Does cervical erosion occur in nulliparous girls and virgins and why? Cervical erosion, causes in nulliparous women, symptoms and treatment Cervical erosion causes in nulliparous women

Cervical erosion is a common gynecological disease, which is often detected in women during a routine gynecological examination, since it has practically no symptoms. Cervical erosion requires constant monitoring and treatment. The causes of cervical erosion are quite varied, let's talk about them in more detail.

To better understand how cervical erosion develops, let's consider the structure of this organ.

The cervix is ​​a tube within which the cervical canal passes. It connects the uterine cavity with the vaginal cavity. At the bases of the vaginal and uterine ends, the cervical canal has physiological narrowings, which in medical terminology are called “pharynx”. The external os is visible at the base of the cervix during a medical examination.

The inner surface of the cervical canal is lined with a layer of epithelium, which consists of columnar cells. And the surface of the cervix, like the vagina, is covered with flat epithelium arranged in several rows. The genital tract is protected from the spread of infections due to the fact that the upper row of this squamous epithelium is regularly renewed. At the border between the mucous membrane of the cervical canal and the epithelium of the cervix inside the external pharynx there is a so-called transformation zone. It is located quite deep and is inaccessible to inspection without special equipment.

Why does cervical erosion form?

Traumatic influences sometimes lead to the appearance of true erosion (ulcers or wounds) on the surface of the cervix. Factors that cause erosion can be very different. Even a woman’s lifestyle matters. However, in terms of cellular structure, all erosions are the same - they are formed exclusively with the participation of ordinary cells of the cervix or cervical canal.
All damage to the cervical mucosa, regardless of their origin, epithelializes after some time. This occurs due to the proliferation of adjacent elements (reserve squamous epithelial cells). Epithelization usually takes no more than 14 days, and the mucous membrane heals in any case, regardless of the reason that led to the formation of erosion. If no complications arise, the process is usually asymptomatic. Since true erosions do not last long and do not cause complaints from patients, doctors observe them quite rarely - in only 2% of cases.

But sometimes incorrect healing of the damaged surface occurs. Columnar epithelial cells grow on the eroded area, which covers the cervical canal from the inside. After this, there is no longer an open wound, but an obvious defect appears on the cervix - an area formed by “other” cells. This defect is called “false erosion” or “ectopia”. The vast majority of diagnosed erosions belong to this type of pathology. Ectopia can form in a little girl, in a nulliparous girl, in every fifth woman suffering from one or another gynecological disease. As for women who have undergone childbirth, ectopia is observed in approximately half of the cases.

That is, there is one process occurring in two stages:

The cervical epithelium is damaged and true erosion occurs.

The healing of the epithelium does not proceed correctly and ectopia is formed.

Therefore, the use of the word “erosion” in oral speech for these cases is quite acceptable.
There is also congenital erosion. It is formed in utero and is not associated with the action of traumatic factors. Therefore, it is initially not an open wound, but a false erosion.

Today you can hardly meet an adult woman who has not heard about such a gynecological problem as cervical erosion. But patients should take into account that the primary medical conclusion “erosion” may suggest both true and false or congenital pathology. To clarify the nature of changes in the mucous membrane, it is necessary to conduct a more detailed diagnosis.

Causes of cervical erosion

In gynecological practice, cervical erosion is the displacement of the columnar epithelium, which lines the inside of the cervix and also covers the uterus and tubes, onto the vaginal part of the cervix.

Type of cervical erosion depending on the cause

Depending on the cause of cervical erosion, there are:

- Traumatic erosion of the cervix. In this case, difficult childbirth, manipulations during surgical interventions, and artificial termination of pregnancy lead to the formation of a wound on the cervix. In older women with displacement of the genital organs, mechanical trauma may occur due to the use of a uterine pessary. If there is any inflammatory process in the vagina or cervical canal (vaginitis, colpitis, cervicitis, endocervicitis), an infection may occur on the cervix.

- Inflammatory erosion of the cervix. This type of erosion is always associated with infectious factors. Sometimes the infectious process takes a very aggressive course. Then local inflammation occurs on the neck, which is complicated by necrosis. In this case, the tissues at the site of inflammation begin to be rejected, and erosion forms. With erosions of an inflammatory nature, characteristic signs are observed - redness, plaque of pus, swelling, and the release of a small amount of blood due to damage to blood vessels.

- Specific erosion of the cervix. In this case, the cause may lie far beyond the genitals. Rarely found in patients with syphilis or tuberculosis. Erosion may also be associated with the presence of sexually transmitted infections. But they are usually easily diagnosed and quickly treated, so damage to the cervix simply does not have time to occur. Only in some cases, when a sexually transmitted infection lasts for a long time, erosion develops against its background.

- Burn erosion of the cervix. May result from therapeutic procedures. The goal of treating false erosion is to destroy the pathological focus with further restoration of the normal mucous membrane over its surface. For this purpose, modern medicine uses several techniques. Thus, cryodestruction (exposure to low temperature), electrocoagulation, laser, radio waves or chemical treatment (the so-called cauterization of cervical erosion) are widely used. As a result of any of these procedures, the same changes occur: the upper “irregular layer” is destroyed, and in its place a scab is formed, under which there is a mucous layer. In this layer, recovery processes begin, the mucous membrane heals, and the crust is rejected over time. But there are cases when epithelization occurs with disturbances, the crust is torn off ahead of schedule, revealing an unhealed ulcer. This wound represents true erosion.

- Trophic erosion of the cervix. The cause of this type of erosion is impaired blood circulation in the tissues and their insufficient nutrition. Trophic erosion is often found in menopausal patients against the background of atrophic processes in the mucous membranes of the genitals and hypoestrogenism.

- Physiological erosion of the cervix. It occurs in healthy young women (up to 25 years of age), then disappears completely without requiring external interventions. The reasons for this pathology still remain unexplored. The course of physiological erosion is greatly influenced by the state of the body's immune defense.

