Quite often, women after visiting the gynecologist’s office for the first time hear about a diagnosis called “cervical ectopia”. This term is not entirely clear to a person without a medical education, and therefore patients are trying to find additional information on this topic.
So what is this pathology? How dangerous is it? Under the influence of what factors does the disease develop and is it possible to somehow prevent its occurrence? What symptoms should I look for? Answers to these questions will benefit many readers.
Cervical ectopy and cervical endocervicosis: what is it?
Of course, first of all, women are interested in the question of what constitutes this disease. In fact, the disease is known in medicine under various terms - this is pseudo-erosion, and endocervicosis of the cervix. What is it and how dangerous can it be?
To answer the question posed, you must first consider the features of female anatomy. The cervix is the lower part of the organ that connects the vagina and the uterine cavity. Inside the neck passes the cervical canal. The vaginal part of the neck is covered by very characteristic flat epithelial cells, which are located in several layers. But the cervical canal is lined with a single layer of cylindrical epithelium. In some patients, for one reason or another, cylindrical cells extend to the vaginal part of the neck, replacing a stratified squamous epithelium. In such cases, women are diagnosed with cervical ectopia with squamous metaplasia.
Physiological ectopia - what is it?
It is worth noting that this pathology is not always dangerous. Special therapy is prescribed only at the risk of complications.
In some cases, replacement of squamous epithelium is generally considered the norm. For example, similar changes in the structure of the cervix are often found in teenage girls and young women. This tissue change is associated with an increase in the level of sex hormones (estrogens), which is completely normal at this age.
Physiological reasons include pregnancy, because during this period of a woman’s life, the body also goes through significant hormonal changes.
What are the causes of the pathological process?
There are other risk factors that can lead to pathological spread of the cylindrical epithelium.
- If we are talking about external exposure, then cervical ectopia can develop against the background of infection penetrating into the neck tissue (including sexually transmitted diseases).
- Risk factors include early onset of sexual activity, neck injuries during sexual intercourse, promiscuous sexual life, the use of barrier contraceptives (such as spirals), and the use of spermicides too often.
- Cervical injuries can occur during childbirth, abortion, diagnostic or therapeutic curettage.
- As for the internal factors, then hormonal imbalance can be attributed to them, for example, with a disease of one or another organ of the endocrine system.
- Endogenous causes also include protracted inflammatory diseases of the reproductive system, against which cervical ectopia (cervicitis and other ailments) can develop.
- There is an assumption that the development of pathology can lead to the use of hormonal contraceptives, as well as bad habits (especially smoking), work in harmful production and a hereditary predisposition. Nevertheless, the importance of these factors has not yet been proved, and therefore the question remains open among researchers.
What are the symptoms of the disease?
Cervical ectopy of the cervix rarely leads to any deterioration in well-being. As a rule, pathology is detected by chance during a routine examination. External symptoms appear only if ectopia is complicated by inflammation.
Signs include the appearance of uncharacteristic whites with an unpleasant odor, as well as itching and discomfort in the external genital area. Some women complain of pain during intercourse, as well as the appearance of spotting at its completion. Burning and soreness during urination are possible. But again, these symptoms indicate the presence of an inflammatory process in the tissues of the neck.
Ectopia and pregnancy: how dangerous is it?
In this case, much depends on whether a cervical ectopia was detected before or during pregnancy. If the pathology was diagnosed during the planning period of the child, then treatment is necessary, especially if during the studies an inflammatory process with infection was detected. In such cases, antibiotic therapy is necessary, after which the pathology section is cauterized.
If ectopia was formed already during pregnancy, then, most likely, it is associated with physiological changes and treatment is not required. In any case, the expectant mother should undergo regular examinations and take tests. When an infection is attached, a gentle antibacterial treatment is performed. Nevertheless, it is possible to cauterize a "wound" only 6-8 weeks after birth.
Chronic form of the disease
The chronic form of the disease is indicated if ectopia, along with complications in the form of the inflammatory process, was not diagnosed on time. Prolonged inflammation is accompanied by approximately the same symptoms as the acute form - patients complain of pain, unpleasant discharge, itching in the genital area.
The chronic form is much more difficult to treat and requires additional diagnostic measures. If you do not treat inflammation of the cervical canal and ectopia, then other complications may appear, including infertility.
Modern diagnostic methods
In fact, cervical ectopy is a pathology that is quite simple to detect with a standard gynecological examination using mirrors. When the cylindrical cells of the neck of the vagina extend beyond the permissible limits, then these areas become more red. The cervix is as if covered with small wounds.
Naturally, further studies are needed for differential diagnosis (this pathology must be distinguished from, for example, true erosion, cancer):
- To begin with, a scraping of cells is taken from the cervical canal. Samples are then sent for cytological analysis, which helps determine the presence of malignant transformation.
- Colposcopy is performed, and the doctor studies the structure and condition of the cervix using special solutions to which healthy and altered cells react differently.
- A biopsy is a study that is performed when a cancer is suspected. During the procedure, the doctor excises a small area, receiving tissue samples for further laboratory research.
- Bacteriological culture of samples taken from the cervical canal allows you to determine whether a bacterial infection is taking place, as well as to find out the exact variety of the pathogen, to find out its resistance to certain types of antibiotics.
- A PCR study is indicated for suspected viral infection - this is almost the only way to accurately determine the pathogen by the characteristics of its DNA.
Drug treatment and its effectiveness
What to do if you have cervical ectopy? Treatment in some cases may not be required at all. For example, in adolescent girls, the pathology often disappears on its own after the normalization of hormone levels. The same applies to pregnant women - ectopia heals after childbirth and lactation.
Specific drug therapy is required if the pathology is complicated by an infection. Depending on the type of pathogen, the patient is prescribed antibacterial, antiviral or antifungal drugs. If ectopia is associated with hormonal imbalance, appropriate treatment with hormonal drugs can be performed.
Other therapies
In addition to drug treatment, sometimes it is necessary to remove the pathology site itself in order to prevent further “sprawl” of the cylindrical epithelium. Modern medicine offers several ways:
- Cryodestruction - the area with pathologically altered tissues is exposed to ultra-low temperatures (in fact, liquid nitrogen).
- Chemical destruction - a procedure in which the cylindrical epithelium is destroyed using chemically aggressive solutions (for example, Vagotil, Solkovagin).
- Diathermocoagulation - cauterization of pseudo-erosion using electric currents.
- Radio wave therapy is a technique that allows you to eliminate pathological areas using high-frequency currents, and without direct contact with the tissues of the cervix.
- Laser destruction is a technique that allows you to quickly remove foci of the disease, minimizing the risk of tissue infection. This technology practically does not require a rehabilitation period.
Are there preventative methods?
Unfortunately, there is no vaccine or any other medicine that can prevent the development of such an ailment. Nevertheless, if you avoid risk factors and follow some standard recommendations, you can minimize the likelihood of such a pathology as an ectopia of the cervical epithelium.
In particular, it is worth abandoning promiscuous sexual relations, and in any case, use protection against sexually transmitted diseases. Any infectious or inflammatory disease of the pelvic organs should respond to treatment on time, because then the likelihood of complications is reduced. In no case should you arbitrarily use hormonal drugs (including birth control). It is important to observe the rules of personal hygiene.