In the normal state, the cervix is covered with cells of stratified squamous epithelium. It consists of three layers: basal, intermediate and superficial. Any change in the maturation or differentiation of epithelial cells may be called dysplasia by doctors. This term is often used to refer to all precancerous conditions of the cervix.
Possible diseases
Doctors identify several pathological conditions that must be paid attention to. So, the so-called background processes are combined into a separate group. These include true erosion, simple leukoplakia, polyps, ectopia, erythroplakia of the cervix. A precancerous condition, which is called cervical intraepithelial neoplasia or dysplasia, has been singled out separately. It is important to understand that background and pre-carceral conditions have different pathogenesis.
But the origin and manifestation of precancerous conditions and cancer are similar. Many people cite HPV as one of the reasons. Thus, the presence of the human papillomavirus in the body is nota guarantee that there will definitely be cancer. But in those women who were diagnosed with precancerous conditions of the cervix, HPV was still diagnosed in 90% of cases. But it must be understood that out of more than 60 types of this virus, about 20 affect the genital organs, and 11 serotypes are considered highly oncogenic.
Papillomovirus
Most often, people are unaware that they have HPV in their body. In some, the disease proceeds in a latent form. This means that people are carriers of the virus, but they do not have any manifestations. In the subclinical form, cytological changes are diagnosed. Clinically expressed HPV is determined when exophytic and endophytic warts are visible.
The most common are the 16th and 18th papillomavirus serotypes. Infection, as a rule, goes completely unnoticed and is not accompanied by the appearance of any symptoms. But at the same time, the virus infects the cells, it is built into their genetic code, and the replication of infected elements begins. This eventually leads to their rebirth and causes dysplasia or cancer.
But it is believed that an important role in the development of diseases is played by the individual susceptibility of the epithelium and congenital defects in defense mechanisms.
Characteristics of background processes
Gynecologists can diagnose a number of diseases of the cervix, which are characterized by specific changes. So, doctors distinguish true, congenital and false erosion.
Even in teenage girls, a gynecologist canexamination to see the displacement of the cylindrical epithelium. After a colposcopy, it becomes clear that it is bright red in color. At the same time, it is impossible to color it with Lugol's solution. This condition is often referred to as pseudo-erosion or ectopia. It can be congenital or acquired. But these are not yet precancerous conditions of the cervix, so such erosions do not require treatment. You just need to watch them regularly.
If the patient's mucous membrane of the cervical canal turns into the vaginal part of the cervix, then this condition is called ectropion. This is a combination of scar tissue deformation of the cervix and pseudo-erosion. On examination, the doctor may see a deformed neck with a slit-like or gaping pharynx with red areas of the cylindrical epithelium. Often they can be with a transformation zone.
Another background process is leukoplakia, the name of the disease is translated as "white spot". With this disease, the stratified epithelium is locally keratinized. In this case, infiltrates form around the vessels of the stroma. Leukoplakia can be simple, then it is referred to as background processes. If atypical cells appear in this disease, then we are already talking about precancer.
Another disease is erythroplakia, but it is quite rare. This name literally translates as "red spot". In this condition, the stratified epithelium atrophies, it becomes thinner to several layers. Intermediate cells disappear. Vessels are visible through the thinned epithelium, so the areas look like redspots.
Also, when examined, the doctor can see outgrowths covered with epithelium. They are called polyps. These are bright pink formations that can be leaf-shaped or oblong. They hang from the cervix.
Causes of erosion
Problems can often be found during a routine examination or colposcopy. If the doctor sees changes, he can explain what causes cervical erosion. So, the most common reasons are:
- infectious diseases, among which the most common are chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, genital herpes, papillomavirus;
- inflammatory diseases of the female genital organs;
- mechanical damage to the mucosa;
- hormonal changes.
As a result of changes, the stratified epithelium, whose layers are poorly linked and loosely laid, is damaged and sloughed off in places. It has been observed that this occurs 5 times more often in women with menstrual irregularities, they may even have more cervical erosion. Instead of a desquamated layer, a cylindrical epithelium is formed.
Provoking factors are called failures in the cycle, frequent change of partners, early onset of sexual activity and reduced immunity. Many of those who have found these problems are interested in whether there are any restrictions if cervical erosion has been diagnosed. What can not be done with this disease? There are no hard limits. It's important to check regularlygynecologist, undergo all necessary examinations and not refuse the prescribed treatment.