Causes of congenital cervical erosion

Congenital erosion is ectopia (pseudo-erosion). When the reproductive system begins to develop in the fetus, the inner surface of the uterus and vaginal rudiments are first completely covered with columnar epithelium. Over time, in the vaginal area and the vaginal part of the cervix, this epithelium is replaced by flat epithelium.

The essence of the problem is that the columnar epithelium is sensitive to hormones. And in newborns, hormonal changes begin in the body, due to which the cylindrical epithelium moves outward, forming false erosion.

What can be done in case of congenital cervical erosion

Until the age of 23 years, congenital erosion is usually not touched, preferring observation tactics. If inflammatory processes occur, they need to be treated. Some patients are prescribed oral contraceptives to regulate hormonal levels.
In addition, women with congenital erosion are advised to use local remedies that help improve epithelization (for example, sea buckthorn suppositories). Sexual intercourse without a condom is undesirable.

Causes of acquired cervical erosion

One of the main causes of acquired erosion is changes in hormonal levels. Such processes are characteristic of puberty, pregnancy, and they can also result from the use of hormonal contraceptives.
In addition, erosion can develop if the cervix has been injured (during childbirth, during an abortion, or due to rough sexual contact).
Inflammatory diseases also play a certain role. They create unfavorable conditions under which the epithelium “looses,” which becomes the basis for the formation of erosion.

Infections and violation of vaginal acidity - causes of cervical erosion

If the acidity shifts to the alkaline side, conditions are created under which the squamous epithelium covering the outer surface of the cervix dies. Its place is taken by a layer of columnar epithelium (normally it lines the cervix), since with a change in acidity an environment suitable for it is formed.

One of the main causes of vaginal acidity is inflammation. Normally, the vagina should have a slightly acidic environment. It is supported by a special vaginal flora - lactobacilli. The second name for these organisms is Dederlein's rods.

If unhealthy flora multiplies in the vagina and an inflammatory process begins, then the pH begins to shift to the alkaline side. Thus, the formation of pseudo-erosion may be associated with inflammation.

Diseases that contribute to the occurrence of cervical erosion

This includes inflammation of the vagina, such as vaginitis, colpitis and some other diseases. Also, sexually transmitted infections can lead to erosion: herpes type 2, genital herpes, gardnerellosis, gonorrhea, ureaplasmosis, mycoplasmosis, trichomoniasis, chlamydia, thrush in women.

Medical scientists have been able to prove that oncogenic types of this virus provoke erosion and subsequently contribute to its transition into a malignant formation. The fact is that all patients diagnosed with cancer have certain strains of the papilloma virus.
At the moment, it is believed that vaccination can be an effective method of combating the papilloma virus. Moreover, it is advisable to carry it out at a young age. According to doctors, vaccination of female adolescents does not increase their sexual activity and can be considered absolutely safe. Read more about the treatment of human papillomavirus infection on our website.

In addition, some additional factors contribute to the formation of erosion:

Fall of immunity.

Early sexual life.

Menstrual irregularities.

A large number of sexual partners.

Neglect of contraception.

The opinion that only women who have given birth suffer from cervical erosion is erroneous. This pathology is observed in women before their first birth, and in adolescents, and even in little girls. Conventionally, the following causes of erosion in nulliparous women can be identified:

- Congenital erosions of the cervix in nulliparous women. By its nature, congenital erosion is a false erosion and is a physiological ectopia. The development of the integumentary epithelium of the cervix and cervical canal begins in the womb. During this period, the presence of columnar epithelium behind the external os is considered normal. But over time, when estrogens are involved in the child’s development process, the transition zone between the columnar and squamous epithelium extends beyond the area of ​​the external pharynx, and for this reason it cannot be seen during a normal examination. Congenital pseudoerosion usually disappears completely when the girl reaches puberty. But sometimes, under the influence of hormonal factors, it can remain. In this case, false erosion is diagnosed at the first gynecological examination after the onset of sexual activity. Congenital erosion in girls can be combined with hormonal dysfunction. This pathology is not considered as a disease. It is considered a temporary physiological condition and does not require special treatment.

- Acquired cervical erosions in nulliparous women. This fairly large group of reasons includes both external and internal factors. Internal causes primarily include infections that occur in a chronic form (not only gynecological), decreased immunity, and hormonal processes. External factors leading to the appearance of erosions are early onset of sexual activity, casual sexual relationships, trauma as a result of abortions.

- Physiological erosion of the cervix in nulliparous women. In gynecological practice, there are rare cases when pseudo-erosion appears in young women who have not yet turned 25 years old. It is not possible to find out the cause of ectopia. It usually goes away on its own without special treatment, and is then considered a physiological phenomenon.

If complicated erosion (false or true) is detected, the patient must be treated. Unfortunately, erosions are prone to recurrence. Typically, relapses occur when erosion is not completely eliminated, when sections of columnar epithelium remain in the affected area. Erosion can also reoccur due to an untreated infection.

Some women believe that erosion may be due to psychological factors. However, erosions are usually of hormonal or organic origin. But the influence of psycho-emotional factors on their occurrence has not been confirmed, so this opinion can be considered erroneous.

Causes of cervical erosion in women who have given birth

The cause of postpartum erosion is traumatic injury. During childbirth, the fetus undergoes forward movements. The uterus has elastic and muscle fibers and therefore stretches. If the birth process is not normal, minor injuries and, in some cases, even ruptures may appear on the cervix.

Of course, all injuries resulting from childbirth must be sutured. However, they quite often cause erosion. A few days after the birth of the child, ulceration forms on the damaged area, accompanied by acute inflammation.

Visually, the erosion that occurs after childbirth is a small ulcer of a bright red hue, which is more intense at the edges. The affected area is covered with a pus-like coating. There are damaged vessels at the bottom of the wound, so erosions are characterized by bleeding.

