What To Know and Do About Cervix Pain

The cervix is a small structure at the bottom of the uterus (womb). It connects to the vagina, where you insert a tampon. The cervix functions as a door to the uterus. It's usually closed to keep the womb safe, but sometimes, like during periods or delivery, it opens up to allow blood or a baby to pass through.

You'll feel cervix pain in your lower abdomen (belly) or pelvis (the area between your hips). Some cervix pain goes away on its own. However, persistent or severe pain could indicate inflammation due to a sexually transmitted infection (STI) or bacterial vaginosis (BV), or a condition like pelvic inflammatory disease (PID) or endometriosis—to name a few possible causes.

Understanding potential causes can help you know when to seek treatment.

How Cervix Pain Presents

Cervix pain may feel like a dull ache, cramp, or pressure in your lower abdomen or pelvis. It may be constant or come and go. It can occur with sex, infections, or unusual cervix features. Depending on the underlying cause, you might also notice:

• Bleeding or pain with sex
• Painful urination (pee)
  
• Unusual vaginal discharge
• Spotting between periods
• Vaginal itching or burning

Potential Causes of Cervix Pain

Cervix pain can happen due to injury, infections, structural abnormalities, or chronic health conditions. 

Injury or Trauma

The cervix is a sensitive area, and any physical trauma to it can cause bruising, inflammation, or small tears in the tissue. Physical trauma can occur during vigorous sexual activity, childbirth, or medical procedures. Some people have a shorter vaginal length, which means the cervix may be closer to the vaginal opening. This increases the risk of injury if there's deep penetration during sexual activity. 

Cervicitis

Cervicitis is inflammation of the cervix. It can result from infections, bacterial vaginosis (BV), or chemical irritants. It's most common among sexually active people ages 15-24. Having human immunodeficiency virus (HIV) increases your risk. Cervicitis may cause dull, achy pain in your lower abdomen or pelvis or discomfort in your vaginal area.

The most common sexually transmitted infections (STIs) that cause cervicitis are:

• Chlamydia: Symptoms include abnormal vaginal discharge, painful urination, and abdominal pain
• Gonorrhea: Symptoms include thick, cloudy vaginal discharge

The following STIs can cause cervicitis, but not as commonly as chlamydia and gonorrhea.

• Genital herpes: Symptoms include painful sores in the genital area along with itching, burning, and flu-like symptoms
• Trichomonas: Symptoms include itching, burning, redness, irritation, and a frothy, yellow-green vaginal discharge
• Mycoplasma genitalium: Symptoms include pain when peeing, unusual vaginal discharge, and discomfort during sex

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria. When this imbalance occurs, harmful bacteria can overgrow, leading to symptoms of discomfort and abnormal vaginal discharge. 

Examples of irritants that could be a risk factor for BV or cervicitis include:

• Harsh soaps or detergents
• Douches
• Fragrances in feminine hygiene products or laundry detergents
• Lubricants, spermicides, or vaginal creams
• Radiation therapy 
• Surgical instruments
• Foreign objects like condoms, diaphragms, cervical caps, or tampons

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It often occurs from untreated STIs. Pain with PID is typically a deep, severe, and persistent dull ache or sharp pain in the lower abdomen or pelvis. Other symptoms may include: 

• Abnormal vaginal discharge
• Fever
• Irregular menstrual bleeding (period bleeding)
• Painful urination (similar to a urinary tract infection (UTI))
• Pain that worsens during sexual intercourse or bowel movements

Cervical Ectropion (Ectopy)

The cervix has flat cells on the outer part (like the lining inside your mouth) and epithelial cells (fingerlike, textured) on the inner part. Cervical ectropion occurs when cells from inside the cervix become visible outside. Ectopy is relatively common and occurs due to higher levels of the hormone estrogen. Teenagers and people who are ovulating, pregnant, or taking hormones are at higher risk. 

Cervical ectropion is usually asymptomatic. However, it may cause symptoms like:

• A dull ache in the pelvis
• Vaginal itching
• Increased vaginal discharge 
• Pain or bleeding with sex or pelvic exams
• Spotting between periods 
• Recurring cervicitis

Endometriosis

Endometriosis is when tissue similar to the lining of the uterus grows outside the uterus. This condition can affect the cervix and cause mild to severe (sometimes debilitating) pain, especially during periods and sex. Other symptoms may include:

• Chronic pelvic pain
• Heavy menstrual bleeding
• Infertility
• Lower back, hip, or leg pain
• Painful urination or bowel movements
• Painful periods

Adenomyosis is similar to endometriosis. Instead of the tissue growing inside the uterus, it grows into the muscular wall of the uterus itself. This can lead to symptoms such as heavy menstrual bleeding. It doesn't typically cause pain, as it's often isolated outside the uterus.

