniasis, etc.);
• candidiasis;
• herpes simplex virus- (genital herpes);
• human papilloma virus;
• birth injuries of the cervix- mechanical damage resulting from unprofessional abortion, diagnostic uterine curettage, artificial dilatation of the cervix using special instruments or installation or removal of a contraceptive device;
• early onset of sexual activity - promiscuity, having multiple sexual partners;
• failure to comply with personal hygiene rules -(for example, a forgotten tampon can cause irritation of the cervix and its inflammation, improper washing - from the anus towards the vagina - often leads to infection with E. coli);
• allergic reaction to latex or spermicidal compounds, etc..

Symptoms and signs

The first symptom of cervicitis may be more intense vaginal discharge that begins immediately after the end of menstruation. However, due to its mild severity, it is quite difficult to detect the disease without a gynecological examination at this stage.

The main symptoms include the following:

• itching, burning of the external genitalia and their redness;
• burning or stinging when urinating;
• copious discharge;
• bleeding between periods;
• painful sexual intercourse;
• slight spotting or even bleeding immediately after intercourse;
• pain in the lower abdomen or lower back (sometimes they appear only during sexual intercourse);
• mild nausea, fever, dizziness and pronounced pain in the lower abdomen (occur when the infection spreads);
• hyperemia and swelling of the external opening of the cervical canal, accompanied by protrusion of the uterine mucosa and minor hemorrhages or ulcerations (detected upon examination).

It is worth noting that depending on the type of causative agent of the disease and the general state of the immune system, cervicitis can have different manifestations. So, for example, cervicitis caused by gonorrhea is usually acute, its symptoms are clearly pronounced. With chlamydial infection, on the contrary, the symptoms are less noticeable.

Cervicitis that occurs against the background of herpes is characterized by a loose, bright red cervix with ulcerations. In the presence of trichomoniasis, the disease is manifested by small hemorrhages on the cervix and the presence of atypical cells in the smear. The human papillomavirus against the background of cervicitis often leads to the formation of condylomas and extensive ulceration of the cervix.

Cervicitis is dangerous because with a mild stage of the disease, its course can be completely unnoticeable. And if it was not detected in an acute form and, as a result, not cured, then the disease passes into a protracted chronic stage. In chronic cervicitis, the main signs of inflammation (swelling and hyperemia) are less pronounced.

However, if left untreated, inflammation will continue to spread to the tissues and glands surrounding the cervix, as a result of which cysts and infiltrates will begin to form, and the cervix will become thicker. Therefore, do not neglect regular visits to the doctor, because this is extremely important for your health and ability to get pregnant and give birth to a healthy child.

Separately, I would like to say about discharge from the urethra or vagina during cervicitis, because depending on their nature, one can also judge the causative agent of the disease. So, for example, with cervicitis against the background of gonorrhea, the discharge, as a rule, becomes yellow with an admixture of pus.
With chlamydia or mycoplasmosis, changes in discharge are less pronounced. They are usually transparent or white, but may have a tint of yellow. If the cause of cervicitis is urogenital trichomoniasis, then the discharge will be foamy. And if the problem is candidiasis, then the discharge is similar to the discharge from thrush. They are white in color and have a cheesy consistency.

Types of infection

Cervicitis has several varieties. Let's talk about each of them.

Spicy

This type of disease is characterized by rapid development. Infectious and inflammatory processes are pronounced, in addition, almost all the symptoms of the disease can often be present at the same time.

Chronic

It can occur against the background of other inflammatory diseases or develop from untreated acute cervicitis.

Typically, chronic cervicitis is accompanied by scanty mucopurulent or simply mucous discharge, and slight swelling of the cervical tissue.

In the case of a prolonged course of the chronic stage of cervicitis, the cervix begins to thicken, and erosion often occurs.

Purulent

Based on the name, it is clear that in this case the inflammation is accompanied by copious mucopurulent discharge.

The cause of their occurrence may be male urethritis caused by sexually transmitted diseases. Most often, this type of cervicitis occurs when the patient has gonorrhea.

Atrophic

With atrophic cervicitis, inflammation is accompanied by thinning of the cervical tissue. In the case of advanced forms of atrophy of various parts of the genital tract, urination disorders are often observed, so in addition to the gynecologist, it is imperative to visit a urologist. Most often, this type of disease develops from a chronic form.

Viral

Caused by diseases of viral etiology (human papillomavirus or genital herpes). Its treatment, as a rule, is complex and quite difficult: the woman is prescribed antiviral drugs, immunomodulators, and irrigation of the uterine cavity with special compounds is also necessary.

Bacterial

With bacterial cervicitis, a strong inflammatory reaction is not observed, although there is still a disturbance in the vaginal microflora. It can be caused by a bacterial infection - colpitis, gonorrhea, vaginosis, etc.

Cystic

The most unpleasant type of cervicitis. Its cause is considered to be a combination of several infections (streptococci, staphylococci, trichomonas, chlamydia, etc.). The result of this “bouquet” of diseases is the proliferation of columnar epithelium on the surface of the uterus and its complete overgrowing with cysts.

According to experts, in this case the cervix is ​​an unpleasant sight, because it is almost completely covered with countless cysts. It is often combined with erosions.

Nonspecific cervicitis

This species is not associated with any sexually transmitted infections. Most often occurs in the presence of bacterial vaginosis. Nonspecific cervicitis occurs, usually in young women, and is characterized by fairly copious purulent discharge. Moreover, as in other cases, inflammation begins due to a violation of the natural microflora of the vagina.

How is the disease diagnosed?

Cervicitis is often asymptomatic, so most often this disease is discovered by chance during routine medical examinations or when visiting a gynecologist for other diseases.

The essence of diagnosis is to identify the causes of an inflammatory infection; it is the identification of the pathogen that guarantees effective treatment.