If local immunity works without disturbances, then a few days after the occurrence of erosion, its bottom is cleared of necrotic fragments. And when the entire surface is completely cleaned, erosion becomes an ordinary wound. After this, the healing process begins.

The diagnosis of “true postpartum erosion” is made in the postpartum period. In such cases, the affected area is treated with wipes soaked in disinfectant compounds. This helps prevent a secondary infection from occurring. After cleansing the injured area, proceed to the use of antibacterial applications. Complete epithelization of the damaged area takes about 12 days.

It often happens that women who have suffered postpartum erosion are diagnosed with erosion again during a routine gynecological examination. Patients do not expect such a diagnosis and are surprised to ask why the disease has returned. It's all about incorrect epithelization of true erosion, when ectopia is formed from columnar epithelium. False erosion that appears after childbirth is treated in the same way as in other cases.

So, we can conclude that the formation of erosion is not due to one cause, but to the combined effect of several factors. To detect erosions in a timely manner, it is imperative to visit a gynecologist. Only this specialist, after appropriate diagnosis, can establish an accurate diagnosis.

Cervical erosion is a disease characterized by pathological changes in the epithelial cover of the cervix, most often in the area around the external os of the cervical canal. Changes can be inflammation, ulcers, benign formations.

A number of different factors can lead to the appearance of erosive processes on the epithelium of the genital organs:

• Traumatic physical impact, which occurs, for example, during rough sexual intercourse or medical abortion (damage can be left by vacuum suction or surgical instruments). Also dangerous can be the incorrect use of vaginal contraceptives (in particular, the contraceptive device).
• Infectious diseases of viral, bacterial and other nature: human papillomavirus, herpes, chlamydia. The occurrence of papillomas is especially dangerous, since such formations on the cervix can degenerate into a cancerous tumor.
• Unstable hormonal levels and menstrual cycle.
• Endocrine system diseases, in particular, diabetes mellitus.
• A separate risk group includes girls who started having sex too early. During the period when the reproductive system has not yet fully formed, sexual intercourse can pose a serious threat to women's health.
• Simple neglect of personal hygiene rules It can also provoke the development of inflammatory and infectious diseases of the female genital tract, thereby becoming an indirect cause of erosion.

If the squamous epithelium of the cervix is ​​damaged, columnar epithelial cells from the cervical canal can “move” to the pathological area. In the cervical area, these cells are perceived as foreign, which is what leads to the appearance of inflammatory and tumor processes.

Symptoms

Cervical erosion is very often asymptomatic, so many women who neglect regular examinations by a gynecologist do not even suspect that they have the disease. But in some cases, as well as as the disease progresses, characteristic symptoms may appear:

1. Increased duration of menstruation and profuse menstrual flow.
2. Between menstruation, bloody and sometimes purulent discharge may appear.
3. Also, sometimes uterine discharge with a strong unpleasant odor appears, often quite abundant.
4. Another characteristic symptom that characterizes not only erosion, but also other lesions of the reproductive system is pain in the lower abdomen that appears during sexual intercourse or urination.

If any of these symptoms appear, you should visit the gynecological office as soon as possible. After all, it is the doctor who will be able to establish a real diagnosis during examination and select the appropriate treatment in time.

You can also watch the causes and signs of cervical erosion in this video:

Treatment for nulliparous women

Erosion, like many asymptomatic diseases, often remains without due attention from the patient. Many women, even knowing that they have such a pathology, are in no hurry to undergo treatment. Usually people are guided by the erroneous opinion about the safety of diseases that occur without symptoms and do not cause significant inconvenience.

But we should not forget that progressive erosion of the cervix can negatively affect the quality of sexual life, reproductive ability and the general condition of the female body. Another big danger is that erosive lesions can eventually degenerate into a malignant tumor. It is much more difficult to cure cancer than ordinary erosion.

Congenital disease

In girls who have not yet entered puberty, the cervical columnar epithelium is partially located on the outside. This condition is called congenital cervical erosion. Normally, these cells move from the cervix into the cervical canal, which is associated with the growth and development of the reproductive system. However, in some cases, erosion remains on the cervix even during fertile age. Then we are talking about a pathological condition.

Treatment of congenital erosion is practically no different from the treatment of a common disease, except that they try to cure such lesions using the most gentle means without the use of harsh surgical interventions. This is done to avoid scarring of the cervix, which negatively affects its elasticity, and therefore the process of the first birth.

In many cases, the pathological epithelium spontaneously moves into the cervical canal during the first pregnancy. This occurs as a result of changes in hormonal levels in a woman’s body.

However, you should remember: an action plan for each patient must be built individually. In any case, only a gynecologist can determine the need for treatment of such a pathology.

Therapy methods

Modern medicine has long been faced with the problem of cervical erosion, and at the moment there are many different treatment methods. In general, they can be divided into two large groups: surgical and conservative (medicinal).

Advice! You should not resort to folk remedies.

Surgical

The most effective and at the same time radical methods are the physical destruction of cells in the pathological area. During the procedure, the columnar epithelium and adjacent healthy tissues are exposed to an aggressive physical factor.

• Electrocoagulation– cauterization of erosion with high frequency electric current.
• Laser cauterization– the pathological area is burned out with a high-intensity laser beam.
• Cryodestruction- a fairly common method based on the destructive effects of low temperatures, in particular liquid nitrogen.
• Radiosurgical excision– a relatively new method, complex and expensive. Used mainly to combat malignant tumors. The eroded area is subjected to short-term, targeted effects of intense ionizing radiation, causing the death of irradiated cells.

There is also a method of chemical destruction, which is otherwise called chemofixation. It is based on the destructive effect of aggressive chemicals on epithelial cells. During this procedure, the doctor applies a chemical to the site of erosion using a special applicator.

The main advantage of surgical methods for treating cervical erosion is their highest efficiency. After the procedure, the pathological area completely dies off with the formation of a scab, and the tissues underlying it are scarred. The likelihood of disease recurrence after high-quality surgical treatment is very low.

