Cervical Ectropion

Introduction

The purpose of this leaflet is to provide you with information about a condition known as cervical ectropion.

This leaflet is not to replace the discussion between you and the healthcare team, but can act as a starting point for discussion and allow you to have an informed choice in your care.

What is cervical ectropion?

Cervical ectropion (sometimes referred to as ectopy or erosion) is a red and often raw looking area on the outer surface of the cervix (neck of the womb).

This is a normal and very common condition. It is not linked to cervical cancer.

There are 2 types of cells found in the cervix (neck of the womb):

• Squamous cells – these are ‘firm’ pink cells and cover the outer part of the cervix.

• Columnar/glandular cells – these are ‘soft, delicate’ red cells and line the inside of the cervix.

Where these 2 types of cells meet at the cervical opening, is an area called the squamocolumnar junction (SCJ).

At birth, the SCJ is positioned at or within the cervical opening but as you age, and especially after puberty the increased amount of female hormone (oestrogen) causes the size of the uterus (the womb) to increase.

As this happens, the rim of the cervix rolls outwards, causing more of the columnar cells to be visible on the cervix.

This is similar to what happens if you roll out your lips, the inside of your mouth is then more visible, when the doctor or nurse looks at your cervix they will see a red area, this is the soft (glandular) cells, this is called an “ectropion.”

Symptoms of cervical ectropion

For the majority of women, cervical ectropion does not cause any problems and may resolve on its own over time. However, in some women it may cause an increase in vaginal discharge or unexpected vaginal bleeding between menstrual periods or after sexual intercourse.

What treatments are available?

Before undertaking treatment it is important to rule out the following;

• Infection.
• Inflammation.
• Any possibility of abnormality on the cervix.

Usually these tests have already been carried out by your GP. This may include swabs and making sure that your cervical screen (if you are eligible for this) is up to date.

Treatment is not always necessary as symptoms may resolve by themselves within 3 to 6 months. Sometimes switching from combined oral contraceptive pill to a different contraception (under medical review) can help to resolve a cervical ectropion.

However, if you have found your symptoms troublesome, or persistent for more than 6 months, your GP may have referred you for further assessment.

Treatment is usually performed at a colposcopy or gynaecology clinic. Treatment used causes the destruction of the ‘soft delicate’ cells to stop them from bleeding, although this is not recommended in pregnancy.

Different types of treatment

There are a few different treatment options available and these are:

Silver nitrate – This is a chemical stick that is applied to the ectropion and cauterises (burns) the area. It takes approximately one to two minutes. It is not used on large areas. Local anaesthetic is not required.

Aftercare following Silver nitrate
You may get some watery, black discharge for up to one week. This will stain your underwear. It is advisable to use pads and not tampons during this time to help reduce the risk of infection.

You may wish to avoid sexual intercourse until the discharge has settled. If you do have intercourse, it is advisable to use a condom as the silver nitrate on the cervix may cause irritation to your partner.

Cryocautery – This is a freezing technique used to treat the ectropion. A small probe with a metal tip is placed onto the cervix or the cervix is treated with a cold spray. The treatment lasts approximately 90 seconds and you may experience some period like pains during this time. Local anaesthetic is not required.

Aftercare following Cryocautery
If the period like pains are still there when you get home, you may take whichever pain relief you normally use, such as paracetamol.

You may have a heavy, watery discharge for approximately two weeks. It is advisable to use pads and not tampons during this time as to help reduce the risk of infection. The discharge should not be yellow or foul smelling as this could indicate an infection. If an infection occurs, see your GP who can prescribe antibiotics. You may wish to avoid sexual intercourse until the discharge has settled.

Cautery using Diathermy – Local anaesthetic is injected into the cervix. An instrument called a coagulation ball which uses an electric current is used and the top layer of cells on your cervix are cauterised.

Aftercare following Diathermy
You may have a slight bloody, watery discharge for 2 to 4 weeks. It is advisable to use pads and not tampons during this time to help reduce the risk of infection. You may wish to avoid sexual intercourse until the discharge has settled. You may experience ‘period’ type pain after the treatment once the local anaesthetic has worn off. You may take whichever pain relief you normally use, such as paracetamol.

You should seek medical advice if you have any of the following symptoms after treatment:

• A smelly discharge.
• Fever or high temperature.
• Heavy vaginal bleeding.
• Severe abdominal pain.

Please note, treatment does not always resolve symptoms completely, and any improvement in symptoms may be short lived. If your symptoms persist or recur after treatment, speak with your GP.

What if I’m pregnant?

Cervical ectropion is very common during pregnancy. Pregnant women are more likely to experience symptoms due to hormonal changes and higher levels of oestrogen in their body. Although these changes are common, any unusual discharge or bleeding in pregnancy should be investigated by your GP, midwife, or early pregnancy unit depending on the stage of your pregnancy to ensure there is no other cause of the bleeding.

Further Advice:

We hope that you have found the information in this leaflet helpful. If you require any further advice regarding your care, please do not hesitate to ask the clinic staff. They are there to support you and are happy to help with any concerns or anxieties you may have.

Contact numbers:

University Hospital of North Tees

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm
Telephone 01642 624172

University Hospital of Hartlepool

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm           
Telephone 01429 522865

You can also contact a Specialist Nurse Colposcopist on the following number:
Colposcopy Hub:
Monday to Friday, 8.30am to 4.30pm
Telephone 01429 522268

Useful Websites:

Cancer Research UK:
www.cancerhelp.org.uk
www.cancerscreening.nhs.uk

Jo’s Cervical Cancer Trust:
www.jotrust.co.uk

The British Society for Colposcopy and Cervical Pathology:
www.bsccp.org.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

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The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]