An accurate diagnosis is established based on the results:

1. examination using gynecological mirrors of the surface of the cervix;
2. extended colposcopy, which allows you to examine even minor changes in the epithelium of the cervix (vascular loops, swelling of the mucous membrane, ectopia or erosion, hyperemia and the nature of inflammation) and determine on the basis of this the effectiveness of further treatment;
3. laboratory tests (bacteria culture for sensitivity to antibiotics and microflora, smear, PCR diagnostics, pH-metry of vaginal discharge, etc.);
4. special diagnostic methods (enzyme immunoassay, DNA probe, etc.).

Methods for treating cervicitis

For successful treatment, it is first necessary to identify the causative agent of the disease and eliminate it and predisposing factors (metabolic, hormonal, immune disorders). Therefore, the type of treatment for cervicitis largely depends on the cause of the disease.

After diagnosing and identifying the pathogen, the gynecologist will prescribe you a number of medications that can combat the infection as effectively and in a short time as possible. Moreover, throughout the entire period of treatment you will need to undergo laboratory tests and undergo colposcopy to monitor the dynamics of recovery.

It is also worth noting that to eliminate the possibility of re-infection, it is worth treating the sexual partner.

Treatment with candles

Suppositories for cervicitis, indicated for its nonspecific form, have an excellent healing effect. By influencing inflammation locally, they eliminate unpleasant discharge and restore tissue damaged by the disease, while removing the affected tissue. The maximum effect can be achieved by combining suppositories with medicinal pads.

But remember that using suppositories during pregnancy, during menstruation and a few days before it begins is not recommended. You should also interrupt treatment with suppositories and consult a doctor if pain, itching, redness or peeling of the external genitalia occurs.

Treatment with folk remedies

In addition to basic drug treatment, patients with cervicitis often use traditional methods.

Let's list a few of them.

Decoction. In equal quantities, take raspberry fruits, birch leaves, wormwood, St. John's wort, mint and horsetail and chop a little. Pour 5 g of the resulting mixture with a glass of boiling water and heat in a water bath for 10 minutes. Infuse the decoction for about an hour, then strain and take 3 times a day daily, a third of a glass, 30 minutes before meals.

Infusion for douching. In equal quantities, take birch leaves, calendula flowers, motherwort herb, dandelion and licorice roots and caraway seeds, chop everything and mix thoroughly. After this, pour 10 g of the resulting dry mixture into 500 ml of boiled water (preferably warm) and heat in a water bath for a quarter of an hour. Then leave the resulting broth for at least 2 hours in a warm place and strain. The douching solution is ready. For each procedure, take 200 ml of infusion and repeat douching 3 times a day.

Ointment. Chop lilac flowers, snakeweed and dandelion roots, fireweed and birch leaves, celandine herbs, wormwood, St. John's wort and sage, as well as flax seeds. Take 50 g of the resulting dry mixture, pour in 500 ml of water and boil over low heat until the volume of water is reduced by about 2 times. Then add 50 g of butter and cook for another quarter of an hour.

After this, remove from heat, add 50 g of honey and stir. Lubricate the bandage strip with the resulting ointment, forming a candle, and do not forget to leave the edge of the bandage free (about 5-7 cm) for easy removal. Insert the resulting candle into the vagina before going to bed.

Surgical treatment methods

If you are diagnosed with a chronic stage of cervicitis and conservative treatment does not give a positive result, then most likely, in the absence of infections, the gynecologist will offer you one of the methods of surgical intervention, namely cryotherapy, diathermocoagulation or laser therapy.

Content

Hyperemia is not a separate disease, but is considered only a symptom. This pathological process can indicate the development of serious diseases, as well as be a temporary physiological or borderline phenomenon, which does not cause harm to health.

When there is redness of the mucous membrane of the cervical uterus, objective symptoms are often not observed, so it is important to visit a gynecologist once or twice a year. Cervical hyperemia occurs in pregnant women and can occur as a result of injury, infection, circulatory disorders, uterine prolapse and elongation, and can also be a sign of heart and lung diseases. Therefore, it is important to promptly identify the cause and begin treatment.

What is hyperemia

Hyperemia of the mucous membrane is a typical pathological process that occurs in response to irritating external or internal factors and is characterized by excessive filling of blood vessels, resulting in redness.

The cervical mucosa takes on a red tint against the background of an increase in arterial blood flow or with obstructed venous outflow.

In medicine, it is customary to distinguish two main types of hyperemia: active type (arterial) and passive (venous).

After visiting a gynecologist, many women wonder: what is cervical hyperemia and is it dangerous?

Causes

Redness of the cervical mucosa can occur as a result of mechanical damage or infection. In medicine, the following causes of hyperemia are identified:

1. Incorrect functioning of the gastrointestinal tract. Most often these are constipation, as they are accompanied by increased intra-abdominal pressure and impaired venous outflow. A hyperemic neck will have a venous type.

2. Exceeding the level of hemoglobin in the blood. Some diseases of the bronchopulmonary system and hematopoietic system may be accompanied by signs of a hyperemic cervix due to a significant increase in the hemoglobin content in the red blood cell.

3. Infectious pathologies. Redness of the cervical mucosa is observed in cases where the infection reaches the genitourinary tract. After hyperemia, the stage of erosion begins. It does not go away on its own and requires the use of antibacterial and other etiotropic drugs.

4. Hypothermia. Doctors recommend that women avoid hypothermia of the pelvic organs (for example, sitting on cold and stone surfaces). A hyperemic cervix, with a decrease in the body's resistance, can go into the stage of erosion. The presence of vaginal dysbiosis contributes to this.

5. Overheating. The cause of redness of the mucous membrane can be not only low temperature. Often this condition is observed in women who work in hazardous production conditions, accompanied by a heating microclimate, when blood vessels begin to dilate and blood flow increases. Treatment in this case is not required, but the patient should be closely monitored.