At the same time, radical surgical methods, such as electrocoagulation, are unsuitable for treating erosion in young girls who have not yet given birth. The scars formed after the procedures significantly reduce the elasticity of the cervix and increase the risk of ruptures during pregnancy and childbirth.

Therefore, if surgical treatment of a nulliparous patient is necessary, doctors try to use the most gentle methods, which, if used correctly, do not leave scars. These include laser cauterization, cryodestruction and chemofixation.

Other disadvantages of radical surgical procedures include a fairly long recovery period (from 1 to 3 months), during which it is necessary to abstain from sexual intercourse, visiting the pool and taking a bath. During and after the procedure, pain may occur in the lower abdomen.

Modern laser and chemical procedures for removing erosion do not require long-term recovery and do not impose restrictions on a woman’s lifestyle.

Medication

As part of the complex treatment of cervical erosion, medications that are freely sold in pharmacies are used together with surgical methods. Mainly products whose action is aimed at the rapid regeneration of damaged tissues and healing of scars. Such medicines are produced in the format of suppositories, ointments and liquids.

Candles

Vaginal suppositories (suppositories) have proven themselves to be a very convenient home treatment for erosion. They are very effective and easy to use, which is why drugs in this form of release are in great demand.

• Depantol– a drug whose main active ingredient (dexpanthenol) has a positive effect on cell regeneration. These suppositories are often used after surgical operations such as electrocoagulation to reduce unpleasant side effects and quickly heal the wound. The drug has virtually no side effects (except for possible local allergic reactions); it can be used during pregnancy.
• Hexicon– the active ingredient of these suppositories is the common antiseptic chlorhexidine. The drug has antibacterial properties and is used for the prevention of infectious and inflammatory diseases of the reproductive system both before and after the main surgical procedure on the cervix.

A feature of these medications, produced in the form of suppositories, is their incompatibility with soap. Proper use of the drugs does not interfere with the toilet of the external genitalia, however, you should still be careful with personal hygiene when using hexicon and depantol.

Ointments and solutions

Another group of pharmaceutical drugs that can be a good help in the treatment of cervical erosion are various creams, ointments and liquids. They are not as easy to use because they often require special applicators or swabs to apply the product.

• Vulnostimulin– cream based on natural plant extracts and essential oils. Mainly used as a local antiseptic, wound healing and anti-inflammatory agent. When treating erosion, the drug is applied to a medical tampon and inserted into the vagina. Due to its natural composition, the cream is quite safe to use; allergic reactions are possible among side effects.
• Vagotil– the drug is an aqueous solution of polycresulene. The active substance has a pronounced coagulating, astringent and antiseptic effect. A tampon soaked in liquid is inserted into the vagina and pressed against the affected area for several minutes. Note! Vagotil is available only with a doctor's prescription. The drug is quite difficult to use, so procedures with Vagotil applications are best carried out by a gynecologist.

IMPORTANT! Pharmaceutical drugs are used only as part of complex therapy and are not a complete replacement for destructive removal of erosion. Before using any medicine, you should consult with your gynecologist to avoid complications.

Diagnostics

Cervical erosion is often detected during a routine preventive examination by a gynecologist.. If the doctor suspects the presence of a pathology, the following series of diagnostic procedures are usually performed:

1. External visual examination with mirrors allows you to evaluate the appearance of the cervix. The eroded area is different from healthy tissue because it is composed of different epithelial cells.
2. Colposcopy is a more thorough optical examination using a colposcope.
3. Cervical smear - it is taken for cytological examination, microflora culture and identification of possible pathological changes.
4. If obvious pathology is detected, a biopsy of cervical tissue may be prescribed. During the procedure, the doctor takes a tissue sample for oncological testing; During the operation, the patient may experience discomfort.

Timely and high quality diagnosing erosion will allow timely determination of the nature and severity of the disease, and therefore, prescribe the necessary treatment as soon as possible.

Conclusion

Being one of the most common female diseases, cervical erosion is often not taken seriously enough by patients and is left without long-term treatment for many years. This approach is fundamentally wrong. After all, a habitual, benign erosion that does not cause inconvenience may well degenerate into cancer and become a serious threat to the health and life of a woman.

This is especially important for young girls who have not yet given birth - erosion can greatly undermine reproductive health. That's why treatment should not be neglected if pathology is still detected, and also do not forget about the main method of prevention - regular examinations by a gynecologist.

The cervix connects the internal genital organs to the vaginal canal. Damage to the epithelium of the vaginal area can cause infertility, and degeneration of epithelial cells leads to the development of a malignant tumor of the uterus. Often a woman does not even know about the existence of the pathology. Symptoms of concomitant diseases that cause damage to the epithelium may be concerning. During an examination for ailments or during a preventive examination, the gynecologist detects erosion. It is necessary to choose a suitable treatment method.

Content:

What is cervical erosion

The inner surface of the cervix is ​​covered with mucous membrane. Moreover, the composition of the epithelium in the area of ​​the cervical canal itself and its outer part extending into the vagina is different. The cells of the internal epithelium are cylindrical in shape, and in the outer part they are flat. Erosion occurs when cracks appear on the vaginal part of the canal, into which columnar epithelium from the neighboring area enters. As it grows, it narrows and even blocks the opening of the cervix, which leads to infertility. Cancerous degeneration of cells is also possible.

Erosion is often confused with cervical ectopia. Ectopia is a harmless movement of a small part of the columnar epithelium into the area of ​​flat epithelium. In this case, at the junction of the two layers around the exit from the channel, a bright pink stripe is formed, which is easily confused with erosion. Ectopia is called pseudo-erosion.

Is it necessary to treat erosion in nulliparous women?

Ectopia often appears in nulliparous young women. It appears as a result of hormonal disorders and inflammatory processes. After eliminating inflammation and establishing hormonal levels, this disorder can go away on its own, and the normal state of the epithelium is restored.

