Cervical Ectropion: Causes, Symptoms, Treatment and Cost

Cervical Ectropion (also known as cervical eversion or fragile cervix) is a medical condition where the cells inside the cervical canal of a woman’s uterus have grown abnormally on the outside of the cervix. It is most common in women during their reproductive years, and it is usually benign, meaning it does not cause any long-term health problems.

There are three types of Cervical Ectropion:

• Physiological ectropion: This type of Cervical Ectropion is the most common variety and usually occurs during puberty, when increased hormones in the body cause the cervix to become more fragile, making it prone to becoming pulled down.
• Pathological ectropion: Pathological Cervical Ectropion is caused by pathology or disease such as endometriosis, infection, trauma, or neoplasia. It is more serious than physiological Cervical Ectropion as it requires medical attention and treatment due to its potential for serious complications like infertility and miscarriage.
• Inverted Cervix Ectropion: This type of Cervical Ectropion involves a complete reversal of the normal anatomic position of the cervix so that it is pulled up towards the back wall of the vagina instead of downwards towards the front wall as seen in other types of Cervical Ectropion. Inverted Cervix Ectropions are rare and can occur without any underlying pathology.

Many factors, including the following, may contribute to cervical ectropion:

• Hormonal changes: During pregnancy and menopause, higher levels of hormones like estrogen may increase the risk of Cervical Ectropion.
• Abnormal cell production: When cells on the surface of the cervix don't shed as expected, ectropion can develop.
• Chronic inflammation: Inflammation caused by certain infections is a potential trigger for Cervical Ectropion.
• Genetic factors or abnormalities in development may also increase the risk of ectropion.

Cervical ectropion may be indicated by these symptoms:

• Vaginal discharge – either clear or milky in color.
• Painful urination
• Increased risk of vaginal infections.
• Irritation, itching, and burning sensation in the cervix area.
• Excessively heavy menstrual flow or an irregular cycle.
• Presence of bleeding between periods.

These steps may be followed in order to prevent Cervical Ectropion:

• Avoid douching, as this can strip away protective mucus and cause the cervix to become dry.
• Refrain from frequent or prolonged use of tampons.
• Wear cotton underwear to keep the vaginal area cool and dry
• Wear loose-fitting clothing to maintain proper ventilation in the genital area
• Use lube during intercourse to reduce friction
• Have regular pap smears and well-woman gynecologic exams to check for Cervical Ectropion.

To check for Cervical Ectropion, your doctor may order the following tests:

• Pelvic examination: During this exam, the doctor will visually inspect the area to check for any signs of infection or abnormalities affecting the cervix as well as take swabs from different areas.
• Pap smears or HPV testing: While both can be used in combination to diagnose Cervical Ectropion, pap smears may be used more often if HPV is already known or suspected in the patient's health history. It can provide additional information about potential infections that have been found in the cervix due to its presence.
• Colposcopy Exam: A colposcopy exam involves using a microscope with an attached camera to magnify a woman’s cervix so that her doctor can check for any signs of infection or abnormalities such as Cervical Ectropion.
• Biopsy: An endocervical biopsy is sometimes used to confirm suspicions of an ectopic condition by collecting samples from infected cells on the inside surface of the cervix which are then examined under a microscope by pathologists in laboratory settings.
• Imaging Tests: Imaging tests such as an ultrasound scan or magnetic resonance imaging (MRI) may also be used to diagnose certain types of diseases affecting women's reproductive system including Cervical Ectropion.

The following are the most typical side effects of cervical ectropion:

• Infertility: Cervical ectropion can lead to difficulty conceiving due to a disruption of the normal cervical environment and the resulting decrease in cervical mucus production.
• Pelvic inflammatory disease (PID):
• This can occur if bacteria from the vagina gain access to the uterus, causing inflammation, scarring, and even infertility.
• Abnormal bleeding: spotting or heavy bleeding between menstrual periods can be caused by ectropion as a result of increased exposure of junctional epithelial cells to blood vessels.
• Irritation, inflammation, and infection of the cervix and vagina: Ectropion can increase a woman’s risk for irritation, inflammation, and infection resulting from bacteria entering the uterus through the cervix.
• Increased risk of sexually transmitted infections (STIs).

These home remedies may help in treating cervical ectropion:

• Applying almond oil or sesame seed oil on the affected area helps to reduce the symptoms of Cervical Ectropion.
• Make a paste of crushed fenugreek seeds and honey, apply it to the affected area, and rinse off after 15 minutes.
• Intake of dietary supplements like vitamin C, copper, choline, and biotin for better results.
• Include antioxidants-rich fruits such as pomegranate and blueberries in the diet to improve immunity & reduce inflammation in the cervix region.

If you have Cervical Ectropion, you should:

• Consume a diet that is well-balanced and full of fresh produce, whole grains, lean proteins, low-fat dairy, and healthy fats.
• Boost your consumption of vitamin C and other antioxidants to aid in the reduction of neck tissue inflammation.
• Consume plenty of omega-3 fatty acids such as fish oil to help reduce inflammation associated with Cervical Ectropion.

