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A healthy cervix lies at the crux of a woman’s health. Yet many women are clueless about this less-often talked about reproductive organ. Unlike the vagina or the ovaries, the cervix doesn’t get much attention.
As per The American Cancer Society's estimates for cervical cancer in the United States for 2021, nearly 14,480 new cases of invasive cervical cancer will be diagnosed and around 4,290 women will die from cervical cancer.
These statistics might seem disheartening, but the good news is that cervical cancer is totally preventable and there is a vaccine that is often not utilized.
We will discuss the cervix, why it’s important, and how you can keep it healthy in this article.
The cervix is a part of the uterus, making up the lower third part of it. It is not very large, 3-5 centimeters thick, 2-3 centimeters across, and situated at the end of the vagina. It is the entry point into the uterus where the sperms travel to meet the eggs for fertilization.
Your cervix is an integral part of your reproductive system and fertility.
Even though small, the cervix is a powerful organ that shoulders a lot of responsibilities such as managing the menstrual flow from the uterus into the vagina, keeping the cervical gate close during non-fertile phases, and flexible in the fertile phases, preventing infection, promoting conception, producing cervical mucus, remaining closed during pregnancy until the time of labor to prevent preterm labor and aid in vaginal birth at the right time.
The cervix is prone to damage post-childbirth. In most cases, the body naturally heals itself post-delivery. But sometimes it doesn’t heal on its own and you might need to consult a doctor as future childbirth can be a problem in case of cervical damage.
A healthy cervix should be a prime focus for women's health. It takes just a few steps to reduce the likelihood of cervical health conditions such as cervical cancer and cervical dysplasia, and ensure that your cervix is healthy and functioning at its optimal best.
Here are the top tips that support good cervical health.
1. Do regular screening tests
One of the most important things you can do is get regularly screened for any cervical abnormalities.
Cervical cancer used to be one of the most common cancer deaths for women. But not anymore because of the availability of regular screening tests.
The two most common tests for early detection of cervical abnormalities are the pap smear or pap test and the human papillomavirus (HPV) test.
The pap test looks for cell changes within the cervix that might cause cancer if left untreated. Most women don’t realize how powerful the pap smear test is in preventing cervical cancer much before the symptoms arise. It takes a long time for the symptoms of cervical cancer to develop (you haven’t mentioned the role of the virus yet in causing cervical cancer.. That is why regular pap tests are recommended for women.
If you find symptoms of cervical cancer such as heavy discharge, abnormal bleeding, spotting, or pelvic pain during menstruation or sexual intercourse, increased urination frequency, or pain while urinating, then it’s time to see a doctor immediately.
If any abnormalities are detected during the pap test, then a follow-up visit and testing will be required. It can include another round of pap test, an HPV test, and maybe a biopsy of the cervix.
If the test results are normal, you can wait for three years for your next pap smear. Pap tests are not just for cytology, but also to detect HPV and its subtype.
HPV is the primary cause of cervical cancer. But out of 100 different kinds of HPV, only 2 are considered high-risk types: HPV-16 and HPV-18. Most types of HPV are low risk and most HPV infections will heal on their own within two years. HPV-16 and HPV-18 are responsible for nearly 70% of cervical cancer cases, and the HPV test is an effective way to detect them early. If the results are positive, then a colposcopy and even biopsy may be required.
The [American Cancer Society](https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21628#:~:text=The%20American%20Cancer%20Society%20(ACS,to%2065%20years%20should%20be) (ACS) lists in its guidelines for 2020 that people undergo the HPV primary test rather than a pap test every five years, beginning from the age of 25 until 65 years. Regular pap tests are recommended in case there is no access to HPV primary testing. Earlier, the ACS had advised screening tests to start from the age of 21 years.
2. Get Vaccinated
HPV is a common virus with several variants that spread via skin-to-skin contact or unprotected sex. The high-risk types can manifest into cervical abnormalities leading to cervical cancer, and the low-risk variants can cause skin and genital warts.
The FDA-approved HPV vaccine can prevent infections from both high-risk and low-risk HPV types.
