Cervix

Cervix

The cervix is a critical part of your reproductive system. It serves as the passageway between your vagina and uterus.

If you simply insert your finger almost to the back of your vagina, you can probably touch it. If you''''ve never had a baby, your cervix will most likely feel like a nose with a small dimple in it. After you''''ve been pregnant and had a child, though, your cervix changes; it may feel more like a chin.

While it may seem like the cervix is part of your vagina, it''''s actually the very lower portion of your uterus--the hollow, muscular organ that sheds monthly menstrual blood if you''''re not pregnant and provides a home for a developing fetus if you are. The dimple that you can feel, which extends into the vagina, is actually the opening to the cervical canal.

Normally, the cervical opening and canal are no larger than a very thin straw, so a foreign object like a tampon can''''t make its way into the uterus. But during childbirth, the opening expands tremendously in order to allow a baby to pass through.

The cervical canal is also responsible for producing cervical mucus. Around the time a woman ovulates, the thin, slippery mucus makes it easier for sperm to enter the uterus. During pregnancy the cells of the canal build a mucus plug, sealing off the uterus and protecting the fetus from any harmful substances.

Flare-ups and Troublemakers

While your cervix can remain healthy throughout your reproductive life, it is susceptible to infection, sexually transmitted diseases (STDs), precancerous changes and cancer.

One common problem that can arise is cervicitis, or inflammation of the cervix. This may be caused by some type of irritation--wearing a tampon too long, for example, or an infection caused by either a virus or bacteria, says Mark Dignan, Ph.D., associate professor in the Department of Family and Community Medicine at the Bowman Gray School of Medicine of Wake Forest University in Winston-Salem, North Carolina. STDs such as trichomonas vaginalis, chlamydia and genital herpes virus can trigger cervicitis. So can having a baby.

The sexually transmitted disease known as the human papillomavirus (HPV), more commonly known as genital warts, can also affect the cervix, says Dr. Dignan. When a woman has HPV, small bumps or warts are likely to grow on the folds of skin around the entrance to the vagina. These warts can also grow directly on the cervix. Certain strains of HPV have been associated with the development of cervical cancer.

Cervical dysplasia can also lead to the development of some cancerous cells, and it''''s a condition that has to be watched carefully by a doctor. If you have cervical dysplasia, the cells that make up cervical tissue start to change, according to James Davidson, M.D., assistant professor of obstetrics and gynecology at the Truman Medical Center in Kansas City and the University of Missouri-Kansas City. He says that the condition can range from mild to severe, depending on how extensive the cell changes are on the lining of the cervix.

With severe dysplasia cells change throughout the cervix lining. The cells start to look like cancer cells but don''''t behave like them, says Dr. Davidson.

Cervical cancer is the third most common gynecological cancer. Approximately 16,000 women develop cancer of the cervix every year, and less than one-third that number die from it. Early detection with a Pap smear is critically important, because it can prevent death from cervical cancer. (For more information on what to expect from a Pap test--and how often to have it done--see page 220.)

Meanwhile, here''''s what you can do to guard your cervical health.

Practice safe sex. Do your best to prevent STDs and cervical cancer by engaging in safe sex, experts say. That means limiting the number of sex partners you have and knowing your partner''''s history and STD status before you have sex. (Yes, safe sex means really getting to know someone well.)

If you and your partner are not monogamous, or if one of you already has HPV, the best insurance is to make sure he wears a condom and uses it correctly. You can also reduce your risk of STDs by using an effective spermicide--such as nonoxynol 9--and by using a diaphragm. (For more information on protecting yourself against STDs, see page 341.)

Get your Pap test. The Pap smear is the screening test most doctors use to examine the health of the cervix and look for cervical cancer and some of its precursors, as well as STDs and dysplasia. This test is part of routine gynecological care, so if your doctor doesn''''t tell you she''''s doing it, you may not be able to tell. The doctor simply takes a sample of tissue from your cervix and stores it on a slide that will be examined at a laboratory.

The test isn''''t 100 percent accurate all the time, but it catches 60 to 85 percent of abnormalities--giving you the chance to get earlier treatment.

Pay attention to unusual symptoms. If you experience painful intercourse, an unusual or odd-smelling discharge, bleeding after intercourse, pelvic pain or unexpected bleeding, call your doctor and tell her what''''s going on. These are all signs that there may be a problem, says Dr. Dignan.

Test for risky strains. If you have genital warts or HPV--one of the most common types of STDs in the United States--there''''s a test that shows whether you have one of the three strains of HPV that put you at higher risk for cervical cancer. Be sure to ask your doctor if you need this HPV test to determine whether your type of HPV causes cancer.

Go for the fruits and veggies. Research indicates that folic acid, or folate--a B vitamin found in certain fruits and vegetables--may help decrease the risk of cervical cancer.

Women can maintain proper levels of folate by eating yellow and green leafy vegetables, citrus fruits, juices, yeast and liver. Or go for a supplement: The Daily Value is 400 micrograms, which is the amount contained in many multivitamins.

Give up the butts. Cigarette smoking places you at higher risk for dysplasia, so do your best to cut back or cut the habit altogether.

See also Reproductive System, Sexually Transmitted Diseases