What are the causes of a friable cervix (cervical friability)?

From the Guidelines

A friable cervix is primarily caused by cervical inflammation or infection, with sexually transmitted infections like chlamydia, gonorrhea, and trichomoniasis being common causes, as indicated by the American Academy of Pediatrics in their clinical report on gynecologic examination for adolescents 1.

Causes of Friable Cervix

The causes of a friable cervix can be multifaceted, including:

• Sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and trichomoniasis, which can lead to cervicitis, as noted in the guidelines for treating STDs released by the CDC in 2002 1
• Human papillomavirus (HPV) infection, potentially leading to cervical dysplasia or cancer
• Bacterial vaginosis and yeast infections, which may contribute to cervical friability
• Hormonal changes during pregnancy, increasing cervical vascularity and making it more prone to bleeding when touched
• Trauma from childbirth, sexual activity, or medical procedures, damaging the cervical tissue
• Certain contraceptives, particularly intrauterine devices (IUDs), occasionally causing cervical irritation

Diagnosis and Treatment

Diagnosis of the underlying cause of a friable cervix is crucial for appropriate treatment. This may involve:

• Pap smears and HPV testing for early detection of cervical abnormalities
• Wet mount or potassium hydroxide examination for diagnosing yeast infections or trichomoniasis
• Laboratory tests for STIs, such as chlamydia and gonorrhea Treatment depends on the underlying cause, including:
• Antibiotics for bacterial infections, such as doxycycline 100mg twice daily for 7 days for chlamydia
• Antifungals for yeast infections
• Antiviral medications for viral infections Regular medical check-ups and prompt attention to symptoms like abnormal vaginal discharge, bleeding after intercourse, or pelvic pain are essential for managing a friable cervix.

From the Research

Causes of Friable Cervix

• A friable cervix can be caused by various factors, including infections such as chlamydia 2, 3, 4, 5.
• Chlamydia trachomatis infection has been linked to an increased risk of cervical cancer, with a meta-analysis showing a significant association between the two 4, 5.
• The infection can cause inflammation and damage to the cervical tissue, leading to a friable cervix 2.
• Other factors that may contribute to a friable cervix include:
  • Cervicitis, an inflammation of the cervix, which can be caused by Chlamydia trachomatis and Neisseria gonorrhoeae 3.
  • Pelvic inflammatory disease (PID), which can cause damage to the reproductive organs, including the cervix 3.
• It is essential to note that not all cases of friable cervix are caused by infections, and other factors such as hormonal changes, trauma, or certain medical conditions may also contribute to this condition.
• Studies have shown that treatment of chlamydia infection can reduce the risk of developing a friable cervix and cervical cancer 2, 4, 5.