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Cervicitis

Last reviewed: 7 Apr 2025
Last updated: 29 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • risk factors for sexually transmitted infection (STI)
  • purulent vaginal or cervical discharge
  • intermenstrual/postcoital bleeding
  • dysuria and urinary frequency
  • easily induced cervical bleeding
Full details

Other diagnostic factors

  • dyspareunia
  • vulval and/or vaginal inflammation
  • strawberry cervix
Full details

Risk factors

  • age 15 to 24 years
  • inconsistent condom use
  • multiple sexual relationships
  • previous STIs
  • bacterial vaginosis (BV)
  • sex worker
  • absence of hydrogen peroxide-producing lactobacilli
  • infertility
  • education <12 years
Full details

Diagnostic tests

1st tests to order

  • pregnancy test
  • wet mount examination of cervical discharge
  • nucleic acid amplification testing (NAAT)
  • rapid tests (OSOM Trichomonas, AFFIRM VPIII)
  • Thayer-Martin agar cervical culture
  • Gram stain of cervical discharge
Full details

Tests to consider

  • cervical cytology
  • herpes simplex virus (HSV) serology
  • HIV serology
  • hepatitis B and C serologies
  • rapid plasma reagin testing
Full details

Treatment algorithm

INITIAL

high-risk nonpregnant women

ACUTE

nonpregnant women

pregnant women

ONGOING

recurrent/resistant infections

Contributors

Authors

M. Jonathon Solnik, MD, FACOG, FACS
M. Jonathon Solnik

Associate Professor of Obstetrics & Gynaecology

Head of Gynaecology & Minimally Invasive Surgery

University of Toronto Faculty of Medicine

Mount Sinai Hospital

Toronto

Canada

Disclosures

MJS serves as a consultant for Medtronic, Olympus, and Hologic, and on the advisory board for Abbvie. He holds stocks in Felix and Field Trip Inc.

Acknowledgements

Dr M. Jonathon Solnik would like to gratefully acknowledge Dr Sharon Jakus, a previous contributor to this topic.

Disclosures

SJ declares that she has no competing interests.

Peer reviewers

Sandra R. Valaitis, MD

Associate Professor and Chief

Gynecology and Reconstructive Pelvic Surgery

University of Chicago

Chicago

IL

Disclosures

SRV declares that she has no competing interests.

Justin C. Chura, MD

Associate Division Director

Gynecologic Oncology

Crozer Chester Medical Center

Upland

PA

Disclosures

JCC declares that he has no competing interests.

Eva Jungmann, FRCP, MSc

Consultant Physician

GUM/HIV Camden Primary Care Trust

Archway Sexual Health Clinic

London

UK

Disclosures

EJ declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text  Abstract

Boyer CB, Shafer MB, Pollack LM, et al. Sociodemographic markers and behavioral correlates of STIs in a nonclinical sample of adolescent and young adult women. J Infect Dis. 2006 Aug 1;194(3):307-15.Full text  Abstract

Marrazzo JM, Weisenfeld HC, Murray PJ, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis. 2006 Mar 1;193(5):617-24.Full text  Abstract

Scholes D, Grothaus L, McClure J, et al. A randomized trial of strategies to increase Chlamydia screening in young women. Prev Med. 2006 Oct;43(4):343-50. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Cervicitis images
  • Differentials

    • Cervical ectropion
    • Cervical dysplasia
    • Cervical cancer
    More Differentials
  • Guidelines

    • European guideline on the management of Mycoplasma genitalium infections
    • British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021
    More Guidelines
  • Patient information

    Chlamydia

    Genital herpes

    More Patient information
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