Worried of your ectropion? Here it is everything you have to know

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Ectropion is a simple and frequent non-cancerous condition in women and occurs when eversion of the endocervix (the cervical canal of the uterus) turns outward and exposes inner columnar epithelium to the acidic vaginal milieu. This everted glandular epithelium has a reddish appearance and may be covered by a yellow turbid discharge.

Ectropion has also been called erosion, which is a poor term because it implies that the external smooth lining cells have eroded away to expose underlying tissue. Although this can occur, most "erosions" represent areas of the cervix where external squamous cells have been simply replaced by overgrowth of inner glandular epithelium.

In the past, it was thought that various types of physical trauma that caused infection might eventually lead to cervical ectropion. Such sources of trauma included sexual intercourse, the use of tampons, the insertion of a speculum, or the insertion of other objects into the vagina.

Other assumed causes included sexually transmitted infections (STI) such as herpes or early syphilis. It was also thought that vaginal douches or other chemicals, such as contraceptive creams or foams, might cause cervical erosion.

Today, these theories have lost ground as experts now believe that cervical ectropion is a normal anatomic phenomenon that some women are born with. Moreover, researchers have shown that sometimes the common denominator is an increase in estrogen levels in the body, which can change or remodel the cervix in normal conditions like adolescence or, thereafter, while pregnancy or birth control pills.

In parous women, the endocervical epithelium may be visible intermittently. The external os is wide and patulous as a result of changes from prior labor and delivery.

In some of these women, opening a vaginal speculum to inspect the cervix by a standard gynecological exam causes the anterior and posterior lips to separate, exposing the endocervical canal. As the speculum is withdrawn by your doctor, the anterior and posterior lips fall together, and often the ectropion disappears.

Ectropion does not need to be treated except in the rare occurrence of excessive mucous discharge, frequent intermenstrual bleeding or post-coital spotting, which are very bothersome to the woman. In such cases, malignancy should be excluded by PAP smear or colposcopy and infections could be checked for by a swab before undertaking any treatment.

Since cases that require treatment are rare, there is no evidence to guide choice of treatment.

In many situations, a very simple medical treatment such as boric acid suppositories 600 mg vaginally at bedtime for two weeks, may be effective.

However, if you have symptoms that started during pregnancy, they should go away 3 to 6 months after you have your baby.

Another option is an ablative procedure using cryosurgery or electrosurgery, but this is invasive and will result in copious vaginal discharge until healing is completed, which may take about 4 weeks, during which tampons and having sex should be avoided.

Ablative treatment can also result in cervical stenosis, which can adversely affect future fertility and, if pregnancy is achieved, labor and delivery.

In conclusion, while the term cervical ectropion or erosion sounds worrisome, it's not. That being said, it can only be diagnosed by a doctor.

If you are experiencing bleeding with intercourse or new vaginal discharge, it's important to get it checked out. A number of conditions can mimic the symptoms and/or experience of cervical erosion like an infection of the cervix or vagina or cervical cancer.

At the Hanoi French Hospital, Dr. Armando Librino and other gynecologists/ obstetrician with years of experience will attend patients with ectropion and gynecological diseases. For an appointment with our gynecologists, please contact us at (84-24) 3577 1100, or send us an inquiry here