Cervical ectropion

The lining of the cervical canal (which is also called the endocervix) produces mucus, which changes in the amount and quality during a woman’s menstrual cycle. The lining of the outside of the cervix (which is also called the ectocervix) is the same as the lining of the vagina which is very similar to skin.

These two types of lining usually meet just inside the opening of the cervix. This junction is called the transformation zone. When the transformation zone and lining of the cervical canal extends outwards onto the vaginal portion of the cervix, this is called a cervical ectropion and looks pinker than the rest of the cervix. 

The position of the transformation zone of the cervix is controlled mainly by the amount of female hormone (oestrogen). Pregnancy and the combined pill are two situations where a woman has more oestrogen than usual and these are the two most common times where a cervical ectropion will be found.

Often there are no symptoms of a cervical ectropion and it is only noticed during a cervical smear examination. Symptoms that can occur include:

• Vaginal discharge – With the mucus cells more exposed within the vagina, more mucus can cause a discharge.
• Postcoital bleeding– the mucus producing cells are not very good at withstanding damage, and are more likely to cause bleeding after sexual intercourse. Bleeding after intercourse is potentially a sign of cervical cancer and if this occurs, you should see your GP.

The diagnosis is usually made by examination. Your doctor will be able to see the mucus producing cells on the outside of the cervix. However, there are times when an ectropion can look like a cervical cancer or cervical infection and therefore a smear and swabs for infection will usually be performed.

If the condition is caused by pregnancy it will go away after the baby is born. If bothersome, sometimes a change in the type of hormonal contraception is required.

Rarely the mucus producing cells will need to be removed by cautery (burning). This is similar to the procedure women have when they have abnormal cells found after a cervical smear. This can be performed with a local anesthetic as an outpatient.

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Matiluko, AF. Cervical ectropion. Part 1 – appraisal of a common clinical finding(external link)(external link). Trends in Urology, Gynaecology & Sexual Health Vol 14, Issue 3, Version of Record online: 13 MAY 2009
Casey, P. M., Long, M. E., & Marnach, M. L. (2011). Abnormal cervical appearance – what to do, when to worry?(external link)(external link) Mayo Clinic Proceedings, 86(2), 147–151.