Patient's question:
Does moderate cervical erosion cause infertility?Doctor's answer:
Hello! First of all, I wish you a speedy recovery! Below, I will discuss "cervical erosion." Cervical erosion is a very common gynecological disease, and many women consult about its treatment. It seems that people are not very familiar with this common condition, and often feel lost and anxious after developing it. They may give up treatment if they don’t see improvement after a period of time. I will share some basic knowledge about cervical erosion, hoping it will be helpful to you.1) What is cervical erosion? In fact, cervical erosion is one manifestation of chronic cervical inflammation. It is not the erosion we usually understand. When the epithelial cells at the cervix opening fall off and are replaced by another type of epithelial tissue, the newly formed epithelium is very thin, and even the underlying blood vessels and red tissue can be seen, making it appear as if there is true erosion. That’s why it’s called cervical erosion, but in reality, it is not true erosion.
2) How does one get cervical erosion? The occurrence of cervical erosion is caused by childbirth, miscarriage, postpartum infection, surgical procedures, or mechanical irritation such as sexual activity that damages the cervix, leading to infection by pathogens. It is important to note that during sexual activity, the penis comes into direct contact with the cervix. If hygiene is not maintained, bacteria can be directly introduced into the vagina, infecting the cervix. For women who already have cervical erosion, it can worsen the cervical inflammation and potentially expand the erosion area. Severe cervical erosion may also cause bleeding during intercourse. Therefore, regardless of whether a woman has cervical erosion, it is essential to practice good sexual hygiene. Both partners should clean their external genitalia before sexual activity, and men should pay attention to removing smegma, as it is believed that cholesterol in smegma can transform into carcinogenic substances under bacterial action. After developing cervical erosion, active treatment is necessary.
3) What are the external manifestations of cervical erosion? After developing cervical erosion, symptoms may include increased vaginal discharge, which becomes viscous, and occasionally purulent or bloody discharge. Lower back pain, abdominal pain, and a heavy sensation in the lower abdomen are also common. It may also cause contact bleeding during intercourse and an unpleasant odor.
4) How is cervical erosion classified? The degree of cervical erosion is determined by the size of the erosion area, which can be classified as mild, moderate, or severe. When the erosion area is less than one-third of the entire cervix, it is classified as mild cervical erosion. If the erosion area accounts for one-third to two-thirds of the cervix, it is moderate erosion. If the erosion area covers more than two-thirds of the cervix, it is classified as severe erosion.
5) The manifestations of cervical erosion can also be divided into three types:
1. Simple type—This is common in the early stages of inflammation, where the erosion surface is covered by a single layer of columnar epithelium, appearing relatively flat and smooth.
2. Granular type—If the inflammation continues, the cervical epithelium becomes excessively proliferative, and the erosion surface becomes uneven, appearing as granules, which is known as granular erosion.
3. Papillary type—If the glandular epithelium and stroma proliferate significantly, the unevenness becomes more pronounced, forming papillae, which is known as papillary erosion. These three types can exist independently or overlap.
6) Treatment for cervical erosion:
1. Medication—Suitable for patients with a small erosion area and shallow inflammation infiltration.
2. Physical therapy—This is a widely used treatment method with the advantages of a short course and good efficacy. It is suitable for patients with a large erosion area and deep inflammation infiltration. Common methods include electrocautery, laser therapy, and cryotherapy.
3. Surgical treatment—If the above treatments are ineffective, or if the cervix is enlarged, the erosion area is deep and extensive, and involves the cervical canal, a cervical conization or total hysterectomy may be considered. However, surgical treatment is rarely used now.
7) Does cervical erosion affect pregnancy? Generally, mild cervical erosion does not affect pregnancy, but severe cervical erosion can thicken cervical mucus, which contains a large number of white blood cells, making it unfavorable for sperm activity and penetration, thus affecting fertility. Therefore, severe cervical erosion requires active treatment.
8) Can cervical erosion lead to cancer? Many women with cervical erosion are concerned about this, and it is also the main reason they seek medical attention. The answer is yes. According to analysis by renowned Chinese gynecologist Lin Qiaozhi and others, women with cervical erosion have a cervical cancer incidence rate of 0.73%, significantly higher than the 0.1% in women without cervical erosion. Under long-term chronic inflammation, columnar epithelium from the cervical canal may develop dysplasia. If not treated promptly, some of these may eventually progress to cancer, though this transformation process is relatively slow.
9) Finally, women who have sexual activity should undergo a comprehensive gynecological examination every year. Those with cervical erosion should also have a cervical TCT smear test annually. Early detection and prevention of gynecological diseases are greatly aided by this.
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