6. Mechanical damage. Hyperemia may appear after sexual intercourse or a gynecological examination. Most often it goes away on its own within 1-2 days.

7. Allergic reaction. Each woman may experience different symptoms. A patient with a hyperemic cervix is ​​allergic to personal hygiene products and medications. In this case, exclusion of the allergen and the use of antihistamines are required.

8. Hormonal changes. Hyperemia of the uterus occurs against the background of hormonal changes in the body during adolescence, pregnancy, and menstruation.

9. Increased blood pressure. Congestion of organs with hypertension is not uncommon. The cervix is ​​no exception.

10. Menopause, during which hot flashes occur.

There are many reasons for redness of the cervical mucosa. In some cases, treatment is not required, since when the irritating factor is eliminated, it goes away on its own. But there are cases when hyperemia is a symptom of the development of serious diseases.

Even with slight redness You should undergo an examination and identify the cause.

Types of hyperemia

In medicine, several types of hyperemia are distinguished depending on the causes, nature of the course, prevalence and pathogenesis.

Redness of the mucous membrane can be:

1. A physiological process resulting from temporary overheating and pregnancy.

2. Pathological, in which the cause is physical factors, allergies, pathogenic microorganisms spreading on the mucous membrane.

Depending on the nature of the course, hyperemia is divided into two types:

1. Chronic, caused by constant exposure to provoking factors, characterized by exacerbations and remissions that replace each other.

2. Acute, when there is short-term severe redness of the cervix. After completing a course of treatment or eliminating the influence of negative factors, it completely disappears.

Also, depending on the degree of prevalence of the pathological process, specialists distinguish:

1. Local hyperemia, when redness is observed only in a certain area.

2. General, in which the pathological process, in the absence of treatment, also affects the vagina.

In addition, hyperemia can be active (arterial) and passive (venous). Each type has its own individual characteristics and is accompanied by certain symptoms.

Arterial hyperemia

It is characterized by an increase in varying degrees of blood flow to the mucous membrane of the cervix, as a result of which it acquires a red tint. The main symptoms are:

1. Redness of the mucous membrane at the site of the flush.

2. Dilatation of arteries.

3. Pulsation in the vessels of the cervix, where it was not previously noted.

4. Acceleration of blood flow in vessels.

5. Reducing the difference in the amount of oxygen in venous and arterial blood.

6. Increase in tissue temperature at the site of localization of the pathological process.

There may also be an increase in lymphatic flow.

Many symptoms are hidden and it is often possible to detect cervical hyperemia only during a gynecological examination.

Venous hyperemia

Passive hyperemia occurs as a result of the influence of various pathological changes, for example, heart failure, compression of blood vessels by a tumor, varicose veins of the pelvic area.

With the venous type, a dark red or bluish tint of the mucous membrane appears. The main symptoms also include:

1. Decrease in body temperature at the site of localization of the pathological process.

2. Swelling and increase in volume of the cervical mucosa.

In this case, accompanying symptoms may occur, for example, discomfort and itching, burning, pain. Venous hyperemia requires detailed diagnosis.

General signs

The presence of redness of the mucous membrane of the cervix can also be determined by certain signs that are of a general nature. These include:

1. Increased heartbeat, headaches with arterial hypertension.

2. Pain and distension in the vaginal and perineal area.

3. Pathological discharge of an infectious nature.

4. Bloody discharge or acyclic bleeding.

5. Symptoms caused by pathology of other organs and systems - bronchial asthma, heart failure, etc.

Any changes on the surface of the cervical spine require additional research and appropriate therapy.

Diagnostics

Diagnosing hyperemia requires a comprehensive examination. This is due to the fact that this state of the body is not a disease, but only a manifestation of certain pathologies. That is why the main goal of diagnostic measures is to identify the main cause of redness of the mucous membrane of the cervix.

First of all, the specialist carefully examines the medical history and conducts an examination. To determine the cause of redness of the mucous membrane, the doctor prescribes the following instrumental diagnostic methods:

• Ultrasound examination of the cervix with Dopplerography. It is necessary to identify the presence of pathological conditions, benign or malignant tumors, which, as they grow, can compress the vessels.

• Electrocardiography. It is carried out to identify heart pathologies. Additionally, Holter monitoring and dynamic blood pressure measurements are performed.
• CT scan. It is carried out to detect tumors or other pathologies of the pelvis that contribute to passive hyperemia.
• Colposcopy.

A laboratory blood test is also prescribed to determine the level of hemoglobin and hormones. Based on the results obtained, the need for treatment and the use of medications is determined.

Treatment

Treatment for redness of the cervical mucosa is comprehensive, addressing all causes of the disease.

The course of therapy depends on what triggered the appearance of hyperemia and may be as follows:

1. Exclusion of all hygiene products that contain alcohol, fragrances and other substances that can cause an allergic reaction.

2. Elimination of significant and sudden temperature changes.

3. Dieting. Refusal of fatty and spicy foods, alcoholic drinks, refined sweets, strong tea and coffee, as they negatively affect the intestines.

4. The use of healing drugs for mechanical damage to the organ.

5. Treatment of varicose veins.

6. Use of antihistamines.

7. Treatment of erosion and STIs.

If the cervix is ​​hyperemic due to infectious diseases, antibacterial, antifungal or antiviral drugs are prescribed. They are used only after the type of microorganism has been established. Broad-spectrum drugs are often used.

In order to reduce hemoglobin, lung and heart diseases are diagnosed and subsequent treatment is carried out. Arterial hypertension involves constant use of medications that control blood pressure.

If edema is present, antihistamines can be prescribed, for example, Claritin, Suprastin. They help relieve swelling. Products for improving blood microcirculation, such as Curantil and Persantine, may also be recommended.

