Cervicitis: symptoms, causes, treatment and when to get tested

Many people with cervicitis have no symptoms, so it may only be found when swabs are taken at a routine check, in a sexual health clinic or during an examination for another reason. NICE CKS notes that chlamydia is asymptomatic in at least 70% of women.

When symptoms occur, the NHS lists the following for chlamydia in women, and the signs overlap with other infections that cause cervicitis. NICE CKS also lists mucopurulent (pus-containing) cervical discharge and an inflamed or friable cervix, which a clinician can see during an examination.

• Vaginal discharge that is not normal for you.

• Bleeding after sex or between periods.

• A burning feeling when you pee.

• Pain in your lower tummy.

• Pain deep inside during sex (listed by NICE CKS).

The cervix is the lower part of the womb that opens into the top of the vagina. Cervicitis is the name for inflammation there. It is a description of what is happening rather than one single disease, so the next step is always to find the cause.

NICE CKS describes how infection of the genital tract with chlamydia, the most common sexually transmitted bacterial infection in the UK, typically causes inflammation of the cervix and/or the urethra in women. Cervicitis is therefore often linked to sexually transmitted infections (STIs), though not always.

The NHS pages used for this guide point to the following causes, most of which are infections. The NHS is clear that you should not self-diagnose from discharge alone: see a GP, sexual health clinic or call NHS 111 if worried.

A doctor or nurse will ask about symptoms and sexual partners and may need to examine the vagina. The NHS says a swab, like a large cotton bud, is used to take a sample of fluid from the vagina, and you may be able to do the swab yourself. You may be asked for a pee sample too, and can be tested even without symptoms. You may also be offered tests for other STIs.

If a vaginal examination is needed, the NHS says a smooth, tube-shaped tool called a speculum is used so the clinician can see the cervix and check for signs of infection, and a swab is taken from the cervix and vagina. You can ask for a chaperone, and for a female doctor. NICE CKS adds that, for women, a vulvo-vaginal swab is the sample of choice for chlamydia testing, with endocervical swabs or first-void urine as alternatives.

Self-test kits for chlamydia and gonorrhoea can be posted to a laboratory. The NHS says you may get a free kit from a sexual health clinic or some pharmacies, and free chlamydia test kits are available to some under-25s.

Treatment follows the cause. For chlamydia, the NHS says antibiotics are given as a single dose or tablets for 7 to 14 days, sometimes before test results are back, and you may need to be tested again afterwards. For gonorrhoea, treatment is a single dose of antibiotics, either an injection or tablets, and you should return about a week later for a repeat test.

Do not have vaginal, anal or oral sex until you and any partner have finished treatment and tests show the infection has gone. Current and recent sexual partners need testing, and a sexual health clinic can help contact them, in the case of gonorrhoea without naming you. If cervicitis is not caused by an infection, treatment depends on what has irritated the area, which a clinician can advise on.

The sources used for this guide do not give a single duration for cervicitis, because it depends on the cause and when treatment starts. The NHS says that chlamydia treatment is a single dose or 7 to 14 days of tablets, and gonorrhoea a single dose. If you have symptoms that persist or return after treatment, go back to the GP or clinic, as re-infection from an untreated partner is possible.

If you are pregnant or planning pregnancy and think you might have chlamydia or gonorrhoea, the NHS says to see a GP or go to a sexual health clinic. Untreated chlamydia in pregnancy can be passed to the baby during birth and cause an eye infection (conjunctivitis) or lung infection (pneumonia), both of which can be treated with antibiotics. If you are pregnant and treated for chlamydia, you are tested again 4 weeks after treatment.

Gonorrhoea in pregnancy can increase the risk of premature birth and low birth weight, and the infection could spread to the baby's eyes during birth, which can cause blindness if not treated with antibiotics. Genital herpes in pregnancy is also looked after by the midwife or GP, with antiviral medicine offered from around 32 weeks to reduce the risk to the baby.

The NHS also says to speak to your GP or midwife if you are pregnant and your vaginal discharge changes.

Yes, if an infection is not treated. The NHS says untreated chlamydia can cause pelvic inflammatory disease (PID), an infection of the womb, fallopian tubes and ovaries, which can lead to infertility or ectopic pregnancy. Untreated gonorrhoea can also cause PID and lead to infertility.

The sooner you get treatment, the easier these complications are to treat, according to the NHS.

The NHS says to get help from NHS 111 if your vaginal discharge changes colour, smell or texture, you bleed between periods or after sex, you get pain when peeing, or you have pelvic pain. For PID, the NHS advises an urgent GP appointment or 111 if the pelvic pain comes and goes, you are pregnant, or you do not feel better after 3 days of antibiotics.

Call 999 or go to A&E for severe or worsening pelvic pain, sharp sudden lower-tummy pain, pain with heavy vaginal bleeding, dizziness or fainting, a very high temperature or shivering, or feeling or being sick and very unwell. With gonorrhoea, red itchy eyes, fever, joint pain or a rash also need urgent advice.

On the NHS, testing and treatment for STIs are provided by sexual health clinics and GPs, and the NHS says many clinics offer a walk-in service. The NHS says clinics often get test results back faster than GP surgeries.

Private doctors and laboratories can also provide testing and treatment. Whichever route you use, make sure partners are tested, ask for a repeat test where advised, and ask that results are shared with your GP if you are happy for this to happen.