Every third woman, especially under the age of 25, at the gynecologist's appointment hears a terrible diagnosis - "Cervical erosion". Naturally, these words are very exciting for women and threaten with a long and serious treatment. Ectopia of the cervix is also called pseudo-erosion, endocervicosis, false erosion, glandular muscle hyperplasia.
It is important for a woman to explain what this process is and why she had it. And most importantly, does it need to be treated? In this case, the doctor cannot, after one gynecological examination, draw a conclusion about the treatment. What study will help to make an accurate diagnosis? How to decide on the tactics of treatment? Read our article.
Why does cervical ectopia appear?
Ectopia is the process of displacement of the cylindrical epithelium, which is located in the cervical canal, outward. Ectopia of the cervix is common in women who are in their reproductive years. This process is associated with age and hormonal levels. If ectopia is often observed in young women under 25 who have not yet given birth, then this is regarded as a variant of the norm due to relative hyperestrogenism. Ectopia of the cervix can also be triggered by taking hormonal contraceptives. After discontinuation of drugs, ectopia disappears on its own within 6-12 months.
Pseudo-erosion (ectopia) may occur during pregnancy. This is again associated with an increase in estrogen levels. Ectopia poses no threat to either the woman or the fetus.
Clinical manifestations of pseudo-erosion of the cervix
Painful symptoms in pseudo-erosion of the cervix are often absent. In some women, ectopia can be manifested by profuse discharge, bloody discharge after rough intercourse. This is often very disturbing for women. Naturally, a trip to the doctor should not be canceled, but there is no danger in this. And the risk exists in the following - if the epithelium is damaged by such sexual intercourse, the risk of inflammation of the cervix increases. When the epithelium is damaged, inflammation begins, which is manifested by secretions with an unpleasant odor. If this symptom occurs, the woman should see a doctor.
Pseudo-erosion of the cervix can only be detected during a gynecological examination in the mirrors. At the same time, a bright red zone is visible around the cervical canal, which has clear boundaries. Inflammatory manifestations and pathological secretion from this area are not detected.
Differentiation between true erosion and pseudo-erosion (ectopia)
To diagnose and confirm the diagnosis of cervical ectopia, as well as to differentiate from true erosion and oncological processes, a Schiller test is performed. When conducting a Schiller test, all areas of ectopia are stained in a light brown color. This is done with 3% acetic acid and iodine. First, acetic acid acts on the epithelium, which is located on the cervix, so that the vessels narrow, and the doctor can see the true processes on the cervix. After that, the epithelial cells are stained with iodine solution. In this case, pathologically altered cells will not be stained. Only extended colposcopy makes it possible to make an accurate diagnosis of erosion or pseudo-erosion (ectopia) and to refute inflammatory or oncological diseases of the cervix.
State of the cervix and pseudo-erosion in menopause
During the transition to menopause, involutional processes predominate against the background of a sharp decrease in the synthesis of sex hormones, and the transition zone of the epithelium shifts to the lower part of the endocervix. But the onset of menopause is not always accompanied by pseudo-erosion and atrophic changes in the epithelium of the cervix and vagina due to the effect of hormones that the adrenal glands produce in a compensatory reaction.
In menopause, colposcopy shows the following picture: the cervix is covered with a multi-layered epithelium, which is unevenly thinned. Under it, the subepithelial vessels of the stroma are translucent with the correct course. They do not always contract with 3% acetic acid and often bleed. Schiller's test is weakly positive in menopause. This does not indicate ectopia or erosion of the cervix.
Is ectopic cervical treatment required?
If an ectopic cervix is detected during extended colposcopy, while the cervix is not inflamed, it does not require any treatment. This process takes place on its own after 25 years or after childbirth.
If, during extended colposcopy, there are areas of pathologically altered epithelium that are not painted over with Lugol's solution (iodine), as well as inflammatory processes, then treatment is necessary at any age. During pregnancy, this issue is resolved individually.
Ectopia will not turn into an oncological disease, but its presence increases the risk of developing tumor processes. In 11% of cases, ectopia is congenital.
Regular examination by a gynecologist and extended colposcopy can prevent the occurrence of serious cervical diseases in women, including cancer. Therefore, with a preliminary diagnosis of pseudo-erosion, it is necessary to conduct an extended colposcopy and clarify everything, because this diagnosis always scares women. And the task of the doctor is to help and calm the patient.
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