Cervical Stenosis (Narrowing) or Stiffness

When the cervix is narrow or stiff, it can block menstrual blood flow during periods, leading to pressure. This can cause stronger uterine contractions (which cause period cramps), making period pain worse.

Cervical Cancer and Human Papillomavirus (HPV)

Most people find out they have cervical dysplasia (abnormal cervix cell changes) during screenings like a pap smear. While it doesn’t always cause pain, it can progress to cervical cancer, which can cause cervix pain, abnormal vaginal bleeding, pelvic discomfort, and pain with sex.

Some strains of human papillomavirus (HPV) cause cervical dysplasia or cervical cancer. Other HPV strains can lead to genital warts, which are small, flesh-colored bumps or clusters in the genital area. However, HPV is not the only cause of cervical dysplasia. 

Less Common Causes

The following are less common causes of cervix pain, but they can cause discomfort and require medical attention:

• Adhesions (excess scarring)
• Chronic inflammatory disorders such as Behcet's (causes blood vessels to swell) and lichen planus (skin inflammation that causes a rash)
• Cervical polyps (non-cancerous growths)
• A foreign object in the cervix
• Nabothian cysts (lumps that block the cervix, leading to fluid accumulation)
• Pelvic floor (muscles that support the bladder and uterus) injury 

When To See a Healthcare Provider

See a healthcare provider for cervix pain that is severe, persists or worsens over time, interferes with daily activities, or occurs with other concerning symptoms such as:

• Fever or chills
• Abnormal or foul-smelling vaginal discharge
• Abnormal vaginal bleeding 
• Difficulty urinating or pain with urination
• Pain during sexual intercourse
• Persistent pelvic or belly pain

If cervix pain occurs during pregnancy or after recent childbirth, immediate medical evaluation is necessary to rule out possible complications. 

Diagnosis

If your primary healthcare provider suspects cervix pain, they will likely refer you to a gynecological provider. These providers have expertise in diagnosing and treating conditions related to the female reproductive system. Diagnosis might involve a medical history, pelvic exam, urine or blood tests, and imaging like an ultrasound or magnetic resonance imaging (MRI) scan. 

A pelvic exam is when the provider checks your vaginal canal and reproductive organs using their hands and a tool called a speculum. It might feel a bit uncomfortable, but it shouldn't hurt. Tests they may perform during the exam include: 

• Pap smear: Screening to detect cervix cell abnormalities
• Culture: A swab sample is sent to a lab to identify specific germs 
• Biopsy: A microscopic exam of a small tissue sample
• Colposcopy: Uses a specific magnifying device to examine the cervix

Cervix Pain Treatment

Cervix pain treatment depends on the underlying cause.

Treatment at home might involve: 

At-Home Treatment

• Soaking in a warm bath 
• Arnica pellets or tea (to reduce inflammation and relieve pain)
• Chamomile tea
• Over-the-counter pain (OTC) relief medications like Advil, Motrin (ibuprofen), or Tylenol (acetaminophen)
• Pelvic floor exercises, such as Kegels, to strengthen the muscles around the cervix 
• Avoiding strenuous activities 

Medical Treatment

Depending on the underlying cause of cervix pain, medical treatments might involve:

• Prescription pain relievers
• Antibiotics to treat an infection
• Boric acid vaginal suppositories to restore the pH (acid-base) balance
• Pelvic floor physical therapy 
• Cryotherapy (freezing to destroy abnormal cells)
• Diathermy or laser therapy (using heat to destroy abnormal cells)
• Surgery, in rare cases where other treatments are ineffective

A Quick Review

Cervix pain can arise for various reasons, including sexual activity, infections, or abnormalities. At-home measures like warm baths, herbal pain relief, and OTC pain relievers can help alleviate mild cervix pain.

Reach out to a healthcare provider if you experience persistent or severe cervix pain. They can help identify the underlying cause and provide effective treatment.