Hyperemia is not an independent disease, but only a symptom of many different diseases.

Don't put off going to the doctor since the lack of treatment leads to serious consequences.

Prevention measures

To avoid redness of the mucous membrane of the cervix, experts recommend following a number of preventive measures. A woman should:

1. Avoid hypothermia and do not sit on stone or cold surfaces.

2. Treat all infectious diseases in a timely manner.

3. Wear underwear made from natural materials that does not restrict movement.

4. Observe the rules of intimate hygiene, taking into account allergy history.

5. Move more and do exercises during the working day.

6. Eat plenty of vegetables and fruits to prevent constipation.

Cervical hyperemia is not a disease, but only a sign of the development of certain pathologies or the result of the influence of external factors. This condition can be accompanied by various symptoms, depending on the type. Redness often goes away on its own, but sometimes requires immediate treatment. That is why, if any symptoms indicating diseases of the genital area appear, you should consult a doctor.

Every day, thousands of women, alarmed that the cervix has become red, turn to specialists with the question: what is the reason for this phenomenon and why did they develop the corresponding symptoms.

First warning signs

Redness of an internal organ is most often not an ordinary skin irritation, but the first warning signal: the cervix is ​​not in order. This sign may indicate the following ailments:

• Erosion
• Polyps
• Oncological diseases
• Inflammation.

Inflammation most often affects the cervical mucus of the uterus.

Only medical specialists can determine what is happening to the reproductive organ and analyze the symptoms accompanying its changes. In some cases, comprehensive diagnostics will be required to identify what processes are occurring in the cervical area. You need to know: self-medication of this organ is strictly prohibited. Only a doctor can select competently effective methods for treating a specific disease. When determining a strategy to combat a disease, he must take into account the dynamics of the development of the disease and the symptoms it exhibits.

The video talks about cervical erosion:

What should it be normally?

The uterus is a unique element of the body; it is pear-shaped and is capable of increasing 500 times during a woman’s pregnancy. The mucous membrane of the vaginal part is covered, if it is not broken, with stratified squamous epithelium. The cervix, when normal, should be pale pink, but not red. The surface of the shell in the absence of diseases of the reproductive organ is shiny. The vascular pattern of a given part of the body, if a woman does not have pathologies of this organ, is uniform. During the menstrual cycle, the shade in this area may change, but only slightly. The red lining of the organ is an indicator that the cervix is ​​susceptible to pathology and destructive processes occur in it.

True erosion in this area is considered a fairly common female disease; representatives of the fair sex suffer from it, regardless of their age.

With this disease, the membrane that covers the cervix becomes bright red. One of the symptoms of true erosion is the presence of loose necrotic deposits in its area. Congenital ectopia is often confused by non-specialists in the medical field with a previous disease. There is a difference between ectopia and erosion, but a symptom of both diseases will be a changed color of this part of the genital organ. Congenital ectopia often occurs in women whose internal genital organs are underdeveloped. With ectopia, the surface of this part of the organ acquires a bright red hue. This phenomenon is present around the external os of the cervix. The red area in this part is covered with columnar epithelium.

The picture shows cervical ectopia

Acquired ectopia surpasses the two previous diseases in its variety of symptomatic manifestations in this area. Areas of columnar epithelium are distinguished by a granular surface on which papillae have formed. The cervix is ​​not red, but pink. In some cases, in the area of ​​damage to the reproductive organ, vascular loops may be visible, which seem to cover the organ itself. Several diseases with similar symptoms can occur simultaneously in one area of ​​the cervix. To differentiate diseases of the reproductive organ, the symptoms of which are similar, biochemical research methods are used.

Surgical interventions

Erotic ectropion often occurs due to acquired ectopia. It is characterized not by a red, but by a pink surface, which distinguishes the uterus. Surgery performed in this area often causes a similar condition in this area. If you examine the area where postoperative sutures are applied, their surface may also be red. In such cases, the eroded area is subject to deformation, which will indicate hypertrophy of the reproductive organ. And the irregular oval shape of foci of inflammation is inherent in another disease - cervical endometriosis. In this case, foci of inflammation protrude noticeably above its surface. Foci of endometriosis have a red or bluish surface, their size can change during the menstrual cycle, when the uterus itself functions differently.

Due to excessive growth of the mucous membrane, the uterus may become covered with polyps. In such cases, it is characterized by a pink or red surface. The state of her channel changes. Lobular formations cover the entire cervix. When erythroplakia develops, its symptoms will differ even more significantly. In some areas, areas of hyperemia that have an irregular shape may be observed. The uterus may be densely or loosely covered with them. And leukoplakia in the area of ​​her neck will look different. The surface of the reproductive organ, contrary to popular belief, does not become red, but white spots and horny deposits appear on it. The latter symptoms help to quickly diagnose leukoplakia. It is quite simple for a doctor to detect the source of the disease: under the thickened epithelium there is a red surface.

The atypical transformation zone is more often called uterine precancer.

Diagnosing the disease is quite difficult, since its symptomatic picture contains signs inherent in various diseases of the reproductive organ. The disease covers various areas and does not spread strictly localized. But glassy areas are not observed in this disease. They are characteristic of another, even more serious illness - cancer of the organ. In this case, the uterus is covered with glassy substances and outgrowths of various shapes. Atypical vessels with a bizarre shape are also symptoms of this disease. In their structure they are similar to embryonic capillaries. The uterus affected by cancer may be pale or red. The first symptom is more often present locally and spreads locally in the first stages of the disease of the reproductive organ.

