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What is a cervical ectropion?
The cervix is the lower portion of the womb (uterus) and connects the womb and the vagina. It is sometimes referred to as the ‘neck of the womb’. It allows the passage of sperm up from the vagina to the womb and the passage of a baby and menstrual blood from your period from the womb to the vagina.
The outside of the cervix (ectocervix), which can be seen on a speculum exam, is hard and smooth with an opening (external os) which leads to the inside of the cervix called the endocervical canal (birth canal).
Ectropion (ek-tro-pee-un) is when something from the inside turns onto the outside. A cervical ectropion happens when the delicate columnar cells come out onto the outside of the cervix.
A cervical ectropion appears red due to the underlying blood vessels appearing through skin which is very thin.
What causes cervical ectropion?
A lot of women are born with a cervical ectropion. It is linked to the hormone oestrogen, so you are more likely to have an ectropion if you are having a natural response to increased oestrogen.
- Younger women
- Going through puberty
- Pregnancy or had a child
- Taking the combined contraceptive pill
It is not cancer and is not linked to cancer.
Signs and symptoms
Some women experience no symptoms and it is an incidental finding on a speculum examination or after having a cervical sample (smear test) taken.
An ectropion does not cause pain.
The glandular cells are very delicate so touching or rubbing them can lead to light bleeding after sexual intercourse or in between periods, especially in the middle of your cycle when your oestrogen is at its highest.
Glandular cells also produce mucus so you can have an increase of your normal discharge.
You may experience
- Light bleeding (spotting) or an increased discharge during or after intercourse
- Light bleeding after your cervical sample (smears)
- Light bleeding in between regular periods
- Light bleeding after exercise, running or horse riding
- Increased discharge with no infection
You should always see your GP if you experience
- A change to your daily vaginal discharge (volume, irritation, colour or smell)
- Heavier and/or longer bleeding after intercourse or between your periods
- Pain during or after intercourse
What is the treatment for a cervical ectropion?
Most people do not have any symptoms and do not need any treatment. Over time the ectropion may change in size and may no longer be visible, but how long this will take is variable.
If you are experiencing symptoms and you take the combine contraceptive pill you may wish to change to a different type.
If you are experiencing symptoms and it is impacting your life you can be referred by your GP to colposcopy at the Women’s Health Unit to be considered for treatment such as:
- Diathermy – this is performed under local anaesthetic and the glandular cells are burned away.
- Silver nitrate – chemical stick used to cauterise small areas of tissue.
It is important to note that the above treatments do not always resolve the symptoms in all people
and can sometimes make them worse.
Nabothian follicle
What is a Nabothian follicle
A Nabothian follicle, which is sometimes called a Nabothian cyst, is a firm, mucus-filled bump found on the ectocervix (surface of the cervix).
You can have more than one present, they range in size from a few millimetres to a few centimetres, and they range from a white colour to a pale yellow/orange.
They are normal and are not linked to pre-cancer or cancer.
They are usually an incidental finding seen on a speculum examination or on ultrasound/MRI/CT scans if large enough.
You may be able to feel them if examining your own cervix such as when you check your IUD strings.
What causes a Nabothian follicle?
Nabothian follicles forms when mucus-producing glands on the ectocervix become covered by normal cervical changes in the transformation zone – an area on the cervix where cells change from one type to another.
Anyone can develop them, but they are more likely to develop during puberty and menopause.
Certain life events can cause the cervical skin cells to grow and block the mucus glands such as:
- Post-birth
- Inflammation (cervicitis) or infection of the cervix
- Injury or treatment to the cervix
Signs and symptoms
Nabothian follicles usually do not cause any symptoms and most people are unaware they have them. If they become very large, they can distort the cervix and it may not be possible to examine your cervix or perform your cervical sample.
What are the treatments for a Nabothian follicle?
They usually do not need any treatment and will resolve on their own. Rarely large cysts will need
drainage of the mucus using a small needle.
Key facts about a cervical ectropion
- It sometimes called a cervical eversion or incorrectly an ‘erosion’
- It is common
- It is normal
- It is not linked to cancer
- It does not affect fertility or pregnancy
- It may not cause any symptoms and often goes away on its own
- It can be treated if causing symptoms such a light bleeding after intercourse or in
between periods
Contact details
If you would like to discuss further or the contents of this leaflet, please contact your GP or speak to your gynaecological health care specialist.
If you have any concerns you can contact the Women’s Health Unit or the Gynaecology Ward for telephone advice.
Ward 40
24 hours – Please note that if clinic staff are busy, they may arrange to call you back later in the day.
PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services.
You can contact them on freephone 0800 032 02 02, email [email protected].
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS website at www.nhs.uk
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