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Health condition · Clinically reviewed

Cervicitis, causes, testing and BASHH-aligned treatment.

Inflammation of the cervix is often silent and usually treatable. The right swabs, the right antibiotics and partner treatment do most of the work.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BASHH, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance including NAAT testing, Mycoplasma genitalium resistance and partner notification.

Key facts

Cervicitis at a glance.

The essentials, in plain English - what it is, what causes it and how it is treated in the UK today.

  • What it is

    Inflammation of the cervix - the neck of the womb - most often triggered by infection but sometimes by chemicals, foreign bodies or hormonal change.

  • Commonest cause

    Sexually transmitted infection - chlamydia and gonorrhoea lead the list, followed by trichomonas, herpes and Mycoplasma genitalium.

  • Non-infectious causes

    Spermicides, douching, latex, retained tampons or pessaries, post-menopausal atrophy, radiation and rare autoimmune conditions.

  • How it presents

    Often silent - when symptoms appear, expect mucopurulent discharge, bleeding after sex, painful sex or pelvic ache.

  • How it is diagnosed

    Speculum exam plus NAAT swabs for chlamydia, gonorrhoea, trichomonas and Mycoplasma genitalium, with wet mount and pregnancy test as needed.

  • Foundation therapy

    BASHH-aligned antibiotics - doxycycline for 7 days, adding IM ceftriaxone if gonorrhoea is suspected, with partner treatment and safer-sex advice.

Why this guide matters

Test properly, treat properly, tell partners.

Cervicitis is common and usually curable. The three points below shape everything else on this page.

  • NAAT testing is the standard

    Modern nucleic acid amplification tests find chlamydia, gonorrhoea, trichomonas and Mycoplasma genitalium reliably - swab-and-treat is not enough.

  • Empirical antibiotics are quick

    BASHH-aligned doxycycline for seven days, with intramuscular ceftriaxone if gonorrhoea is likely, treats most cases while swabs are processing.

  • Partners must be treated too

    Without partner notification and treatment, reinfection is almost guaranteed - sexual health clinics can help confidentially.

How the diagnosis is made

From first swab to a clear plan.

The steps a UK GP or sexual health clinic will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and STI risk

    Recent partners, contraception, symptoms in partners and any new products used vaginally - the story usually points to the cause.

  2. 02

    Assessing

    Speculum examination

    Looking for a friable cervix that bleeds on contact, mucopurulent discharge or the classic strawberry appearance of trichomonas.

  3. 03

    Assessing

    Pregnancy test

    Always considered before treatment - it changes which antibiotics can be used and whether onward referral is needed.

  4. 04

    Confirming

    NAAT swabs

    Nucleic acid amplification tests for chlamydia, gonorrhoea, trichomonas and Mycoplasma genitalium - the modern standard.

  5. 05

    Confirming

    Wet mount, pH and KOH

    Bedside tests to spot trichomonads, clue cells of bacterial vaginosis, candida and shifts in vaginal pH.

  6. 06

    Next steps

    HPV and cervical screening

    A chance to check screening is up to date - persistent friability or bleeding can also raise questions about the cervix itself.

  7. 07

    Next steps

    HSV swab if ulcers seen

    Painful vesicles or ulcers on the cervix or vulva warrant a herpes NAAT and antiviral treatment.

Typical timeline: clinic visit to treatment on the same day, with swab results in days.

Symptoms

What cervicitis actually looks like.

Often silent, sometimes obvious - and always worth a proper look if there is discharge, bleeding or pain.

  • No symptoms at all

    The most common presentation - cervicitis is often picked up incidentally during screening or a smear.

  • Mucopurulent discharge

    A yellow or greenish discharge visible at the cervical os on speculum exam - a key sign of infective cervicitis.

  • Bleeding between periods or after sex

    Intermenstrual or postcoital bleeding from a friable, inflamed cervix - always worth investigating properly.

  • Painful sex

    Deep dyspareunia during or after intercourse - the inflamed cervix is tender to touch.

  • Dysuria and pelvic ache

    Burning on passing urine and a low, dragging pelvic discomfort - sometimes the only clues to underlying infection.

  • Friable cervix on examination

    A cervix that bleeds on gentle contact with a swab - a strong sign of active inflammation.

  • Strawberry cervix

    Punctate haemorrhages classically seen with trichomonas infection - not always present but very suggestive.

  • Red flag - pelvic pain and fever

    Pain rising into the lower abdomen with fever suggests pelvic inflammatory disease and needs same-day assessment.

Treatment

How cervicitis is treated in the UK.

Empirical BASHH-aligned antibiotics first, tailored to the organism once swabs are back, with partner treatment throughout.

  • Doxycycline 100 mg twice daily

    Seven days - first-line for chlamydia and the empirical backbone of BASHH-aligned cervicitis treatment.

  • Ceftriaxone 1 g intramuscular

    A single dose added when gonorrhoea is suspected or confirmed - reflects current UK resistance patterns.

  • Moxifloxacin 400 mg daily

    Seven to fourteen days for macrolide-resistant Mycoplasma genitalium - guided by resistance testing where available.

  • Metronidazole for trichomonas

    Oral course for confirmed trichomonas - treat the partner at the same time to prevent reinfection.