Changes throughout life

In some cases, changes in the uterus are accompanied by pain symptoms, in others - not. It is surrounded by internal organs, they mutually influence each other. When diagnosing its diseases, a whole complex of symptoms that appear in a given area of ​​the body is considered. However, it is necessary to remember: many diseases in this area can manifest asymptomatically. Problems in functioning can develop against the background of other diseases of the genitourinary system. The uterus may be injured or subject to unsuccessful surgery, which also worsens its condition. In order for her pathologies to be detected on time, a woman must undergo regular examination by a gynecologist. The uterus in a woman’s body does not remain in a static state; it changes throughout life. The red surface of the reproductive organ often occurs during puberty.

This phenomenon is due to the fact that one epithelium is replaced by another. The red surface can also be a manifestation of a reaction to factors irritating this organ. If the uterus is renewed with disturbances and there is no slow replacement of one epithelium by another, when the woman is 16-17 years old, the surface of the organ becomes red, conditions are created for the development of its pathologies. If timely measures are not taken, cancer may also develop.

When the area of ​​the reproductive organ turns red, this is one of the first warning signs indicating that there are problems in its functioning.

The cervix is ​​a very vulnerable part. Her condition will depend on various factors, not least of which is the woman’s age. It is at greatest risk in people aged 15 to 24 years. It is during this period, as experts say, that the cervix becomes a platform for the development of various pathologies. At this time, it is especially vulnerable to the negative effects of external factors. The cervix is ​​less protected from destructive changes due to a woman’s early onset of sexual activity or frequent changes of sexual partners. For various diseases of the uterus, symptoms may be different. She often suffers from infection. The cervix is ​​prone to destructive changes due to early pregnancies, which do not improve the condition of the body as a whole. Among women who are affected by various ailments of the cervix, a significant category are those who have had an abortion at least once.

Diseases of the cervix in gynecology are one of the main reasons for visiting a doctor for diagnosis and treatment. At the same time, specialists do not observe a trend towards a decrease in their number. Basically, these pathologies are characteristic of young, sexually active women of reproductive age.

CERVIX

Anatomy

The cervix in women is a kind of connecting tube between the uterus and the vagina, its length is 3-4 cm, its diameter is approximately 2.5 cm. The cervix has two parts: lower and upper. The lower part is called vaginal because it protrudes into the vaginal cavity, and the upper part is called supravaginal because it is located above the vagina. The cervical canal runs inside the cervix, which opens into the uterine cavity through the internal os. The mucous membrane of the cervical canal forms folds. In addition to the folds, there are numerous branching tubular glands. Sometimes they can become clogged and form cysts (Nabothian follicles or Nabothian gland cysts).

NORMAL, HEALTHY CERVIX

On the outside, the surface of the cervix has a pinkish tint, it is smooth and shiny, strong, and on the inside it is bright pink, velvety and loose. The mucous membrane of the vaginal part of the cervix is ​​normally covered with stratified squamous epithelium; with simple colposcopy, its surface is pale pink, shiny, and in the second half of the menstrual cycle it becomes slightly cyanotic. After treatment with a 3% solution of acetic acid, the mucous membrane turns pale, then again evenly turns pale pink. The vascular pattern is uniform. Lugol's solution evenly stains the neck dark brown.

Photo of the cervix (normal)

PATHOLOGY OF THE CERVIX

The main and most common disease of this localization is cervical erosion or ectopia.

True erosion of the cervix with simple colposcopy is an area of ​​the mucous membrane devoid of epithelial cover, with clear protruding edges; the bottom of the erosion is uneven, bumpy, bright red, in places with loose necrotic deposits. Treatment of the mucous membrane with a 3% acetic acid solution does not change the colposcopic picture. When applying Lugol's solution, the area devoid of epithelium is not stained

Congenital ectopia (the location of the border between stratified squamous and columnar epithelium on the outer surface of the vaginal part of the cervix) often accompanies underdevelopment of the internal genital organs. With simple colposcopy, this pathology of the cervix has the appearance of a bright red area, a regular round shape, located around the external pharynx; with extended colposcopy, the area of ​​ectopia with clear, even boundaries is evenly covered with columnar epithelium; there are no transformation zones (areas of replacement of one type of epithelium by another). The area of ​​congenital ectopia is not stained with Lugol's solution

Acquired ectopia, or pseudo-erosion, is characterized by a varied colposcopic picture, especially striking changes are revealed after treatment with a 3% solution of acetic acid. Often, on the outer surface of the vaginal part, areas of bright pink cylindrical epithelium, displaced from the cervical canal, are identified, with a granular surface formed by round or oblong papillae, in which terminal vascular loops are sometimes clearly visible.

In every fourth observation of cervical disease in the dynamics, acquired ectopia is combined with hypertrophy of the exocervix, in every third - with a pronounced inflammatory component (bright hyperemia of the surface, increased vascular pattern, pinpoint hemorrhages). When treated with Lugol's solution, unstained areas of columnar epithelium are observed on a dark brown background, which makes it possible to clearly determine the localization of the process.

Cervical ectopia is one of the diseases united by the term “background pathology”. By themselves, such painful conditions do not lead to the development of cervical cancer, but against their background the risk of malignant neoplasms increases.

PRE-CANCEROR AND BACKGROUND DISEASES OF THE CERVIX - LIST

1. Eroded ectropion characterized by a combination of acquired ectopia with old ruptures of the cervix during childbirth and its cicatricial changes as a result of previous surgical interventions (for example, suturing, biopsy, diathermocoagulation). An eroded ectropion may be accompanied by severe deformation and hypertrophy.

2. Foci of endometriosis have an irregular oval shape, pink, red or bluish-purple color, protruding above the surface of the mucous membrane. Their sizes often change throughout the menstrual cycle. With extended colposcopy, the color of endometriosis foci on the exocervix does not change.