Diagnostics of background processes
As a rule, women with an affected cervix do not complain about anything. There are no signs of erosion. True, some have whitish discharge, which does not cause any discomfort. After sexual intercourse, spotting or ichor may appear. In this case, you should see a doctor as soon as possible. He is able to assess the condition, determine whether there is cervical erosion. The name of the disease in such a situation is more important for the doctor. It is from the identified problem that further treatment tactics will depend.
On examination, pseudo-erosion looks like a red spot of irregular shape. It stands out against the background of pale mucosa. During colposcopy, it becomes clear that the problem areas are covered with red papillae of a rounded or oblong shape, because of them the surface looks like velvet. Do not be afraid of colposcopy, it's just an examination with a special device that can enlarge the area by 30-40 times.
Diagnosis of a disease such as leukoplakia is also not difficult. In some patients, the keratinized layers of cells are visible to the naked eye, they look like white plaques that rise on the ectocervix (the part of the cervix protruding into the vagina). In others, they can only be detected during colposcopy. To clarify the diagnosis, the cervical tissue can be treated with an iodine solution. The affected keratinized areas do not turn brown, they look like a surface covered with a whitish film. To determine the nature of leukoplakia (simple or with atypical cells), a biopsy is necessary.
Also, during examination, the gynecologist can see cysts on the cervix. The reasons for their appearance are as follows:
- genital infections that provoke the development of inflammatory diseases;
- cervical injury during childbirth, abortion, diagnostic curettage;
- hormonal disorders.
Cysts look like sacs that are filled with mucus. They emerge from the overgrowth glands, which look like small white swellings. If there are failures in their work, then the ducts are closed. In the case when only one sac is visible during examination, it is called an endometriotic cyst. But there are times when there are several. In such situations, the doctor says that these are Nabothian cysts on the cervix. It is desirable to find out the reasons for their occurrence. After all, their appearance can be triggered by infections that need to be treated. As a rule, doctors recommend only one method of treatment - removal of cysts. This is done by puncturing the sac, removing viscous mucus and treating the place where it appears.
Treatment tactics
When a doctor finds problems with the cervix, he should talk about what needs to be done next. So, first of all, the specialist will conduct a colposcopy, take material for cytological examination and, if necessary, offer to do a biopsy. Complete examinationallows you to determine what causes cervical erosion. It is also important to make smears on the microflora, to identify if there are any infectious diseases. It is mandatory to find out if the patient has HIV, syphilis or viral hepatitis. In addition, the gynecologist can give a referral for an examination for the presence of trichomonas, ureaplasma, HPV, chlamydia, mycoplasma, gardnerella.
After that, you can start treatment. Depending on the size, causes of appearance and other factors, the gynecologist will offer to cauterize the cervix with electric current, perform cryodestruction, laser coagulation, or use the radio wave method.
In some cases, simply watching erosion is sufficient. This tactic is chosen in cases where it is found in young nulliparous girls. Most often, they are caused by hormonal changes.
Description of treatments
Moxibustion is one of the most common ways. But at the same time, the procedure has a lot of side effects. As a result of cauterization, rough scars can form, the throat of the cervical canal can narrow. In addition, healing after the procedure takes a long time. But, despite all the shortcomings, cauterization of cervical erosion is often used. Reviews indicate that the procedure is unpleasant, but it cannot be called too painful. Many women simply talk about the feeling of discomfort in the lower abdomen. In addition, there may be vaginal discharge after the procedure.
The doctor must also warn about a number of restrictions. Without fail, there must be sexual rest for at least a month after the procedure. There are also restrictions on lifting weights - you can wear no more than 2 kg. The ban is imposed on visiting saunas, baths, taking baths, engaging in intense physical activity.
Cryodestruction often leads to a shortening of the cervix. In addition, as a result of the procedure, the cervical pharynx may narrow. It is impossible to call cryodestruction excessively painful, patients are more embarrassed by the accompanying unpleasant odor.
Many prefer to use more modern methods, such as radio wave treatment of cervical erosion. It is carried out by a special apparatus "Surgitron". The electrode located in it emits high-frequency waves, they form heat when they meet tissues. At the same time, the cells seem to evaporate.
Also, laser treatment is considered highly effective. Exposure to a beam of waves leads to the fact that pathologically altered cells are removed. In this case, the surrounding tissues are affected slightly. This method is considered the least traumatic.
