The cervix and the uterus are important parts of the female reproductive system. The cervix connects the uterus to the vagina. In the body, it helps the sperm to pass to the uterus and also maintains a sterile environment in the uterus by secreting mucus.
The uterus or the womb is shaped like a pear and is found behind the bladder and is a cardinal organ in the reproductive system. The uterus provides nourishment and helps in fetal development.
For many women, compromised uterine and cervical health has become a menace, and this has negatively impacted their progress and kept them from the achievement of their goals. Timely awareness about such sources of fright in women can help them to make wise decisions and pave the way to better health.
In women, there are many such conditions of the cervix that can become troublesome. Some of them are:
Cervicitis: Due to an infection in the cervix, inflammation occurs. These infections are largely contacted while sexual intercourse and through organisms such as gonorrhea, Chlamydia, and herpes. When the infection further spreads to the uterus and fallopian tubes, it causes PID (Pelvic inflammatory disease) which may cause difficulties in conceiving.
Cervical cancer: Around 99% of cervical cancers result from infection due to a single organism called the human papillomavirus (HPV). Regular testing through a screening test called a Pap test or Pap smear is highly recommended to prevent women from becoming victims of cervical cancer. Through the Pap test screening alone, a large population of women has been saved.
Cervical incompetence: This condition can cause the cervical opening to dilate or open up much earlier than it should during pregnancy, leading to the delivery of a premature baby.
Cervical dysplasia: Refers to the presence of abnormal cells in the cervix and can become a cancer threat.
Cervix polyps: Polyps are the tiny growths on the cervical lining and can cause bleeding in the vagina.
In case you are worried about abnormal vaginal bleeding (in-between periods, after sexual intercourse) or foul-smelling discharge through a vagina or pelvic pain not associated with menstrual periods, it is important to open up to the doctor and get tested for any of the cervical conditions. After a physical examination, the doctor may prefer the following relevant tests to confirm the condition.
A Pap test or Pap smear: In this test, the smear of the cervix is examined for cellular changes to detect cervical cancer.
Biopsy: From the cervix, a tissue sample is taken and analyzed to diagnose cancer and other conditions.
Imaging techniques such as CT scan, MRI scan and PET scan are used to determine the spread of cancer.
HPV DNA test: This test is used to detect the presence of the genetic material of the human papillomavirus in the cells taken from the cervix.
Currently, the management of cervical conditions has been successful to a great extent.
To prevent the early dilation of the cervix during pregnancy, the cervix may be closed using stitches.
Antibiotics and anti-cancer medications are used in the treatment of infection and cancer respectively.
Sometimes to treat cervical cancer, high-energy laser beams and radiations are used for destroying the cancerous cells and control the spread.
In some other cases, a hysterectomy or the surgical removal of a cervix and uterus is opted to give a complete cure from cancer.
Last but not the least, HPV vaccination is very effective in young and adolescent females to prevent cervical cancer.
After a certain age, regular introspection of uterine health becomes of paramount importance in a women's life. Certain medical conditions of the womb can cause discomfort and severe pain. Awareness about these conditions and early detection in women can ward off a lot of trouble.
Uterine pain should not be brushed away as normal pain. It is usually felt in the lower abdominal region and moves on further up to the back. If the condition persists for longer periods it can result in irregularities in menstruation and difficulties in conceiving. Hence, timely consultation can help immensely to nick this bud at the onset itself. The wide range of uterine conditions/ diseases can be effectively summed up as:
Dysmenorrhea or painful menstruation is felt earlier to or during the menstrual cycle. It can be managed with hormonal therapy or medication.
Menorrhagia refers to heavy and/or prolonged menstrual bleeding resulting in anemia. Treatments may be required for controlling the bleeding and for anemia.
Uterine Prolapse is a condition in which the ligaments and muscles holding the uterus get weak. As a result, the uterus descends towards the bladder. This can cause symptoms like urine leakage.
Congenital Uterine Malformations are the defects in the formation of a uterus from birth itself. These defects in the uterine structure can interfere with normal pregnancy or result in miscarriage.
Uterine polyps and Fibroids – Polyps are the small growths that occur within the uterus and fibroids are growths that are mainly attached to the uterine walls and are larger and variable in size. Both conditions cause pain and non-periodic bleeding in women.
Endometriosis – When the endometrial (inner uterine lining) tissue is found outside the uterus due to certain conditions, it can trigger inflammation and the formation of scar tissue.
Uterine cancer or endometrial cancer
The diagnosis of uterine conditions may require a pelvic exam, pap smear, urine and blood tests. Certain imaging tests (computed tomography or ultrasound) are useful in the identification of abnormalities in anatomy. Treatment of the above health conditions of the uterus is largely based on the cause. Medication is mainly recommended in case of pain and infection management. Hormonal therapies and surgery such as hysterectomy can also be sought when problems get severe. In the case of cancers, chemo and radiation therapies can give relief. In general, one or two therapies are combined to get a fruitful result.
Human Papillomavirus Virus infection, smoking, and age over 30 years - are the conditions that make women more susceptible to cervical cancer.
The HPV vaccine can help to prevent cervical cancer to a large extent. It works best when given before the age of 12 in girls and is readily available in the market.
A smear is taken from the organ of interest in Pap test and looked under a microscope for cellular changes and abnormalities. It helps to see if a cell is cancerous or not.
When the uterus is removed surgically it is called a Hysterectomy. It may be done in conditions such as uterine fibroids or prolapse and uterine cancers.
HOD And Consultant - Obstetrics & Gynaecology
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