Patient's question:
I got married last year. Recently, I've been experiencing lower abdominal pain, especially during my period. I'm very worried it might affect fertility, and I also feel extremely cold and afraid of the cold. Can cervical erosion be left untreated?Doctor's answer:
Cervical erosion is the most common pathological change of chronic pelvic inflammation. The appearance of the vaginal part of the cervix at the external os of the cervix is a fine granular red area, known as cervical erosion. The erosion surface is covered by a complete single-layer columnar epithelium of the cervical canal. Due to the thinness of the columnar epithelium, the underlying stroma, which is not true erosion. True erosion, pathologically, refers to epithelial desquamation and ulceration, and the term "cervical erosion" has been abandoned in foreign countries, replaced with "columnar epithelial metaplasia of the cervical canal." China still uses the term "cervical erosion." Some physiological conditions, such as adolescence, pregnancy, or women taking oral contraceptives, may lead to cervical erosion due to increased estrogen levels, causing hyperplasia of the columnar epithelium of the cervical canal and the outward shift of the original squamocolumnar junction, making the external os of the cervix appear red, resembling erosion. This is known as physiological erosion, which returns to normal after estrogen levels decline. Cervical erosion is classified into three types based on the depth of erosion: In the early stage of inflammation, the erosion surface is covered only by a single-layer columnar epithelium, known as simple erosion. Due to excessive glandular epithelial hyperplasia accompanied by stromal hyperplasia, the erosion surface becomes uneven and granular, forming granular erosion. When stromal hyperplasia is significant, the erosion surface appears papillary, known as papillary erosion. Based on the size of the erosion area, it is classified into three degrees: Mild erosion covers less than one-third of the entire cervix, moderate erosion covers between one-third and two-thirds, and severe erosion covers more than two-thirds. Treatment primarily involves physical therapy, with commonly used methods including laser, cryotherapy, infrared coagulation, and microwave therapy. Wound healing takes 3-4 weeks, while deeper erosion may require 6-8 weeks. A routine cervical scraping for cytological examination should be performed before treatment. Physical therapy is contraindicated during acute cervical inflammation. Treatment should be conducted 3-7 days after the menstrual cycle ends. Sexual intercourse, vaginal irrigation, and tub baths should be avoided until the wound heals. Regular follow-up should be conducted after treatment to monitor for cervical stenosis. For smaller areas with superficial inflammation, local application of traditional Chinese medicine can be effective.