A friable cervix is cervical tissue that easily bleeds or tears upon touch or examination. This heightened sensitivity makes it prone to inflammation or bleeding. While often a symptom, it is not a disease itself.
Understanding a Friable Cervix
A friable cervix often appears reddened or inflamed during a pelvic examination. It arises from factors increasing tissue fragility, such as cervicitis, stemming from infections like chlamydia, gonorrhea, trichomoniasis, or bacterial vaginosis.
Hormonal changes also contribute to friability. Increased blood flow and altered hormone levels during pregnancy can make the cervix more sensitive. Cervical ectropion, where glandular cells extend to the outer surface, can also lead to easy bleeding. Benign growths like cervical polyps may also cause bleeding.
The Link to Infertility
A friable cervix does not directly cause infertility. Fertility challenges arise from underlying conditions, such as untreated infections or chronic inflammation, which create an unfavorable environment for conception.
Chronic cervicitis can alter cervical mucus, making it hostile to sperm and hindering their travel into the uterus. Untreated infections like chlamydia and gonorrhea can spread, leading to pelvic inflammatory disease (PID). PID causes scarring and damage to fallopian tubes, significantly impacting fertility.
Inflammation affects cervical mucus quality and quantity, crucial for sperm transport and survival. Normal mucus becomes thin and watery around ovulation to facilitate sperm movement. When inflammation disrupts this, mucus might remain thick or unsuitable. While discomfort during intercourse might indirectly affect conception, it is not a direct physiological barrier. Many individuals conceive without difficulty once the underlying cause is addressed.
Diagnosis and Management
Diagnosis begins with a pelvic examination, observing the cervix for inflammation, lesions, or easy bleeding. A Pap test collects cervical cells for abnormal changes or human papillomavirus (HPV) detection. If abnormalities are noted, a colposcopy, a magnified examination, may be conducted, sometimes with a biopsy. Tests for sexually transmitted infections (STIs) and bacterial vaginosis are also common, involving swabs or urine samples.
Management focuses on treating the root cause. Bacterial infections like chlamydia or gonorrhea are treated with antibiotics. Viral infections, such as herpes or HPV, have no cures, but treatments manage symptoms. Hormonal imbalances may be addressed with hormone therapy, especially if low estrogen levels are a factor.
For symptomatic conditions like cervical ectropion, minor procedures such as cauterization can seal off blood vessels. Symptomatic cervical polyps can also be removed. Treating the underlying condition often resolves friability, addressing any related fertility concerns.
Friable Cervix During Pregnancy
A friable cervix is common during pregnancy, primarily due to increased blood flow and hormonal changes. This can lead to light spotting or bleeding, particularly after intercourse or a pelvic examination. Such bleeding is often benign and does not typically indicate a serious problem for the pregnancy or baby.
While light spotting is common, any vaginal bleeding during pregnancy warrants medical attention to rule out other potential causes. Healthcare providers assess the situation to ensure no more serious issues, such as infection or other pregnancy complications. In most cases, a friable cervix in pregnancy is a transient condition that resolves without intervention.