Characterization of dysplasia
Most often, precancerous conditions develop with traumatic lesions of the cervix. Particular care must be taken by those who have cervical erosion. Cancer against the background of it is unlikely to begin to develop, but the fields of dysplasia in some cases are found just against the background of pseudo-erosion.
Specialists distinguish 3 stages of this disease. The first degree is called mild. With it, deep layers are affected - basal and parabasal epithelial cells. The upper layersremain normal. There are no external signs of the disease. It can only be detected during cytology, while the scraping should be taken deeply.
In the second degree - moderate dysplasia - changes can affect up to 2/3 of the epithelial cells. There should be no abnormal cells at this stage.
In severe dysplasia of the third degree, maturation and differentiation of cells takes place only in the surface layer. The remaining layers are affected. More detailed examinations show the presence of cells with atypia.
Diagnosing dysplasia is not so easy. The disease proceeds without any pronounced signs, it has no characteristic symptoms. On examination, a gynecologist can determine ectopia, leukoplakia, and see papillomas. Sometimes with dysplasia it happens that the cervix is not changed.
The diagnosis can be established by a cytological examination of a smear taken from the cervix. If during the research it was found that the taken material contains cells with dikarosis (changes in the nuclei), then histology is necessary. It is made from materials taken during a biopsy.
Causes of dysplasia
In most cases, it is difficult to understand what became the basis for the appearance of problems with the reproductive organs of a woman. But there are a number of factors that can trigger the onset of the disease. So, for example, if a patient has stitches on the cervix, then there is a violation of the nutrition of her tissues. And this can become an impetus for the development of the disease.
Provoking factors also include:
- immune and hormonal disorders;
- the presence of erosive foci - the transition zone between the flat and cylindrical epithelium, located on the outer part of the neck, is dangerous;
- the presence in the body of a highly oncogenic type of HPV.
Risk factors are as follows:
- earlier the beginning of a girl's sexual life at a time when the epithelium is not yet normally formed;
- long-term use of intrauterine and hormonal contraceptives;
- multiple births;
- the presence of sexually transmitted infections;
- malnutrition with deficiency of vitamins C, A and beta-carotene.
It has also been found that male hygiene affects the appearance of these female diseases. Smegma, which accumulates under the foreskin, can cause precancerous conditions of the cervix to develop. This is due to the presence of carcinogenic substances in it, which, during sexual intercourse, enter the cervix.
Possible ways to get rid of the problem
Treatment tactics directly depends on what degree of dysplasia was diagnosed. So, at the first stage, it is often recommended to simply observe the tissues in dynamics and carry out conservative treatment, which is aimed at eliminating the possible cause of the onset of the disease. As a rule, antiviral or antibacterial therapy is carried out, designed to eliminate infectious agents. In the absence of positive dynamics, as well as in cases where dysplasia of the 2nd or 3rd degree was immediately diagnosed,surgical treatment is recommended.
However, it can be carried out in the same way as cauterization of cervical erosion. Reviews indicate that this method gives very good results. Cryosurgery or laser treatment may also be used. In some cases, diathermoconization is used. This method consists in the fact that the altered tissues are excised in the form of a cone, the top of which is directed towards the internal os. Removed tissue sections are additionally sent for histology.
It is important to know that patients with dysplasia have a 10 to 20 times higher risk of developing cancer than those without the problem. In the first stage, there is a possibility of a reverse development of the disease - this happens in about half of the cases. But in 40% of women it will progress, in the rest it will be in a state of stabilization.
Alternative Medicine
Hearing an unpleasant diagnosis for themselves, not everyone agrees to treatment with traditional methods. Even if the doctor offers a fairly gentle and highly effective radio wave method for treating cervical erosion, there will be those who refuse the procedure.
Some are starting to look for alternative methods. The most popular douches are diluted infusions of calendula (1 tsp in ¼ cup of water), eucalyptus (1 tsp diluted in a glass of water), tampons with sea buckthorn oil or mummy.
But these are not all the options for how the cervix can be treated with folk remedies. Some healers recommendbrew for douching St. John's wort at the rate of 1 tbsp. l. for a half-liter jar of boiling water. The herb must be boiled for about 10 minutes and insisted for at least half an hour.
If you decide to refuse qualified assistance and will be treated by these methods, then regularly go to the gynecologist in order to monitor the condition of the cervix. Only in this way it will be possible to see the deterioration in time and try to correct the situation.
