A friable cervix refers to cervical tissue that is unusually sensitive and prone to bleeding or inflammation with minimal contact. It is not a condition in itself, but rather a sign of an underlying issue that often warrants medical attention.
What is Friable Cervix and Its Signs
A friable cervix is characterized by tissue that bleeds readily upon direct contact, such as during sexual intercourse or a pelvic examination. This increased fragility stems from changes in the cervical tissue, making its blood vessels more susceptible to rupture.
Individuals with a friable cervix may experience several noticeable signs. Bleeding after sexual intercourse, known as post-coital bleeding, is a common indication. Spotting or light bleeding between menstrual periods can also occur. Some may also observe bleeding after a gynecological examination or the insertion of a tampon.
These signs arise because the delicate cervical tissue, when friable, cannot withstand typical physical interactions without minor trauma. The surface cells or underlying capillaries become easily disrupted, leading to visible bleeding. Other less specific symptoms can include unusual vaginal discharge, or discomfort during sexual activity. A friable cervix may sometimes present without symptoms, discovered only during a routine medical check-up.
Why a Friable Cervix Occurs
A friable cervix typically occurs due to various underlying factors that cause changes or inflammation in the cervical tissue. Cervicitis, inflammation of the cervix, is a common reason and can be caused by infections or irritants. Sexually transmitted infections (STIs) such as chlamydia, gonorrhea, trichomoniasis, and herpes simplex virus (HSV) are frequent infectious culprits, leading to inflammation that makes the cervix delicate and prone to bleeding.
Hormonal fluctuations can also contribute to cervical friability. During pregnancy, for instance, increased blood supply to the cervix and hormonal changes can make the tissue more sensitive and likely to bleed. Similarly, conditions involving low estrogen levels, such as during menopause or with certain hormonal birth control methods, can thin the cervical tissue, increasing its susceptibility to irritation and bleeding.
Benign growths like cervical polyps can also cause friability. These polyps often have a rich blood supply and can bleed easily when touched. Cervical ectropion, sometimes called cervical eversion, is another common cause where the softer glandular cells from inside the cervical canal are present on the outer surface of the cervix. These glandular cells are more fragile than the squamous cells normally found on the outer cervix, making them prone to bleeding.
How Friable Cervix is Diagnosed and Treated
Diagnosing a friable cervix begins with a healthcare provider performing a pelvic examination. During this exam, the cervix is visually inspected, and a speculum is used to allow for a clear view. The provider may gently touch the cervix with a cotton swab to observe if it bleeds easily, which is a direct sign of friability.
To identify the underlying cause, further tests are often conducted. A Pap smear, which collects cervical cells, is performed to check for abnormal cell changes, including those that might indicate precancerous conditions or the presence of human papillomavirus (HPV). Tests for sexually transmitted infections (STIs), such as chlamydia and gonorrhea, are also commonly done using cervical swabs or urine samples, as these infections are frequent causes of cervicitis. If abnormalities are noted, a colposcopy, a magnified examination of the cervix, may be performed, sometimes with a biopsy to collect a small tissue sample for detailed analysis.
Treatment for a friable cervix depends entirely on the identified cause. If an infection is present, antibiotics are typically prescribed; for example, doxycycline or azithromycin for chlamydia, or ceftriaxone for gonorrhea. For hormonal causes, such as those related to pregnancy, the condition often resolves on its own over time. In cases of low estrogen, hormone replacement therapy may be considered.
Cervical polyps can usually be removed in an office setting using specialized forceps, with the base sometimes cauterized to prevent further bleeding. Cervical ectropion often does not require treatment unless symptoms are bothersome, in which case cauterization might be an option. It is important to seek medical attention if experiencing symptoms of a friable cervix to ensure proper diagnosis and appropriate management.