3. Polyps of the cervical canal- these are diseases formed as a result of excessive growth of an area of ​​the mucous membrane with or without underlying stroma. They are detected with the naked eye in the form of round or lobular formations of red or pink color in the cervical canal. With extended colposcopy, you can determine the type of epithelium covering the polyp. Polyps are often combined with hyperplastic processes of the endometrium. Polyps of the mucous membrane of the cervical canal are connective tissue outgrowths covered with the surrounding epithelium.

4. Erythroplakia(translated from Greek as “red spot”) implies processes of local atrophy and dyskeratosis of stratified squamous epithelium with sharp thinning while maintaining normal epithelial cover in the adjacent areas of the ectocervix. When examined using vaginal speculum, it appears as irregularly shaped areas of hyperemia that bleed easily when touched. Colposcopically, a sharply thinned squamous epithelium is determined in this area, through which the underlying tissue is visible. The surface of erythroplakia turns pale when treated with acetic acid solution; it is not stained with Lugol's solution. Treatment of this disease of the female cervix consists of destroying the lesion by diathermocoagulation, conization, cryodestruction or radio wave surgery.

5. Leukoplakia is a background disease of the cervix and, when examined in a speculum, has the appearance of a white spot or a dense, rough plaque, firmly associated with the underlying tissue and not disappearing after drying the mucous membrane of the exocervix with a tampon. Colposcopy reveals horny overlays with a rough, folded or scaly surface in the area of ​​the spots. Sometimes the thickened epithelium is partially desquamated and a surface with a reddish tint is found underneath it - the basis of leukoplakia, which does not protrude above the mucous membrane. With pronounced proliferation, the papillary basis of leukoplakia can be determined, with the papillary surface rising above the unchanged mucous membrane. After treatment with a 3% solution of acetic acid, the areas of the base of leukoplakia turn pale and are more clearly visible. Areas are not stained with Lugol's solution.

This pathology of the cervix is ​​not accompanied by any symptoms. Cytological examination does not reliably differentiate simple leukoplakia and leukoplakia with atypia, since cells taken from the surface of the epithelium do not reflect the processes occurring in the basal layers; a cervical biopsy with histological examination is required. Treatment of the disease is carried out individually depending on the type of leukoplakia, its size, as well as the age and reproductive function of the patient.

6. Atypical transformation zone(dysplasia, or precancerous condition of the cervix) is a combination of various changes in the epithelium. Dysplasia, or cervical intraepithelial neoplasia (CIN), refers to processes of structural and cellular atypia (impaired cell differentiation) with impaired epithelial layering without involvement of the basement membrane. According to the WHO classification (1995), mild, moderate and severe dysplasia are distinguished.

The colposcopic picture is varied. Against the background of whitish or hyperemic areas, areas of leukoplakia and its varieties, erythroplakia, iodine-negative zones, fields of atypical epithelium, rising above the level of the mucous membrane, with keratinization of glands and vascular atypia are determined. The glands that have a wide border with a matte tint around the mouth of the duct are most suspicious of malignancy. Atypical vessels have a corkscrew-like appearance and do not contract under the influence of acetic acid. A pronounced atypical transformation zone can be distinguished from cervical intraepithelial neoplasia only by histological examination.

Precancer and cervical cancer have a common etiology and pathogenesis, and human papillomavirus is currently considered the cause of these diseases. The virus is detected in 90% of cases of moderate, severe dysplasia and cervical cancer.

7. Cervical cancer, the most dangerous of diseases, colposcopically it looks like swollen glassy areas with outgrowths of various shapes, on which convoluted atypical vessels are randomly located. They do not anastomose with each other, have a bizarre shape (corkscrew-shaped, hairpin-shaped, loop-shaped, varicose, etc.), functionally defective, do not have a muscle layer and their structure resembles embryonic capillaries.

Photo of the cervix (pathology)

Cervical erosion	Cervicitis
Cervical cancer	Nabothian cysts	Polyp

DIAGNOSIS OF CERVICAL DISEASES

The main methods for examining the condition and diagnosing the pathology of the exo- and endocervix in gynecology are:

• Examination of the cervix in the speculum,
• Colposcopy (extended and video),
• Oncocytology of the cervix,
• Cervical biopsy
• HPV tests (Digen test);
• Blood tumor markers.

WHERE TO GET CERVIX DIAGNOSIS AND TREATMENT IN MOSCOW

Interested in having your cervix examined? In Moscow, you can undergo a complete diagnosis at our medical center. At your service is a complete list of necessary instrumental studies and tests for diagnosing cervical diseases and identifying possible precancerous pathologies.

Today the reception is held by:

Covered with stratified squamous epithelial cells. It consists of three layers: basal, intermediate and superficial. Doctors may call any change in the maturation or differentiation of epithelial cells dysplasia. This term is often used to describe all precancerous conditions of the cervix.

Possible diseases

Doctors identify several pathological conditions that must be paid attention to. Thus, the so-called background processes are combined into a separate group. These include true erosion, simple leukoplakia, polyps, ectopia, erythroplakia of the cervix. A separate precancerous condition is identified, which is called cervical intraepithelial neoplasia or dysplasia. It is important to understand that background and precarceral conditions have different pathogenesis.

But the origin and manifestation of precancerous conditions and cancer are similar. Many people call HPV one of the reasons. Thus, the presence of human papillomavirus in the body is not a guarantee that there will definitely be cancer. But those women who were diagnosed with precancerous conditions of the cervix were still diagnosed with HPV in 90% of cases. But it is necessary to understand that out of more than 60 types of this virus, about 20 affect the genitals, and 11 serotypes are considered highly oncogenic.

Papillomavirus

Most often, people do not even suspect that they have HPV in their bodies. For some, the disease occurs in a latent form. This means that people are carriers of the virus, but they do not have any manifestations. In the subclinical form, cytological changes are diagnosed. Clinically expressed HPV is determined when exophytic and endophytic condylomas are visible.