Treatment of women, especially nulliparous women, for cervical erosion is not required if they are not bothered by any painful symptoms. It is only recommended to undergo regular gynecological examinations to prevent complications. Treatment is mandatory in the following cases:

1. Simultaneously with ectopia, the woman has a chronic inflammatory disease that is difficult to treat.
2. A woman is diagnosed with papillomavirus or another infection, and there are complaints of unusual bloody discharge from the genital tract, pain in the lower abdomen, and in the lower back.
3. If copious mucous discharge appears, there are cysts.
4. In the presence of cervical dysplasia. Dysplasia occurs due to the fact that the inside of the cervical canal turns outward. This condition often occurs in newborns, but by the time of puberty it goes away on its own. If dysplasia does not disappear, then the cylindrical epithelium remains outside and can degenerate into cancer. In this case, the pathology requires mandatory treatment, regardless of whether the woman intends to give birth in the future or not.

Warning: A malignant tumor in the vaginal area of ​​the uterus in the initial stage is difficult to distinguish by appearance from erosion, therefore, to establish an accurate diagnosis, a routine gynecological examination is not enough; colposcopy is required.

Video: Causes of cervical erosion, need for treatment

Diagnosis of erosion

Erosion is detected during a gynecological examination using speculum. The area of ​​erosion is distinguished by a brighter color and granular structure of the epithelium. To study the changes in detail and establish their benign or malignant nature, the colposcopy method is used. A colposcope helps to examine the affected area with optical magnification and lighting. This allows you to distinguish true erosion from ectopia and detect changes characteristic of a cancerous tumor. At the same time, a biopsy of the suspicious area can be done (for this, a piece of tissue is cut out). A smear is also taken to detect infection and study microflora.

A cytological examination of the affected area is performed. To do this, using a spatula and brush, a scraping is taken from the surface of the cervix (the procedure is painless). The material is then examined under a microscope. The composition and nature of the tissues of the affected area are examined. A smear of the cervix is ​​taken to detect papillomavirus (a common cause of cancer).

The danger of treating erosion in women without children

When treating erosion, the affected cells are destroyed. This can also damage healthy tissue. When they are mechanically removed using various cauterization methods, scars remain on the neck, and fusion of the canal walls can occur. This leads to infertility.

Scarring causes the tissue to lose its elasticity. During childbirth, this may cause ruptures in the cervix. Scarring leads to the fact that the cervix will spontaneously open during pregnancy, causing a miscarriage. Due to fear of complications during pregnancy and childbirth, nulliparous women sometimes delay treatment for cervical erosion until the birth of the child. However, the doctor must decide what to do after the examination.

Erosion is treated in two ways: cauterization and chemofixation. For cauterization the following are used:

• liquid nitrogen (cryodestruction);
• electricity;
• radio waves;
• laser radiation.

Video: What is ectopia. How to treat erosion in nulliparous women

What methods are used to treat erosion in nulliparous women?

Cervical erosion in nulliparous women is most often treated with chemofixation. Preparations (Vulnostimulin, Vagotil, Solkovagin) containing a mixture of acids are used. When treating the affected surface, they destroy diseased cells without damaging healthy ones. After treatment, the wound heals quickly without leaving scars.

Non-contact laser cauterization and radio wave methods are also used to treat nulliparous women. Their advantage is that healing occurs much faster than using contact methods. No scars are formed.

To regenerate the mucous membrane during erosion in nulliparous women, suppositories (Depantol, Hexicon) are also used for insertion into the vagina. Other methods are used for nulliparous women only if absolutely necessary.

Erosion in the tissues of the genital organs is a fairly common problem among the fair sex. According to statistics, in most cases, such a pathology develops after pregnancy (successful or interrupted). Nevertheless, cervical erosion in nulliparous girls is also diagnosed, because there are many causes of this disease. So what is the disease and how dangerous can it be? What should you pay attention to during diagnosis? Are there effective treatments? The answers to these questions are of interest to many patients.

Erosion: brief information about pathology

It is considered one of the most common ailments of the reproductive system. According to statistics, about 50% of women of childbearing age suffer from this disease. The disease is accompanied by a disruption of the structure of the epithelial layer that lines the cervical canal.

Cracks appear in the epithelial layer, which are then overgrown with other elements, which, accordingly, affects the properties and functioning of the organs of the reproductive system. The columnar epithelium begins to grow, spreading to other areas of the genital organs. As the disease progresses, small ulcers begin to appear in the wall. Cervical erosion is diagnosed in nulliparous girls, mothers and even pregnant women. This problem is quite common, so it is worth familiarizing yourself with the basic information about the disease.

Cervical erosion in a nulliparous girl: causes

Of course, first you should learn about possible risk factors. In what cases does cervical erosion develop in nulliparous girls? The causes may be different:

• the presence of infections, especially those transmitted during sexual intercourse;
• inflammation in the organs of the reproductive system, in which irritation of the mucous membrane of the cervix is ​​observed;
• disruption of the natural microflora of the vagina, which is observed, for example, with thrush;
• changes in hormonal levels;
• taking hormonal medications;
• improper use of mechanical or chemical contraceptives;
• a weakened immune system, which increases the risk of developing infectious or inflammatory diseases;
• promiscuous sexual intercourse;
• cervical injuries that can occur during gynecological procedures or too active sexual intercourse;
• activation of papillomavirus or herpes infection;
• in some cases, the pathological process begins in girls even before birth, in the womb.

It is in such cases that cervical erosion most often develops in a nulliparous girl. The reasons, as you can see, can be very diverse, so you should never ignore the problem.

What are the dangers associated with the disease?

Why is cervical erosion dangerous in nulliparous women? Its consequences can be very sad, especially when it comes to pregnancy. As the disease progresses, the tissue of the cervix loses its elasticity. Therefore, during childbirth there is a high risk of fetal asphyxia. In addition, there is a possibility of cervical rupture during the birth of the baby. In turn, this increases the possibility of severe infectious diseases of the reproductive system. Often, after severe cervical ruptures, women have problems with subsequent pregnancies - the number of miscarriages increases.

