Understanding Cervicovaginitis: Causes & Treatment

Cervicovaginitis is a condition whereby the vagina and cervical squamous epithelial cells (mucosa) become inflamed due to infection or other cause.¹ This damages the surface cells, and leads to ulceration and reduced epithelial thickness, since the top (superficial) layer of cells is lost. The superficial and intermediate cells (containing glycogen) can be lost, with the deeper cells swollen due to an influx of neutrophils in the space between cells.²

Symptoms of cervicovaginitis

Ulceration or lesions on the vaginal or cervical epithelium
Excess discharge
White discharge
Frothy, grey or greenish-yellow discharge
Foul smelling (malodorous) discharge
Discharge may not smell bad
Lower abdominal pain
Back ache
Itching
Redness
Painful sex (dyspareunia)
Upon examination, there will be evidence of congestion and ulceration, patchy white areas

Risk factors include living in a tropical area in a developing country.

Infectious causes of cervicovaginitis

Trichomonas vaginalis
Candida albicans
BV-causing bacteria – Bacteroides, Peptostreptococcus, Gardnerella vaginalis, Gardnerella mobiluncus
Chlamydia trachomatis
Haemophilus ducreyi
Mycoplasma hominis
Streptococcus
Escherichia coli
Staphylococcus (MRSA)
Neisseria gonorrhoea
Herpes simplex virus (HSV1 or HSV2)

Non-infectious causes of cervicovaginitis

A foreign body – IUD, tampon, etc.
Trauma to the area
Irritant creams or gels

Diagnosis and treatment of cervicovaginitis

Diagnosis is made by a doctor after an examination and testing. Usually the source of the inflammation can be found, and treatment pursued – either antimicrobials or removing the irritant. ^3,4

References

1.
Nkwabong E. What are the most common sexually transmitted bacteria in women with cervico-vaginitis nowadays? Indian J Sex Transm Dis. Published online 2020:39. doi:10.4103/ijstd.ijstd_143_15
2.
Baris II, Keles AN, Karakaya YA. The Influence of Cervicovaginitis Agents on Epithelial Cell Changes: Comparison of Mardin City’s Data with the Literature. TJPATH. Published online 2012:231. doi:10.5146/tjpath.2012.01129
3.
Pino A, Rapisarda AMC, Vitale SG, et al. A clinical pilot study on the effect of the probiotic Lacticaseibacillus rhamnosus TOM 22.8 strain in women with vaginal dysbiosis. Sci Rep. Published online January 28, 2021. doi:10.1038/s41598-021-81931-z
4.
De Rosa N, Santangelo F, Todisco C, Dequerquis F, Santangelo C. Collagen-Based Ovule Therapy Reduces Inflammation and Improve Cervical Epithelialization in Patients with Fungal, Viral, and Bacterial Cervico-Vaginitis. Medicina. Published online August 18, 2023:1490. doi:10.3390/medicina59081490