Bleeding from the cervix is often slight, erratic and painless. Sometimes the discharge doesn’t resemble blood at all, but is brownish or like stained fluid. It can occur at any time during the cycle, and is more common after sexual activity or examination by a doctor. Many of the common causes of cervical bleeding are not related to cancer and are easily treated. Bleeding caused by cancer of the cervix is less common when women have regular Pap smears.
The tissue which lines the inner cervical canal (columnar epithelium) is very delicate in comparison to the tissue lining the vagina and the outer surface of the cervix (squamous epithelium). The junction of the columnar and squamous epithelium is called the transitory zone and is usually situated just at, or just inside, the cervical canal.
Cervical eversion occurs when the transitory zone is located on the outer surface of the cervix, leaving much more of the friable columnar epithelium on view and prone to bleed on contact.
Columnar epithelium is normally visible at the cervical opening during adolescence and pregnancy. Women who take the Pill also commonly develop cervical eversion. DES daughters (DES = diethylstilboestrol, a synthetic oestrogen) are sometimes born with a ‘congenital’ eversion, and can develop a cervical eversion that extends into the vagina. Some doctors also blame irritation from the string attached to an IUD, but this is disputed.
Cervical eversion usually causes few problems and is often discovered at a routine Pap smear. Sometimes the eversion causes an increase in vaginal secretions and the area becomes infected, but sometimes the eversion is caused by an infection. When there is an infection in the cervical canal, the swollen membranes are inclined to protrude from the cervical opening. In severe cases and when infection is present, the tissue becomes angry, red and looks unhealthy. Contact bleeding (especially bleeding after sex) is common and an offensive and/or blood-stained discharge may be present.
The bleeding associated with cervical eversion will alter depending on the associated complaints and the amount of blood lost. Slight bleeding may be brownish and thin or sticky. After sexual contact, the bleeding may be heavier and brighter. Cervicitis will often cause the bleeding to be yellowish or brown and offensive.
The medical approach
Regular monitoring of the cervical eversion is desirable, and some women may have to stop the Pill. Occasionally the area is treated with diathermy or laser treatment, especially if inflammation or infection are a problem.
The natural therapist’s approach
Local astringent remedies which improve the tone and strength of the mucous membranes, treat secondary infection and stop bleeding are used for cervical eversion. Cervical eversion is considered to be associated with Heat and Moistness, and the remedies chosen are Cooling and Drying.
• Hydrastis canadensis is the herb of choice, either in the form of a cream, pessary or wash. Treatment needs to be continued until all inflammation has reduced. (A repeat speculum examination is warranted.)
• Calendula officinalis, also in the form of a wash, cream or pessary is also useful. Pbytolacca decandra, as a combination pessary with Calendula officinalis, is popular in Europe.
• Agents such as tea-tree oil are far too harsh, and should never be used for this condition in dilutions stronger than 1:20 (5 per cent), irrespective of the severity of the secondary infection. A cream containing 5 per cent tea-tree oil, 10 per cent hydrastis and 10 per cent calendula in an aqueous or vitamin E base is useful when applied to the cervix.
Women who are taking the Pill, and who would like to continue to do so, may find that their symptoms are helped with folic acid and B complex vitamins. The reasons for this are not clear, but may be related to improvement of the underlying hormonal triggers.
Cervicitis is an inflammation or infection that affects the cervix. It is usually caused by bacteria, although the type is not always identified. Often the woman is run-down or her vaginal environment is altered sufficiently for opportunistic infections to develop. The diagnosis is usually on the basis of an offensive or blood-stained vaginal discharge and pain on moving the cervix, either during sex or when the cervix is examined.
The medical approach
Cervicitis is often treated with antibiotic creams, and in some cases, oral antibiotics as well. Creams and pessaries are inserted at night to keep the medication near the cervix.
The natural therapist’s approach
Astringent and antiseptic creams, pessaries or douches are used for cervicitis. Creams and pessaries which are inserted at night are favoured because they stay in contact with the cervix for longer. The herbs Hydrastis canadensis, Calendula officinalis and tea-tree oil are effective in the treatment of cervicitis.
Echinacea angustifolia or E. purpurea can be taken for long-term and recurrent infections, and to support a weakened immune system when the woman is run-down and unable to fight off trivial infections.
Abnormal Tissue Tone
Healthy tissue in the human body forms a barrier between the inner structures of the body and the outside world. When the tissue becomes unhealthy, either through abrasions, poor diet or age, it forms a less efficient barrier, allowing noxious (often infectious) material to pass into the body and the normal body fluids to pass out.
This is an important concept in natural medicine since the integrity, strength and tone of all tissues throughout the body are believed to have marked effects on an individual’s ability to maintain health. As examples, a breach in tissue tone of the mucous membranes of the respiratory tract may contribute to hayfever; and poor tissue tone of the cervix can cause infections and discharges such as cervicitis.
Poor tissue tone is treated with herbal astringents — agents which are applied directly to the tissues to ‘tighten’ and improve the integrity of the barrier between the tissues and the outside world. Creams, pessaries or washes of herbs such as Calendula officinalis and Hydrastis canadensis are astringent, anti-microbial, anti-inflammatory and healing to the mucous membranes.
Abnormal tissue tone may also be a feature (but not the cause) of a wide variety of serious cervical pathologies including cervical cancers and identification of the condition must first be obtained before any treatment is instituted.