  • Aciclovir for herpes

    Antiviral therapy when HSV is confirmed on ulcers or NAAT - shorter, milder episodes with early treatment.

  • Remove the trigger

    Stop the spermicide, douche, latex product or retained foreign body - non-infectious cervicitis often settles once the irritant is gone.

  • Topical oestrogen

    For atrophic cervicitis after the menopause - restores the vaginal and cervical epithelium and eases symptoms.

  • Partner notification and screen

    Recent partners need testing and treatment - the single most effective step to prevent reinfection.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or sexual health clinic knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • BASHH. UK national guideline for the management of infection with Chlamydia trachomatis.

  • BASHH. UK national guideline for the management of gonorrhoea in adults.

  • BASHH. UK national guideline for the management of Mycoplasma genitalium infections.

  • NICE CKS. Chlamydia - uncomplicated genital infection; Pelvic inflammatory disease.

Red flags

When cervicitis needs urgent attention.

Most cervicitis is managed in primary care or a sexual health clinic. These are the situations that need faster or specialist input.

  • Pelvic inflammatory disease

    Pelvic pain, fever, cervical excitation or adnexal tenderness - needs same-day treatment to protect future fertility.

  • Pregnancy and cervicitis

    Untreated infection in pregnancy raises the risk of preterm delivery and neonatal infection - always test and treat promptly.

  • Persistent postcoital bleeding

    Bleeding after sex that continues after treatment deserves colposcopy to look beyond infection at the cervix itself.

  • Suspected sexual assault

    Anyone disclosing recent assault needs a sexual assault referral centre for coordinated forensic and medical care.

  • Suspicion of cervical cancer

    A hard, irregular or ulcerated cervix, or persistent bleeding, warrants urgent gynaecology referral.

  • Neonatal risk in late pregnancy

    Chlamydia or gonorrhoea near delivery can cause neonatal conjunctivitis and pneumonia - treat and inform the maternity team.

  • Disseminated gonococcal infection

    Fever, rash and joint pain in someone with gonorrhoea is a systemic emergency needing hospital care.

  • Treatment failure

    Persistent symptoms after appropriate antibiotics may signal resistance, reinfection or an alternative diagnosis.

  • HIV and other STIs

    Cervicitis is a marker of exposure - always offer a full sexual health screen including HIV, syphilis and hepatitis B.

Living with it

A treatable condition, with clear next steps.

Four things that make the biggest difference - finishing the course, pausing sex until it is done, telling partners and checking again at three months.

A quiet reminder

Reinfection is the commonest reason symptoms return.

Partner treatment and safer-sex advice matter as much as the antibiotics themselves.

  1. 01 Finish

    Complete the full course

    Take every dose of antibiotics, even once symptoms settle - partial courses fuel resistance and cause relapse.

  2. 02 Pause

    No sex until treatment is done

    Abstain for seven days after single-dose therapy or until the full course is finished for both you and your partner.

  3. 03 Partners

    Tell recent partners

    Contact tracing through the sexual health clinic is confidential and stops the cycle of reinfection.

  4. 04 Recheck

    Test of cure at three months

    A repeat NAAT at three months picks up reinfection early - the single most useful follow-up step.

Frequently asked

Everything we get asked about cervicitis.

Quick answers on symptoms, testing, antibiotics and partner treatment.

  • What is cervicitis?

    Cervicitis is inflammation of the cervix, the neck of the womb. It is most often caused by sexually transmitted infections such as chlamydia, gonorrhoea, trichomonas, herpes or Mycoplasma genitalium, but non-infectious causes include spermicides, douching, latex, retained tampons, post-menopausal atrophy and radiation.

  • What are the symptoms of cervicitis?

    Many women have no symptoms at all. When present, they include mucopurulent vaginal discharge, bleeding between periods or after sex, painful sex, burning on passing urine and a low pelvic ache. On examination the cervix often looks red and bleeds easily on contact.

  • How is cervicitis diagnosed?

    A speculum examination looks for discharge and a friable cervix. NAAT swabs test for chlamydia, gonorrhoea, trichomonas and Mycoplasma genitalium. Wet mount, vaginal pH and KOH testing help spot bacterial vaginosis and candida. HPV or cervical screening and a pregnancy test are considered where appropriate.

  • How is cervicitis treated?

    BASHH-aligned first-line therapy is doxycycline 100 mg twice daily for seven days. Intramuscular ceftriaxone 1 g is added if gonorrhoea is suspected. Trichomonas is treated with metronidazole and herpes with aciclovir. Mycoplasma genitalium may need moxifloxacin because of rising macrolide resistance. Non-infectious cervicitis usually settles once the trigger is removed.

  • Do partners need treatment?

    Yes. Recent sexual partners need to be tested and treated, even if they have no symptoms. This is the single most effective step to prevent reinfection and onward transmission. Sexual health clinics can help with confidential partner notification.

  • Is a test of cure needed?

    A repeat NAAT at around three months is recommended after treatment for chlamydia or gonorrhoea, mainly to detect reinfection. Symptoms that do not settle after antibiotics should prompt earlier reassessment for resistance, reinfection or an alternative diagnosis.

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