What is Cervical Ectropion?

A cervical ectropion, sometimes also called cervical erosion, is a medical condition in which the lining of a woman’s cervix protrudes down into her vagina. Most of the time this isn’t noticeable from the outside, but is usually pretty easy for a medical professional to diagnose during an exam. It can happen for a number of reasons, but the hormonal shifts associated with puberty, pregnancy, and menopause are the most common; hormone-based oral birth control pills are also to blame in many instances. In most cases the condition isn’t serious and no treatment may be required. In rare cases the ectropion can cause pain, however, particularly during sexual intercourse, and it can also contribute to foul-smelling discharge. The symptoms can often be alleviated with medication or, in serious cases, surgery to remove the protruding tissues.

The cervix is the lower, narrowest, neck-like portion of the uterus and it forms a canal from the base of the uterus that opens into the vagina. A concentration of specialized cells called epithelial cells form epithelial tissue here, which creates part of the lining of the cervix; these cells help the tissues stretch and flex as needed for proper reproductive function. The formal name for the cervical lining is the “central columnar epithelium,” and in rare cases this will actually begin peeling away from the cervix and slipping into the vaginal cavity.

The subsequent erosion often creates a red, raw appearance near the top of the vaginal opening that medical care providers can see when performing an exam. In most cases the color is the natural color and texture of the epithelium and it often looks much more alarming than it really is. Tissue protrusions like this are usually somewhat problematic from a medical standpoint, but the color and original appearance can make it seem like a crisis when, in most cases, it will right itself with time.

Cervical ectropion is relatively common, and it usually develops during pregnancy, during puberty, or with the taking of birth control pills. The cervix tends to enlarge due to the hormonal shifts that come with these events, and these fluctuations can cause the columnar epithelium to protrude out from the cervical canal. Erosion also can be caused by congenital factors, infections, or chemicals. Chemical exposure is most common in women who use douches or spermaticidal contraceptives. Vaginal trauma from intercourse or the insertion of a tampon or foreign object might also be a cause.

Many women don’t experience any symptoms, but of those that do pain during sex and thick, foul-smelling vaginal discharge are among the most common. Some people also report hard stools and mild constipation, though a lot of this depends on individual anatomy and how closely situated the bowels and reproductive organs are. Bleeding after sex is also quite common. The protruding tissues can irritate the vaginal walls and that, coupled with the friction of intercourse, can often lead to light bleeding as blood vessels rupture.

The condition usually does not require treatment, and in most cases will gradually go away on its own. If things don’t get better after a few weeks or if a woman is experiencing significant pain or lifestyle problems, though, there are usually a few options.

Hormone therapy or a discontinuation of oral contraceptives is often the first step. Cryotherapy, which is freezing the area, and diathermy, which is cauterizing, can also be used. Cryotherapy and diathermy are usually painless and can be done on an outpatient basis, though they are more or less permanent and are often considered surgical. Even the most aggressive treatments aren’t always foolproof, though. The cell tissues from the columnnar epithelium can always grow back and become extended again, and women who are taking oral contraceptives tend to have a higher probability of recurrence.

Cervical ectropion is a non-cancerous condition in and of itself, but a cancer screening is usually performed on a woman who has this problem because many of the symptoms are the same. In fact, cervical cancer often looks almost just like ectropy in its early stages. One of the only ways for care providers to definitively say whether the erosion is due to a problem with the cellular lining or a cancerous growth elsewhere in the cervix is to take a sample and test it.