The most common are the 16th and 18th serotypes of papillomavirus. Infection, as a rule, goes completely unnoticed and is not accompanied by the appearance of any symptoms. But at the same time, the virus infects cells, it is integrated into their genetic code, and the replication of infected elements begins. This ultimately leads to their degeneration and causes the appearance of dysplasia or cancer.

But it is believed that the individual susceptibility of the epithelium and congenital defects in defense mechanisms play an important role in the development of diseases.

Characteristics of background processes

Gynecologists can diagnose a number of cervical diseases that are characterized by specific changes. So, doctors distinguish true, congenital and false erosion.

Even in teenage girls, the gynecologist can see displacement of the columnar epithelium during examination. After colposcopy, it becomes clear that it is bright red in color. However, it is impossible to paint it with Lugol's solution. This condition is often called pseudoerosion or ectopia. It can be congenital or acquired. But these are not yet precancerous conditions of the cervix, so such erosions do not require treatment. You just need to monitor them regularly.

If the patient's mucous membrane of the cervical canal everts onto the vaginal part of the cervix, then this condition is called ectropion. This is a combination of scar deformation of cervical tissue and pseudo-erosion. Upon examination, the doctor may see a deformed neck with a slit-like or gaping pharynx with red areas of columnar epithelium. Often they can have a transformation zone.

Another background process is leukoplakia, the name of the disease is translated as “white spot”. With this disease, the stratified epithelium becomes locally keratinized. In this case, infiltrates form around the stromal vessels. Leukoplakia can be simple, then it is classified as a background process. If this disease appears, then we are talking about precancer.

Another disease is erythroplakia, but it is quite rare. This name literally translates as “red spot”. In this condition, the stratified epithelium atrophies and thins down to several layers. Intermediate cells disappear. Vessels are visible through the thinned epithelium, so the areas look like red spots.

Also, during examination, the doctor can see growths covered with epithelium. They are called polyps. These are bright pink formations that can be leaf-shaped or oblong. They hang from the throat of the cervix.

Causes of erosions

Problems can often be detected during a routine examination or colposcopy. If the doctor sees changes, he can explain what causes cervical erosion. So, the most common reasons are:

Infectious diseases, among which the most common are chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, genital herpes, papillomavirus;

Inflammatory diseases of the female genital organs;

Mechanical damage to the mucous membrane;

Hormonal changes.

As a result of the changes, the multilayered epithelium, the layers of which are poorly cohesive and loosely laid, is damaged in places and sloughs off. It has been observed that this occurs 5 times more often in women with menstrual irregularities, they may even have greater cervical erosion. Instead of the desquamated layer, columnar epithelium is formed.

Provoking factors include disruptions in the cycle, frequent changes of partners, early onset of sexual activity and reduced immunity. Many of those who have discovered these problems are interested in whether there are any restrictions if cervical erosion has been diagnosed. What cannot be done with this disease? There are no strict restrictions. It is important to simply see a gynecologist regularly, undergo all the necessary examinations and not refuse the prescribed treatment.

Diagnostics of background processes

As a rule, women with an affected cervix do not complain of anything. There are no symptoms of erosion. True, some experience whitish discharge, which does not cause any discomfort. After sexual intercourse, bloody discharge or ichor may appear. In this case, you should see a doctor as soon as possible. He is able to assess the condition and determine whether there is cervical erosion. The name of the disease in such a situation is more important for the doctor. Further treatment tactics will depend on the identified problem.

On examination, pseudo-erosion looks like a red spot of irregular shape. It stands out against the background of pale mucous membrane. When performing a colposcopy, it becomes clear that the problem areas are covered with red papillae of a round or oblong shape, because of which the surface looks like velvet. You shouldn’t be afraid of colposcopy, it’s just an examination using a special device that can enlarge the area 30-40 times.

Diagnosis of a disease such as leukoplakia is also not difficult. In some patients, the keratinized layers of cells are visible to the naked eye; they appear as white plaques that rise on the ectocervix (the part of the cervix that protrudes into the vagina). In others, they can only be detected during colposcopy. To clarify the diagnosis, cervical tissue can be treated with iodine solution. The affected keratinized areas do not turn brown; they look like a surface covered with a whitish film. To determine the nature of leukoplakia (simple or with atypical cells), a biopsy is necessary.

Also, during examination, the gynecologist may see cysts on the cervix. The reasons for their appearance are as follows:

Sexual infections that provoke the development of inflammatory diseases;

Injury to the cervix during childbirth, abortion,;

Hormonal disorders.

Cysts look like sacs filled with mucus. They arise from the nabothian glands, which appear as small white swellings. If there are malfunctions in their work, the ducts close. In the case when only one sac is visible upon examination, it is called an endometriotic cyst. But there are times when there are several of them. In such situations, the doctor says that these are Nabothian cysts on the cervix. It is advisable to find out the reasons for their occurrence. After all, their appearance can be caused by infections that need to be treated. As a rule, doctors recommend only one treatment method - removal of cysts. This is done by puncturing the sac, removing viscous mucus and treating the place where it appears.

Treatment tactics

In cases where the doctor discovers problems with the cervix, he should tell you what needs to be done next. So, first of all, the specialist will perform a colposcopy, take material for cytological examination and, if necessary, offer a biopsy. A complete examination allows you to determine what causes cervical erosion. It is also important to do microflora smears to determine if there are any infectious diseases. It is mandatory to find out whether the patient has HIV, syphilis or viral hepatitis. In addition, the gynecologist can give a referral for examination for the presence of trichomonas, ureaplasma, HPV, chlamydia, mycoplasma, and gardnerella.

After this, you can begin treatment. Depending on the size, causes of appearance and other factors, the gynecologist will suggest cauterizing the cervix with electric current, performing cryodestruction, laser coagulation or using the radio wave method.