According to static data, cervical erosion in nulliparous girls can be accompanied by malignant tissue degeneration and, accordingly, the development of cancer. That is why it is important to diagnose the disease in time and begin to treat it.

Cervical erosion in nulliparous girls: symptoms

Unfortunately, in most cases the disease occurs without any visible signs. However, some changes are still worth paying attention to. Erosion of the cervix in nulliparous girls may be accompanied by the discharge of so-called leucorrhoea. Sometimes women complain of nagging pain in the lower abdomen, but they quickly pass.

Symptoms include spotting that appears regardless of the menstrual cycle; such disorders should alert the patient. In more severe cases, bleeding is possible, which appears, for example, during or after sex.

What procedures are needed to make a diagnosis?

How is cervical erosion diagnosed in nulliparous girls? Reviews from doctors indicate that in most cases the disease is discovered completely by accident, during a routine gynecological examination. When examined using mirrors, the doctor may suspect the presence of erosions, which is a reason for further tests:

• Colposcopy is considered an informative diagnostic method. Using a special device (colposcope), the doctor must carefully examine the walls of the vagina and part of the cervix. To obtain more information, the tissue is treated with iodine solution or acetic acid - this way the doctor has the opportunity to see the boundaries of the erosion areas.

• The specialist also takes a smear from the vagina, because it is important to determine the composition of the microflora. The same procedure allows you to determine the presence of bacterial pathogens.
• Sometimes PCR diagnostics are also necessary, especially if there is a possibility of activation of herpes or papilloma viruses.
• It is necessary to take urine and blood samples for analysis, and also determine the level of hormones in the blood.
• is carried out if there is a suspicion of malignant tissue degeneration.

During diagnosis, it is important not only to determine the presence of erosion in the cervix, but also to identify the causes of the development of pathology.

Main stages of treatment

This disease requires complex treatment. Firstly, it is necessary to restore the normal structure of the cervix and prevent the increase in areas of erosion. Secondly, it is important to prevent the development of infectious and inflammatory diseases, which will only worsen the situation.

Erosion therapy includes both taking medications and the process of cauterizing the affected areas. There is an opinion that moxibustion is contraindicated for nulliparous women, as it can lead to problems in the future. This statement is partly correct. The simplest and most accessible method of cauterization is electrocoagulation. However, after the procedure, as a rule, quite large scars form on the cervix, which can make a subsequent pregnancy impossible.

Fortunately, there are many gentle cauterization methods known, after which there are practically no traces left on the tissue. So for nulliparous girls?

Suppositories and other drugs for the treatment of erosion

Medicine has at its disposal many medications for the treatment of the erosive process, mainly vaginal suppositories. For example, in modern medicine they use drugs such as Depantol, Suporon, Hexicon, and sea buckthorn suppositories.

These medications are easy to use at home. They accelerate the healing processes of erosion areas, promote the development of normal microflora, soften tissues, accelerate the removal of pathological secretions, and relieve a woman of discomfort. In addition, their cost is quite affordable. Unfortunately, treatment only with suppositories is possible only in the early stages of the disease. In other cases, drug treatment must be supplemented by cauterization of the affected areas.

Cryodestruction of erosion: advantages and disadvantages of the method

What to do if cervical erosion is detected in a nulliparous girl? Treatment is often carried out using liquid nitrogen. The procedure is not too painful and does not last long. The doctor inserts a special cryoprobe into the vagina, after which he treats the erosion areas with liquid nitrogen, which has an ultra-low temperature. Thus, the damaged areas of the epithelium are frozen out.

The recovery period lasts no more than a few weeks. There are no scars left on the tissue (if the equipment is used skillfully), and the procedure is affordable. On the other hand, liquid nitrogen is ineffective for deep erosions, since it makes it possible to treat only superficial layers - there is a risk of relapse.

Treatment by chemical cauterization

One of the most accessible methods is considered to be cauterization of areas of erosion using special medications. For example, medications such as Vagotil or Solkovagin are often used. During the procedure, the doctor treats the affected epithelium with chemicals that destroy the columnar epithelium layer.

This technique is simple, and the drugs are inexpensive. However, about five consecutive treatments are required to achieve maximum effect. And again, this method is only possible in the case of small, shallow erosion.

Radio wave treatment of erosion

The safest and most painless method is carried out using a special device “Surgitron”, which makes it possible to destroy atypical epithelial cells. Modern equipment helps remove areas of erosion, even if they are located in deep layers. Moreover, the procedure is practically painless, and the recovery period is minimal. There is no direct contact with the patient's blood or tissues, so the risk of infection is minimized. It is this method that is recommended for nulliparous girls and women who are planning a pregnancy in the future.

Unfortunately, not every clinic can afford to purchase the equipment necessary for the procedure. And the cauterization itself will be expensive for the patient.

Is treatment possible with folk remedies?

Is cervical erosion treated at home in nulliparous women? Treatment with folk remedies is possible only with the permission of the attending physician - in no case should you refuse medical care. Various folk recipes can be used as aids, but cannot replace full-fledged therapy.

Sea buckthorn oil is considered a good healing agent. This product, by the way, contains vitamins and minerals necessary for tissues. Sometimes doctors recommend soaking a tampon in natural sea buckthorn oil and inserting it into the vagina. In the same way, you can treat erosion with honey.

Disease prevention

The issue of preventing cervical erosion is very relevant. Unfortunately, there is no medicine that can prevent the development of the disease. Nevertheless, following a few simple rules will help you avoid the disease or at least diagnose it at an early stage.

