Cervical ectropion (previously known as cervical erosion) is a condition in which the inner lining of the cervix (columnar epithelium) protrudes through the cervical opening and grows on the outer surface of the cervix, making the area appear red and inflamed. This is not a painful condition.
Cervical ectropion is a benign and painless condition. It is seen very commonly in young women, noted for example when a cervical smear or swabs for a possible infection is being taken. It is caused by hormonal changes, especially in pregnant women who may complain of vaginal bleeding or discharge.
A cervical ectropion is not unusual in those taking the combined oral contraceptive pill containing oestrogen.
A cervical ectropion is diagnosed by looking at the neck of the womb (cervix) with a speculum.
A cervical ectropion does not usually need treatment, unless there is persistent vaginal discharge or repeated post coital bleeding (see leaflet). While vaginal discharge is the most common symptom, most women are asymptomatic, which means they have no symptoms at all. In such situations, they do not need treatment.
The vaginal discharge from the ectropion may be excessive in nature as the cells in this area are rather sensitive and react by producing excess fluid. However, the discharge is not offensive and is not associated with itching or soreness. If this the case, medical advice should be sought to rule out an infection.
It is important to check that the woman is up to date with her cervical smears before treating the cervical ectropion, to ensure no coincidental precancer cervical cells are missed or buried with the treatment. Women may sometimes bleed from a cervical ectropion when a smear is taken, as the brush used can disturb the delicate columnar cells. This is not unusual and settles in a few days.
Treatment involves the use of diathermy to the red area (electrical treatment) under local anaesthetic. Sometimes cryotherapy (cold freezing technique) is used or silver nitrate sticks are used to cauterise the area in the outpatient setting, especially if the ectropion is small. You may experience some mild discomfort in your tummy. By all these methods, the idea is to encourage new skin to replace the more sensitive cells and encourage new cells like the outer surface of the cervix to take their place. Repeat treatment may be needed if the symptoms persist.
After treatment to the ectropion, you may experience some light bleeding or discharge for 1-3 weeks as the area heals. You may have very mild period like pain which should settle with your usual painkillers. You should avoid sexual intercourse and tampons until you have completed stopped bleeding and the discharge has settled.
Dr Nitu Bajekal FRCOG Dip IBLM
Consultant Gynaecologist and Women’s Health Expert
Lifestyle Medicine PhysicianUpdated January 2020