From the Guidelines
A friable cervix is a condition that requires immediate medical attention, as it may be a sign of an underlying infection, such as chlamydia or gonorrhea, or other conditions like cervical ectropion or cervical cancer, and should be evaluated with a pelvic examination and possibly tests for infections and a Pap smear, as recommended by the American Academy of Pediatrics 1 and the U.S. Preventive Services Task Force 1.
Causes and Risk Factors
The causes of a friable cervix can include cervical inflammation, sexually transmitted infections, cervical ectropion, or cervical cancer.
- Cervical inflammation (cervicitis) can be caused by sexually transmitted infections such as chlamydia or gonorrhea.
- Cervical ectropion is a condition where the inner cervical cells grow on the outer surface of the cervix, which can cause bleeding and discharge.
- Cervical cancer is a rare but serious condition that can cause abnormal vaginal bleeding, pelvic pain, and other symptoms.
Diagnosis and Treatment
Diagnosis of a friable cervix typically involves a pelvic examination, possibly with tests for infections and a Pap smear to rule out abnormal cells.
- A pelvic examination can help identify any abnormalities in the cervix, such as bleeding, discharge, or lesions.
- Tests for infections, such as chlamydia or gonorrhea, can help identify the underlying cause of the friable cervix.
- A Pap smear can help rule out abnormal cells or cervical cancer. Treatment depends on the underlying cause of the friable cervix.
- Antibiotics may be prescribed to treat infections such as chlamydia or gonorrhea.
- Observation may be recommended for cervical ectropion, which often resolves naturally.
- More specific interventions, such as surgery or chemotherapy, may be necessary if precancerous or cancerous changes are detected.
Importance of Regular Gynecological Check-ups
Regular gynecological check-ups are important for early detection and management of cervical conditions, including a friable cervix.
- The U.S. Preventive Services Task Force recommends screening for cervical cancer every 3 years with cytology alone, every 5 years with hrHPV testing alone, or every 5 years with cotesting for women aged 30 to 65 years 1.
- Women with a history of cervical cancer, precancerous lesions, or other risk factors may need more frequent screening.
- Regular check-ups can help identify any abnormalities in the cervix, including a friable cervix, and allow for early treatment and prevention of complications.
From the Research
Definition and Causes of Friable Cervix
- A friable cervix refers to a condition where the cervix is soft, fragile, and prone to bleeding [ 2 ].
- This condition can be caused by various factors, including cervicitis, which is the inflammation of the cervix, usually caused by an infectious agent, often sexually transmitted [ 2 ].
Symptoms and Diagnosis
- The symptoms of a friable cervix can be nonspecific, but may include an increase in vaginal discharge and/or intermenstrual bleeding [ 2 ].
- Diagnosis of cervicitis, which can cause a friable cervix, can be made using commercial systems based on molecular techniques that include almost all known pathogens associated with cervicitis [ 2 ].
Treatment and Management
- Treatment of cervicitis, which can cause a friable cervix, may involve empirical antibiotic therapy that covers common pathogens such as C.trachomatis and N.gonorrhoeae [ 2 ].
- In some cases, procedures such as loop electrosurgical excision procedure (LEEP) or cold-knife conization (CKC) may be necessary to diagnose and treat cervical intraepithelial neoplasia (CIN) [ 3 ].