The most common cause of cervical cancer is the high-risk human papillomavirus (HPV), which is found in around 99% of cervical cancer cases.
The CDC recommends all boys and girls get the HPV vaccine at around the age of 11 or 12 as it elicits a stronger immune response when taken during the preteen years. Two doses of the HPV vaccine are taken until age 14. The vaccine can be given as early as 9 years and until 45 years. A three-dose series of the vaccine is required for those 15 years and above.
A study published in the journal Pediatrics has shown the sharp decline in the number of American women who enter adulthood infected with HPV ever since the availability of the vaccine.
While the HPV vaccine is effective, it is important to note that it doesn't provide full protection against all the cancer-causing variants of HPV. It’s important to note that the vaccine does not cure existing HPV infections, but helps prevent new infections. So, regular screening is still important irrespective of whether you received the HPV vaccine.
There is another vaccine called Gardasil 9, which prevents cervical cancer by covering nine HPV types. It helps prevent around 90% of cervical, vaginal, vulvar, and anal cancers and prevent genital warts. The vaccine is approved by FDA for males and females from the age of 9 to 26.
3. Practice Safe Sex
HPV is a common sexually transmitted disease spread through sexual skin-to-skin contact. Both hetero and homosexuals are at risk, as penile penetration is not required to transmit the virus.
Practicing safe sex is a practical option, as it helps prevent unwanted pregnancies as well as protect against sexually transmitted infections that can lead to an unhealthy cervix.
Using condoms is one solution as it can reduce the risk of HPV infection by up to 70% Please note that condoms do not provide full protection as there is remaining skin contact even with the use of condoms. Other recommendations include delaying initiation of sexual intercourse, and decreasing number of sexual partners to prevent exposure to the high risk HPV. Also, if you notice symptoms of cervical problems such as abnormal vaginal discharge, bleeding and pain during sex, then it’s time to consult a doctor for further examination.
*4. Take Preventive Measures *
If you want to maintain a healthy cervix, then you have to get into the preventive mindset and action mode. You need to eliminate or minimize all the harmful or risk factors for cervical problems. These include an unhealthy lifestyle, weak immune system, stress, harmful habits, and addictions.
People with a weak immune system will find it harder to fight off the HPV infection naturally. The ways to build your immune system is through self-care, including a nutritious diet, regular exercise, and restful sleep as well as doctor consultations.
Smoking has been linked to the development of cervical cancer. Even exposure to second-hand smoke can put you at risk for cervical cancer. So, try to stop the habit, and avoid exposure to second-hand smoke as much as you can.
Take care of your mental health as stress can also cause cervical abnormalities. Be social with your friends and family, and take breaks from a hectic schedule. Consult a mental health professional if you need help with stress management and your mental well-being.
5. Follow your doctor’s recommendations
It’s surprising how often women who are detected with abnormalities in their pap or HPV tests do not follow through with their doctor’s recommendations and treatment. So, follow-ups for further examinations and treatment are missed because of various reasons such as lack of understanding of the gravity of the problem, insurance terms, mistrust of doctors, or communication regarding the follow-up procedures.
Listening to the doctor’s instructions and following through is important for a healthy cervix. Seek a second opinion when in doubt, but be proactive about your cervical health. Check with your insurance company about the terms and conditions, and most often, the treatment costs should be covered.
Never leave a physician’s office until you’ve listened fully and are clear about the next steps in your treatment plan. Stay abreast of all routine exams and be regular with your annual visits. Always share any sign or symptom that you notice is amiss with your primary care doctor.
When you take care of your cervix, you are taking care of your health. Whether it is having a nutritious diet, doing regular exercise, using condoms and practicing safe sex, using stress management tools, or going for regular screening and vaccinations, a little care goes a long way when it comes to your cervical health.
(Disclaimer: We routinely draw upon public health resources to inform our write-ups. Information in this article may be drawn up from multiple public health sources, including:
Dr. Arun Villivalam is a general practitioner and primary care doctor serving the communities of Los Gatos, Campbell, and Saratoga, CA.