Foods to avoid in Cervical Ectropion may include:

• Spicy or acidic foods: Foods that are spicy or acidic, such as tomatoes, peppers, citrus fruits, and vinegar, should be avoided as they can irritate the sensitive tissue in the cervix.
• High-fiber foods: High-fiber foods such as raw vegetables and whole grains may aggravate the condition and should be avoided.
• Dairy products: Dairy products can increase mucus production in the body which may lead to inflammation in the cervix and should be avoided.
• Processed meats: Processed meats such as hot dogs, bacon, sausage, etc., contain nitrates which can irritate the tissue of your cervical lining and should not be consumed if you have Cervical Ectropion.
• Alcohol: Alcohol consumption is known to dehydrate the body which could worsen Cervical Ectropion symptoms so it is best avoided when you have this condition.

Cervical Ectropion is typically treated through:

• Cold compresses: Cool compresses may be applied to help reduce swelling, inflammation, and discomfort related to ectropion.
• Skincare products: Protect the damaged skin region from additional irritation and dryness using gentle, non-irritating skincare products like petroleum jelly or zinc oxide.
• Birth control pills: Oral contraceptives may be prescribed to help regulate hormone levels and restore the normal balance of estrogen to ease the symptoms of Cervical Ectropion.
• Cryotherapy: The abnormal tissue is frozen off using liquid nitrogen.
• Laser Surgery: The damaged tissue is removed using a laser beam.
• Cone Biopsy: It involves the removal of an area of neck tissue by means of a disc-shaped or cone-shaped device with slight suction applied to it which separates the affected from a normal layer of epithelium.
• Hysterectomy: If ectropion becomes severe, it can be treated using hysterectomy, the surgical removal of the uterus and cervix along with the endocervical canal and its connected structures like fallopian tubes, ovaries, etc.

It is advisable to consult a doctor specializing in Women’s Health, such as a gynecologist or obstetrician, for issues related to Cervical Ectropion.
The doctor may diagnose the condition through physical examination and take into account factors such as past medical history and other risk factors.

The following drugs are often prescribed to treat cervical ectropion:

• Hormone therapy: This type of therapy uses hormones to regulate the development and growth of Cervical Ectropion. Examples of hormones used for this purpose include progesterone, estradiol, and oral contraceptives.
• Antibiotics: These drugs are prescribed to reduce inflammation and promote healing in the affected area. Examples include tetracyclines, metronidazole, and ampicillin.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are used to reduce inflammation and discomfort in the area surrounding the Cervical Ectropion. Examples include ibuprofen, naproxen sodium, and acetaminophen.
• Steroid creams: These lotions, which include topical corticosteroids, may be administered directly to the region in question to lessen the pain and swelling brought on by Cervical Ectropion. Examples include clobetasol propionate cream and hydrocortisone cream.

Recovery from Cervical Ectropion depends on various factors such as the cause of it, any accompanying treatments, and lifestyle modifications that are implemented. Nonetheless, recuperation often takes between two and four weeks. During this time period, treatments typically focus on relieving discomfort and irritation while reducing inflammation and eliminating the underlying cause.

The results of therapies may not always be long-lasting, even if they often help to improve symptoms. Recurrence following treatment is common and close monitoring of risk factors and signs/symptoms should be done periodically to ensure successful management of Cervical Ectropion.

The following drugs are often prescribed to treat cervical ectropion:

• Hormone therapy: This type of therapy uses hormones to regulate the development and growth of Cervical Ectropion. Examples of hormones used for this purpose include progesterone, estradiol, and oral contraceptives.
• Antibiotics: These drugs are prescribed to reduce inflammation and promote healing in the affected area. Examples include tetracyclines, metronidazole, and ampicillin.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are used to reduce inflammation and discomfort in the area surrounding the Cervical Ectropion. Examples include ibuprofen, naproxen sodium, and acetaminophen.
• Steroid creams: These lotions, which include topical corticosteroids, may be administered directly to the region in question to lessen the pain and swelling brought on by Cervical Ectropion. Examples include clobetasol propionate cream and hydrocortisone cream.

Depending on the severity of the problem and the kind of therapy required, the cost of Cervical Ectropion treatment in India varies. Common treatments for this condition may include cryosurgery, electrocautery, laser therapy, antibiotics, and topical creams. On average, these treatments can range anywhere between ₹1000 - ₹15000 depending on the complexity of the procedure and other additional costs such as doctor's fees.

Side effects which may be caused by Cervical Ectropion treatments are:

• Bleeding: Cervical Ectropion treatments can cause light, irregular vaginal bleeding or spotting.
• Pain: Pain when urinating, pelvic discomfort, generalized abdominal pain and lower back pain may be experienced as a side effect of treatment.
• Infection: The vagina or cervix area can become infected due to the condition or due to treatment complications such as the movement of bacteria from the uterus to other areas of the body.
• Infertility: In rare cases, Cervical Ectropion may lead to fertility issues such as difficulty getting pregnant or recurrent miscarriages due to difficulties with implantation of the embryo in the uterus.
• Effect on contraception: Because Cervical Ectropion can increase vaginal pH levels, it could affect the efficacy of certain contraceptives, like diaphragms and some forms of birth control pills.