What is cervical ectopy?

An ectopy is a common and normal finding on the cervix.

It can also be called an ectropion, an erosion or an eversion. These words all mean the same thing. An ectopy is an area of soft delicate cells called glandular cells that are often found on the inside of the canal that leads to the womb. At certain times of life these cells move to the outside of the cervix. These delicate glandular cells look very different from the normal pale pink skin cells as they are red and soft. Being soft they can bleed easily especially when having a speculum examination, a smear or during sex. This bleeding does not mean they are abnormal.

How will know I have an ectopy?

An ectopy can be seen when you have a smear and can sometimes cause concern. If your smear is normal there is nothing to worry about. An ectopy is common and harmless. It is not linked to cervical cancer or any other condition that causes cancer. Sometimes you may be referred to the colposcopy clinic for a closer look if your practice nurse or GP is not sure.

What does an ectopy look like?

An ectopy looks like an area of red cells around the opening to the womb (os). They can be different sizes and shapes.

What causes ectopy?

 A lot of people are born with cervical ectopy but it can be caused by hormonal changes. This means you are more likely to have it if you are:

· younger (under 30 years old)

· going through puberty

· pregnant

· taking the contraceptive pill.

What can I do about my ectopy?

You don’t need to do anything. An ectopy is normal. They often disappear by the menopause. Stopping the pill can reduce the size of an ectopy after several months but it rarely disappears completely. We do not need to treat a normal ectopy that does not cause symptoms. It is part of normal human biology. If an ectopy causes symptoms of bleeding with sex, it can be distressing. This can be treated with cold coagulation in the clinic which is also known as cautery. Before considering cold coagulation for ectopy we will need to take biopsies to be sure the tissue is normal. Sometimes this will stop the bleeding without the need for further treatment.

What treatments are available?

Treatment is not usually needed and symptoms may go away by themselves within 3 - 6 months. Sometimes changing from combined oral contraceptive pill to a different contraception can help.

If you find the symptoms worry you or do not go away after 6 months your GP can give you more help. You may get referred for treatment. Treatment is usually done at a colposcopy clinic. Treatment tries to get rid of the delicate cells to stop them from bleeding. This is not recommended in pregnancy.

The different treatment options available are:

  • Silver nitrate. This uses a chemical stick to superficially burn (cauterise) the ectropion. You will not usually need a local anaesthetic.
  • Cold coagulation. This involves cauterising the ectropion with a hot metal probe for 30 - 60 seconds. This is done using local anaesthetic.
  • Cryocautery. This involves a cold probe freezing the cervix for 90 - 180 seconds.

It is normal to have ‘period like pain’, mild vaginal bleeding and discharge after treatment. It may last for 1 - 4 weeks. Tampons, penetrative intercourse and swimming should be avoided until the bleeding and discharge has completely settled. This will reduce the risk of infection.

You should get 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 get rid of the symptoms completely. Any improvement in symptoms may be short lived. If your symptoms persist or come back after treatment, speak to your GP.

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