The cervix: Anatomy, conditions, tests & treatments
The cervix is the neck of the womb (uterus) that connects the vagina and uterus.
The cervix is made of cartilage covered by smooth, moist tissue, and is about 2.5cm across. There are two main portions of the cervix:
The part of the cervix inspected during a gynaecological examination is called the ectocervix.
The opening in the centre of the ectocervix is called the external os and links the uterus and vagina.
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The tunnel through the cervix, from the external os into the uterus, is called the endocervix, or endocervical canal.
The area between the endocervix and ectocervix is known as the transformation zone.
Cervical mucus that changes in consistency during the menstrual cycle is produced by the cervix. This plays a role in preventing or promoting pregnancy.
During monthly periods, the cervix opens slightly to allow blood flow.
The cervix can dilate far wider during labour and childbirth.
Conditions affecting the cervix include:
- Human papillomavirus (HPV)
- Weakened cervix (cervical incompetence), weakened muscles in the cervix are a risk factor for miscarriage
- Cervicitis, infection causes inflammation of the cervix that can spread causing pelvic inflammatory disease (PID)
- Cervical intraepithelial neoplasia (CIN), cervical dysplasia, abnormal cells that can develop into cervical cancer
- Cervix polyps, usually harmless growths that can cause vaginal bleeding
- Cervical cancer.
- Smear test, HPV test: A sample of cells is taken from a woman's cervix and examined for HPV infection with a risk of cervical cancer, or signs of cell changes that left untreated may become cervical cancer.
- Colposcopy: A follow-up test for an abnormal smear test. A gynaecologist views the cervix with a special instrument called a colposcope.
Cervical biopsy: Tissues samples may be taken during colposcopy for laboratory testing.
- Cone biopsy: A cone-shaped section of tissue is taken for laboratory testing.
- CT scan, as part of cervical cancer investigations.
- MRI scan, as part of cervical cancer investigations
- PET scan, as part of cervical cancer investigations after a special chemical is injected to enhance images.
- HPV vaccinations given to teenage girls while at secondary school to protect against the types of HPV responsible for most cervical cancers and genital warts.
- Cervical cerclage, stitches closing the cervix during pregnancy as a precaution against miscarriage or premature birth.
- Cervical cancer treatments, including radiotherapy, chemotherapy, large loop excision of the transformation zone (LLETZ), cone biopsy, laser therapy and operations to remove parts of the cervix and womb.