From the Guidelines
Cervicitis is primarily caused by sexually transmitted infections, most commonly Chlamydia trachomatis and Neisseria gonorrhoeae, as evidenced by the 2006 guidelines on sexually transmitted diseases treatment 1. The causes of cervicitis can be broken down into:
- Infectious causes:
- Non-infectious causes:
- Chemical irritation from douching or exposure to chemical irritants 1
- Idiopathic inflammation in the zone of ectopy, which may be related to persistent abnormality of vaginal flora 1 It is essential to note that in many cases of cervicitis, no organism is isolated, especially in women at relatively low risk for recent acquisition of these STDs, such as women aged >30 years 1. The treatment of cervicitis depends on the specific cause, and it is crucial to treat the condition promptly to prevent complications such as pelvic inflammatory disease, infertility, or increased risk of HIV transmission 1.
From the FDA Drug Label
Urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae. The causes of cervicitis are Chlamydia trachomatis and Neisseria gonorrhoeae 2.
From the Research
Causes of Cervicitis
- Cervicitis is typically caused by Chlamydia trachomatis and Neisseria gonorrhoeae, which are sexually transmitted infections 3, 4
- Bacterial vaginosis (BV) is also associated with cervicitis, and treatment of BV with metronidazole gel has been shown to increase the resolution of cervicitis 5
- Other reproductive tract infections, such as trichomoniasis, human papillomavirus, and herpes simplex virus, have also been linked to cervical inflammatory epithelial changes 6, 7
Risk Factors
- Having multiple reproductive tract infections increases the risk of cervical inflammatory epithelial changes, with a 72.6-fold increased risk when infected with two or more agents 6
- The presence of inflammatory epithelial changes is significantly associated with infections such as chlamydia, human papillomavirus, and bacterial vaginosis 6
- Women with inflammatory smears are at increased risk of developing preneoplastic or neoplastic changes and may transmit infections to their partners 7
Diagnosis and Treatment
- Diagnosis of cervicitis is typically made through a pelvic exam and commercial systems based on molecular techniques that include almost all known pathogens associated with cervicitis 4
- Empirical antibiotic therapy that covers C. trachomatis and N. gonorrhoeae is recommended for women at high risk of infection by these pathogens 4
- Treatment of BV with metronidazole gel has been shown to increase the resolution of cervicitis, and may have nonspecific anti-inflammatory effects or affect the BV flora 5