In some cases, simply observing the erosion is sufficient. This tactic is chosen in cases where it is detected in young nulliparous girls. Most often, their appearance is caused by hormonal changes.

Description of treatment methods

Cauterization is one of the most common methods. However, the procedure has many side effects. As a result of cauterization, rough scars may form and the throat of the cervical canal may narrow. In addition, healing after the procedure takes quite a long time. But, despite all the shortcomings, they often use evidence that the procedure is unpleasant, but it cannot be called too painful. Many women simply talk about a feeling of discomfort in the lower abdomen. In addition, there may be vaginal discharge after the procedure.

The doctor must also warn about a number of restrictions. It must be done at least a month after the procedure. There are also restrictions on lifting weights - you can carry no more than 2 kg. A ban is imposed on visiting saunas, baths, taking baths, and engaging in intense physical activity.

Cryodestruction often leads to shortening of the cervix. In addition, as a result of the procedure, the cervical pharynx may narrow. Cryodestruction cannot be called excessively painful; patients are more embarrassed by the accompanying unpleasant odor.

Many people prefer to use more modern methods, for example, the radio wave method for treating cervical erosion. It is carried out with a special device “Surgitron”. The electrode located in it emits high-frequency waves, they generate heat when they meet tissues. In this case, the cells seem to evaporate.

Laser treatment is also considered highly effective. Exposure to a beam of waves leads to the fact that pathologically altered cells are removed. In this case, the surrounding tissues are slightly affected. This method is considered the least traumatic.

Characteristics of dysplasia

Most often, precancerous conditions develop with traumatic lesions of the cervix. Those who have cervical erosion need to be especially careful. Cancer is unlikely to begin to develop against this background, but fields of dysplasia in some cases are detected precisely against the background of pseudo-erosions.

Experts distinguish 3 stages of this disease. The first degree is called mild. With it, the deep layers are affected - the basal and parabasal. The upper layers remain normal. There are no external signs of the disease. It can only be detected by cytology, and the scraping must be taken deeply.

In the second degree - moderate dysplasia - changes can affect up to 2/3 of the epithelial cells. At this stage there should be no atypical cells.

In the third degree, maturation and differentiation of cells occurs only in the superficial layer. The remaining layers are affected. More detailed examinations show the presence of cells with atypia.

Diagnosing dysplasia is not so easy. The disease occurs without any obvious signs and has no characteristic symptoms. During the examination, the gynecologist can determine ectopia, leukoplakia, and see papillomas. Sometimes with dysplasia it happens that the cervix is ​​not changed.

The diagnosis can be made with a smear taken from the cervix. If during the research it was established that the taken material contains cells with dikaryosis (changes in the nuclei), then histology is necessary. It is made from materials taken during a biopsy.

Reasons for the development of dysplasia

In most cases, it is difficult to understand what became the basis for the emergence of problems with a woman’s reproductive organs. But there are a number of factors that can trigger the onset of the disease. So, for example, if a patient has stitches on the cervix, it means that there is a malnutrition of her tissues. And this can become an impetus for the development of the disease.

Provoking factors also include:

Immune and hormonal disorders;

The presence of erosive foci - the transition zone between flat and columnar epithelium, located on the outer part of the cervix, is dangerous;

The presence of a highly oncogenic type of HPV in the body.

The risk factors are the following:

Early onset of sexual activity by a girl at a time when the epithelium is not yet normally formed;

Long-term use of intrauterine and hormonal contraceptives;

Multiple births;

The presence of sexually transmitted infections;

Poor nutrition with deficiency of vitamins C, A and beta-carotene.

It was also found that men’s hygiene also influences the occurrence of these female diseases. Smegma, which accumulates under the foreskin, can cause precancerous conditions of the cervix to begin to develop. This is due to the presence in it which, during sexual intercourse, ends up on the cervix.

Possible ways to get rid of the problem

Treatment tactics directly depend on the degree of dysplasia that was diagnosed. Thus, in the first stage, it is often recommended to simply observe the tissues over time and carry out conservative treatment, which is aimed at eliminating the possible cause of the disease. As a rule, antiviral or antibacterial therapy is carried out to eliminate infectious agents. In the absence of positive dynamics, as well as in cases where dysplasia of the 2nd or 3rd degree was immediately diagnosed, surgical treatment is recommended.

However, it can be performed in the same way as cervical surgery. Reviews indicate that this method gives very good results. Cryodestruction or laser treatment can also be used. In some cases, diathermoconization is used. This method consists in the fact that the changed tissues are excised in the shape of a cone, the apex of which is directed towards the internal pharynx. The removed tissue areas are additionally sent for histology.

It is important to know that patients with dysplasia have a 10-20 times higher risk of developing cancer than those who do not have this problem. At the first stage, there is a possibility of reverse development of the disease - this happens in approximately half of the cases. But in 40% of women it will progress, in the rest it will be in a state of stabilization.

Alternative medicine

Having heard an unpleasant diagnosis, not everyone agrees to treatment with traditional methods. Even if the doctor offers a fairly gentle and highly effective radio wave method for treating cervical erosion, there will be those who refuse the procedure.

Some are starting to look for alternative methods. The most popular are douching with a diluted infusion of calendula (1 tsp in ¼ glass of water), eucalyptus (1 tsp diluted in a glass of water), tampons with sea buckthorn oil or mummy.

But these are not all the options for how the cervix can be treated with folk remedies. Some healers recommend brewing St. John's wort for douching at the rate of 1 tbsp. l. for a half-liter jar of boiling water. The herb must be boiled for about 10 minutes and infused for at least half an hour.

If you decide to refuse qualified help and are treated with the indicated methods, then regularly visit a gynecologist in order to monitor the condition of the cervix. This is the only way to see the deterioration in time and try to correct the situation.