It is extremely important for women to adhere to personal hygiene rules and avoid casual sexual contact. You should definitely consult a doctor and choose safe but effective means of contraception, since the causes of erosion include not only sexually transmitted diseases, but also artificial termination of pregnancy. All infectious and inflammatory diseases must be diagnosed in time and treatment must begin immediately. Patients are also strongly recommended to visit a gynecologist twice a year for a preventive examination (even if there are no complaints about their health).

Untreated cervical erosion in nulliparous women leads to difficulties in conceiving and subsequent problematic childbirth.

A woman can hear a message from a doctor about cervical erosion during a routine examination or when visiting for complaints of other diseases. Practice shows that such a diagnosis is made to every second woman.

Treatment of cervical erosion in nulliparous women requires correct identification of the cause of the disorder and its exact nature, because “erosion” refers to several different conditions.

Causes of erosion

When informing a woman about the presence of erosion, the gynecologist does not specify what kind of condition he is observing. There are several similar conditions, common to which is a violation of the mucous membranes of the cervix. In fact, many doctors dispute the very name “erosion” (literally it means “destruction, ulcer”), considering the wording “ectopia” to be correct.

Normally, the doctor, examining the cervix in the mirrors, sees the external os of the cervix, covered with dense pink epithelium. The cells of this epithelium are flat, with strong walls, tightly arranged in rows. A covering of many layers of flat cells provides protection to the walls of the vagina and the external os of the cervix from mechanical and chemical damage.

Flat epithelium is adjacent to another type of integumentary cells - cylindrical, which line the cervical canal (located inside the cervix). This epithelium performs a completely different function - it secretes thick mucus, which seals the uterine canal from infection and third-party fluids.

In some cases, the cervical epithelium “forgets” its boundaries, columnar cells appear on the outer, vaginal side of the cervix. During the examination, the doctor may observe:

• small cracks or spots on the cervix that bleed when pressed with an instrument - true erosion;
• uneven red areas on the cervix, or ectopia (false erosion);
• influxes of red epithelium - or congenital erosion.

The mechanism of this phenomenon is unknown, but the underlying circumstances that lead to this condition have been studied. The reasons for the appearance of the true form of pathology:

• medical procedures - termination of pregnancy, installation of an intrauterine device;
• hard sex;
• use of sex toys;
• infectious diseases, including sexually transmitted diseases.

It is diagnosed quite rarely - microcracks in the mucous membrane heal within 10-14 days. Healing can proceed naturally, and the squamous epithelium coating at the site of the lesion is restored, or columnar epithelium, characteristic of the cervical canal, will begin to grow in the area of ​​cracks.

Causes of cervical erosion in a nulliparous woman:

• changes in hormonal levels;
• use of hormonal contraceptives;
• infection with sexually transmitted infections, including sexually transmitted diseases;
• HPV lesions.

There is also a congenital form of the disorder, which is diagnosed in girls and nulliparous girls. It is believed that the cause of the phenomenon is hormonal imbalances in the body of the mother and fetus during intrauterine development or hormonal disruptions during the development of a girl.

It is considered inappropriate to treat erosion of this type; its signs disappear on their own, without outside intervention, after reaching the age of 25 years or the birth of a child.

Is it necessary to treat erosion if outwardly this condition does not pose a danger? It usually occurs or is accompanied by inflammatory diseases of the reproductive organs and decreased immune defense. This is partly because the thick, viscous mucus secreted by the cylindrical cells is not typical for the vagina, and is a breeding ground for infection that a weakened immune system cannot contain.

Ectopia forms growths on the surface of the cervix, which in severe cases can completely block the access of sperm to the cervical canal.

Factors that weaken the immune defense of a woman’s body and indirectly affect the development of ectopia will be:

• frequent stress;
• nervous and physical overload;
• presence of systemic diseases;
• past infectious diseases;
• too early onset of maturation and sexual activity;
• diabetes;
• disorders of the thyroid gland;
• psychosomatic factors.

Treatment of cervical erosion in nulliparous women is a complex process that takes into account both the physiological and psychological characteristics of the patient. Treatment methods must be as effective as possible, while at the same time gentle, in order to fully preserve the reproductive capacity of girls.

Symptoms and diagnosis

Changes in the mucous membranes of the cervix do not manifest obvious symptoms; the woman usually does not observe any unpleasant signs. Pathology can only be detected by examination by a doctor.

Erosion in nulliparous women can signal side symptoms that will indicate a complication, that a concomitant infection has appeared:

• discomfort and spotting occurs during sexual intercourse;
• yellowish or greenish leucorrhoea with an unpleasant odor is noted;
• periodic pain in the lower abdomen may occur;
• pink discharge appears.

These symptoms should alert a woman and become a reason to see a doctor.

The presence of the disease is confirmed by a visual examination in the mirrors and a thorough diagnosis. If necessary, specialized specialists are involved. The purpose of diagnosis is to determine the disorder in the formation of mucous membranes, the type, boundaries of the lesion and determine treatment methods.

The doctor refers the woman to:

• general clinical blood test;
• biochemical analysis;
• analysis for the presence of sexually transmitted infections, HIV, HPV;
• blood and urine tests for hormones (if necessary);
• Ultrasound of the abdominal organs;

A bacteriological culture of the smear is performed to determine the microbiological composition of the vagina, and, if necessary, a PCR test to identify specific viruses.

Important in determining the extent and size of the lesion is colposcopy - a specific examination of the cervix using a magnifying binocular with additional lighting.

The cervix is ​​examined at the beginning of the monthly cycle (before the 7th day). To identify altered cells, the doctor dries the surface of the cervix, then the surface is treated with a solution of acetic acid, which makes it possible to identify the erosion zone. To more accurately identify the lesion, secondary treatment is carried out with Lugol's solution, which stains the altered cells.

If there is a suspicion of a tumor, the doctor takes tissue from the affected area for histological examination. Based on the research conducted and the collected medical history, the doctor selects the desired treatment method. How to treat erosion will depend on the extent of the lesion detected - small and medium ones are treated conservatively, if large areas of erosion are detected, a decision to use cauterization is considered.

