Causes of cervical erosion

Written by Wang Jing Hua
Obstetrics and Gynecology
Updated on September 13, 2024
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Cervical erosion is considered a physiological phenomenon, not a disease. It is part of the normal anatomical structure of females, characterized by a more apparent red appearance of the columnar epithelium on the cervix. This is due to the relatively high levels of estrogen in young women, which causes the columnar epithelium to evert from the cervical canal, resulting in a vigorous growth of the epithelium, and thus the red, erosion-like appearance. This is normal, and as age increases, the columnar epithelium gradually moves inward and is covered by squamous epithelium, resulting in a smooth appearance of the cervix.

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Is electrocauterization good for cervical erosion?

Cervical erosion electrocautery is a treatment method used in the past. Nowadays, most cases can generally be treated through physical methods like laser, electrocoagulation, and cryocondensation. After electrocautery, the cervical tissue typically becomes harder, which can result in cervical lacerations during childbirth for patients who plan to conceive in the future. Therefore, electrocautery is rarely used now, and most treatments currently employ laser or electrocoagulation methods. Patients with cervical erosion should first visit a hospital for cervical cancer screening, which generally involves TCT and HPV testing. If these tests show no cervical cancer or precancerous lesions, simple cervical erosion is generally not a serious issue. At this time, topical medications or some physiotherapy treatments can also be used for symptomatic treatment. (Please undergo medication under the guidance of a professional doctor, and do not medicate blindly.)

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Is cervical erosion serious?

Cervical erosion is actually a physiological phenomenon and is not alarming. It is caused by the increased levels of estrogen in the body, which causes the columnar epithelium inside the cervical canal to descend and evert. During gynecological examinations, this part of the cervical canal appears red and granular, like eroded protrusions, as if it has decayed. However, this is not the case. When the estrogen levels in a woman's body decrease, this tissue will retract back into the cervical canal and will no longer be visible. In most cases, treatment is not necessary. Treatment is only required if the erosion is combined with an infection, or if there is bleeding after intercourse, or if there is an increase in thick, sticky vaginal discharge that affects sperm passage. Additionally, some women may have cervical cancerous changes that also appear as erosive growths. Therefore, when a woman notices cervical erosion, it is advisable to undergo a TCT screening to rule out the possibility of cervical intraepithelial neoplasia and precancerous lesions of the cervix.

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How long does cervical erosion bleed after the scab falls off?

Cervical erosion, if treated with methods like laser or electrocoagulation, may experience bleeding during the scab shedding process. This bleeding usually ceases within about a week. It is common for the blood volume to increase slightly when the scabs fall off, then the bleeding gradually decreases, and stopping within a week is considered normal. If bleeding persists for more than a week after treatment for cervical erosion, it is necessary to visit a hospital for relevant examinations, and receive targeted treatments based on the condition of the cervical wound. If there is active bleeding, treatment should be based on the examination results. Therefore, if bleeding due to scab shedding from cervical erosion lasts excessively long, it is crucial to seek appropriate medical attention at a hospital. Generally, sexual intercourse should be avoided within a month after the operation for cervical erosion, and anti-inflammatory targeted treatments are necessary post-surgery.

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How to check for cervical erosion?

Firstly, women who are sexually active and have cervical erosion need to visit a hospital for further examinations such as colposcopy to check for erosion. Cervical erosion is a physiological manifestation, caused by the external migration of columnar epithelium from the cervical canal due to hormonal levels, presenting as an erosion-like appearance. Thus, this condition is also a physiological response. Once sexually active, women who have been sexually active for over two years need to regularly undergo cervical cytology testing using the human papillomavirus (HPV) and liquid-based cytology to see if there are other potential issues. If there are no problems, cervical erosion can be periodically monitored, and it's advised to avoid cold exposure, fatigue, spicy and irritating foods, and maintain cleanliness of the external genital area.

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Symptoms of cervical erosion

Most patients with cervical erosion do not exhibit symptoms. Those with symptoms largely display an increased amount of vaginal discharge, which is mucopurulent. Vaginal secretion can stimulate itching and burning sensation in the vulva. Additionally, symptoms may include bleeding outside of menstruation periods and post-coital bleeding. If combined with a urinary tract infection, symptoms can include urgency to urinate, frequent urination, and painful urination. Gynecological examination may reveal congestion and edema of the cervix, mucosal eversion, and mucopurulent secretions attached or even flowing out of the cervical canal. The cervical canal mucosa is fragile and prone to bleeding. If infected with Neisseria gonorrhoeae, due to the involvement of paraurethral and vestibular glands, congestion and edema of the urethral and vaginal openings may be observed, along with a copious amount of purulent discharge.