From the Guidelines
Eversion of the cervix is a normal anatomical variation that typically requires no treatment, as it is not a disease but rather a normal variant, and this is supported by the American Academy of Pediatrics' clinical report on gynecologic examination for adolescents 1. When examining the cervix, it is essential to completely visualize the cervix to note the presence of any lesions, as well as the presence or absence of an ectropion, which is a normal developmental finding of the adolescent cervix 1. The key characteristics of cervical eversion include:
- A reddish appearance due to the columnar cells being more vascular than the surrounding squamous epithelium
- Increased susceptibility to infection
- Potential symptoms like increased vaginal discharge or post-coital bleeding
- Common occurrence in women of reproductive age, particularly those using hormonal contraceptives, and during pregnancy It is crucial to distinguish cervical eversion from cervical ectropion and from pathological conditions through proper examination, as described in the American Academy of Pediatrics' clinical report 1. Regular cervical screening should continue as recommended regardless of the presence of eversion, and treatment options like cauterization or cryotherapy are rarely necessary and should only be considered if the patient experiences troublesome symptoms. In the context of a speculum examination, the clinician should inspect the vaginal walls for discharge and lesions, and the cervix should be completely visualized to note any abnormalities, as outlined in the clinical report 1.
From the Research
Eversion of Cervix
- Eversion of the cervix, also known as cervical ectropion, is a condition where the glandular cells lining the cervical canal are everted to the outside of the cervix, often causing symptoms such as abundant leucorrhoea, postcoital bleeding, recurrent cervicitis, pelvic pain, and dyspareunia 2.
- Treatment options for cervical ectropion include cryotherapy, which has been shown to be an effective and feasible treatment, improving quality of life scores and symptom relief, although it may not significantly impact female sexual function 2.
- Other treatment options, such as microwave therapy, have also been studied, with some evidence suggesting that it may be effective in improving cervical appearance and reducing symptoms, although the methodological quality of the studies is generally low 3.
Related Conditions
- Uterine inversion is a rare but potentially life-threatening obstetrical emergency that can occur during childbirth, often accompanied by postpartum hemorrhage and hypovolemic shock, and requires prompt recognition and management 4.
- A short cervix in the second trimester is a significant risk factor for spontaneous preterm birth, preterm prelabor rupture of membranes, and subsequent adverse perinatal outcome, and treatment options such as cerclage, progesterone, pessary, and combination therapy are available 5.
Treatment Options
- Cryotherapy is a commonly used treatment for symptomatic cervical ectropion, and has been shown to be effective in improving quality of life scores and symptom relief 2.
- Microwave therapy may be an effective treatment option for cervical ectropion, although further studies are needed to confirm its efficacy and safety 3.
- Excisional procedures, such as loop electrosurgical excision procedure, and ablative therapies, such as cervical cryotherapy, can be effective at treating cervical precancer, although excisional procedures may be associated with adverse obstetric outcomes 6.