Treatment of erosion

Many nulliparous women are wary of treating erosion, fearing that it will not allow them to get pregnant and give birth normally. This is not true. Modern methods of treating cervical erosion for nulliparous women assume complete preservation of reproductive ability.

Congenital form

In the case of congenital erosions, a wait-and-see tactic is used - the doctor periodically monitors the girl’s condition. She is explained her condition and the rules of prevention, which are designed to prevent infection from occurring:

• sufficient physical activity;
• complete balanced nutrition;
• selection of linen from natural fabrics;
• careful adherence to personal hygiene;
• use of high-quality hygiene products;
• choosing one partner for sex;
• use of protective equipment during sexual intercourse;
• using pads instead of tampons during menstruation;
• maintaining safety when swimming in open waters.

The doctor prescribes periodic examinations and smear sampling to examine the microflora. If infection has occurred, symptomatic treatment is undertaken.

Small and medium erosion

If small or medium-sized lesions are detected without the influence of infection, the doctor monitors the patient’s condition. If a woman is healthy and follows preventive measures, the body will correct the disorder over time. Observing the patient every three months, the doctor monitors the condition of the smear and the appearance of atypical cells. Treatment is indicated if the affected area increases. The doctor prescribes:

• traditional methods of treatment;
• anti-inflammatory drugs in case of infection;
• general strengthening agents (vitamin complexes, immunostimulating drugs).

Conservative treatment can be long-term; if it is not effective, the use of gentle cauterization methods is considered.

Great erosion

If massive erosion of the cervix is ​​detected, treatment in nulliparous women is optimally carried out by cauterization. The reason that caused the violation must first be thoroughly investigated. To do this, a comprehensive examination is used with the involvement of specialists - therapists, endocrinologists; the patient must undergo blood tests (general and biochemical, testing for HIV and sexually transmitted infections, hormone analysis). A smear is examined to determine the vaginal microflora.

After determining the cause, treatment is prescribed. Detected infections are treated first. In addition, the following are appointed:

• hormonal drugs (if necessary);
• anti-inflammatory drugs (antibiotics) in various forms;
• restoratives;
• suppositories;

After the condition has normalized, a control examination is carried out (the doctor must make sure that there is no inflammation and the intestinal microflora is normalized), and a date for cauterization is set. It is performed in the first week after menstruation. The methods that the doctor chooses depend on the technical capabilities of the clinic, the professional training of the staff, and the financial capabilities of the patient.

Cauterization methods

For cauterization, modern, invasive methods are used to treat cervical erosion in nulliparous patients without scar formation and deformation of the cervical canal. These include:

• laser vaporization method;
• chemical fixation.

Cauterization allows you to mobilize the body's forces to restore the epithelial cover on the cervix.

Laser cauterization is performed using a hydrocarbon laser and a working diode. The equipment allows you to very accurately outline the affected area and burn out the altered cells to the required depth. Large areas of the lesion must be treated several times, which makes the treatment extended over time.

A protective scab forms over the burnt area, which comes off on its own in 10-14 days; up to 30 days, a new, flat epithelium will form on the burn area.

During the recovery period, the woman is subject to restrictions that protect the intervention area from infection. Prohibited:

• swimming in open water pools;
• bathing in a sauna, hot tub;
• hypothermia or overheating;
• sexual intercourse;
• use of tampons;
• hard physical labor;
• nervous overload.

The woman is recommended to give up smoking, fatty and heavy foods, and alcohol during the recovery period. The doctor conducts a follow-up examination after the first menstruation has passed. If you are planning a pregnancy, it is better to wait until your cycle returns and plan to conceive after your third period.

In a similar way, the affected area is exposed to the radio wave method, which is considered the most modern. Some gynecologists consider it the “golden” standard for the treatment of erosion. The advantages of the method are accuracy, bloodlessness, and painlessness. A thin film is formed at the site where the changed cells are cut. The restrictions after cauterization are the same as with laser vaporization.

In some cases, a chemical fixation method is used. The method consists of applying a tampon with a caustic chemical composition to the damaged area of ​​the mucosa to eliminate the columnar epithelium. One of the economical and proven methods is used in the early stages of the onset of pathology.

If a woman does not comply with the rules of behavior during the rehabilitation period, erosion may resume, which will require re-treatment. In some cases, the recurrence of erosion will indicate an error in determining the true cause of ectopia.

Traditional methods of treatment

For a woman who has not given birth, self-treatment of cervical erosion with folk remedies is unacceptable. She uses them only in consultation with her doctor. In the case of small and medium erosions, they can be used very effectively.

The most commonly used:

• sea ​​buckthorn oil is an effective wound-healing and anti-inflammatory agent with a powerful vitamin composition. Can only be used in the absence of pathogenic flora and inflammation in the vagina. For treatment, tampons soaked in warm oil are used, or the cervix and vaginal walls are lubricated with a heated substance; procedures are carried out at night; you can use candles with sea buckthorn oil;
• liquid May honey - the administration procedure is similar to that described above, the swab with honey is removed after a few hours; you can make candles from equal quantities of honey, propolis and lard;
• ointment with propolis (suppositories) that can be used in the development of an inflammatory process in the vagina. To produce the medicine, high-quality fat (vaseline) is used in a ratio of 1:10, injected on a tampon, the course of treatment is 10 days.

Any treatment for ectopia should be prescribed and monitored by a gynecologist.

Prevention of pathology

Ectopia is a condition whose development can be stopped by following simple rules of prevention:

• careful adherence to personal hygiene;
• timely treatment of inflammatory diseases;
• correct contraception;
• exclusion of abortion as a method of birth control;
• avoiding alcohol and smoking;
• maintaining optimal physical activity.

A strong immune system, correct sexual behavior, and the absence of bad habits will allow a woman to maintain a healthy reproductive system for a long time, conceive and bear a healthy baby.