Cervical Erosion and Infections in Young Women: A Guide

Polycystic Ovary Syndrome (PCOS)

Doctor, I am 24 years old and have never had sexual intercourse.
In June, I experienced itching and yellow-green discharge due to a genital infection.
After repeated occurrences, the doctor performed a pelvic exam and noted significant cervical erosion.
A Pap smear was done, and the results were normal.

1.
How could I have cervical erosion if I have never had sexual intercourse? Do I need treatment for this?
2.
The infections have been intermittent, and I have been undergoing treatment for recurrent fungal and bacterial infections.
In September, I experienced frequent urination, and the doctor indicated a bacterial infection that was also treated.
Since August, during my two menstrual periods, I have had episodes of bleeding that lasted three days, with one day having a heavier flow.
On September 6, my period lasted 15 days, and on October 7, it lasted 20 days, with significant bleeding on the afternoon of the 22nd, including blood clots.
However, by midnight, the bleeding decreased, and today I only have a small amount of light brown discharge.
What could be the reason for this? I have never experienced this before.

Xiao Yu, 20~29 year old female. Ask Date: 2000/10/23

Dr. Li Guanghan reply Obstetrics and Gynecology

At 24 years old and with no sexual activity, experiencing yellow-green discharge is likely due to inadequate hygiene during menstruation.
Sanitary pads should be changed frequently, as menstrual blood can promote bacterial growth within about two hours (blood is an excellent culture medium for bacteria).
Generally, in the absence of sexual activity, physicians do not perform pelvic examinations unless there is a persistent issue.
The presence of severe cervical erosion with normal Pap smear results is contradictory.

1.
Cervical erosion typically requires treatment to prevent pelvic inflammatory disease.

2.
The frequent urination you experienced in September may be caused by bacteria in the vagina, as the vagina is very close to the urethra.
It is advisable to drink plenty of water, urinate frequently, and wash the external genitalia with clean water.

3.
Based on your menstrual cycle, the lack of ovulation in August and September may be influenced by work stress or emotional factors; treatment is usually necessary only if this persists for three months.
The occurrence of two menstrual periods in October, one of which was lighter, is likely due to ovulation and is considered a normal physiological phenomenon.

Reply Date: 2000/10/23

More Info

Understanding cervical erosion and infections in young women is crucial for maintaining reproductive health. Cervical erosion, often referred to as cervical ectropion, occurs when the cells from the inside of the cervical canal (glandular cells) extend to the outer surface of the cervix (ectocervix). This condition is common and can happen in women of all ages, regardless of sexual activity.
1. Cervical Erosion and Its Causes:
Cervical erosion is not necessarily a sign of disease or a precursor to cervical cancer. It can be caused by hormonal changes, particularly during puberty, pregnancy, or when using hormonal contraceptives. In your case, even without sexual activity, hormonal fluctuations could lead to cervical changes. Additionally, inflammation or irritation from infections can also contribute to the appearance of cervical erosion.
2. Need for Treatment:
Treatment for cervical erosion is typically not required unless it is associated with significant symptoms or complications. If your healthcare provider has conducted a Pap smear and found normal results, this is reassuring. However, if you are experiencing recurrent infections, it is essential to address these underlying issues. Persistent infections can lead to inflammation, which may exacerbate the appearance of cervical erosion.

3. Recurrent Infections:
The presence of yellow-green discharge and itching suggests a possible bacterial or yeast infection. These infections can be recurrent for various reasons, including hormonal changes, antibiotic use, or changes in your vaginal flora. It is essential to follow your doctor's recommendations for treatment and to complete any prescribed courses of antibiotics or antifungal medications.
4. Menstrual Irregularities:
The irregular bleeding you are experiencing, especially with increased flow and the presence of clots, can be concerning. This could be due to several factors, including hormonal imbalances, the effects of infections, or even stress. It is crucial to monitor these symptoms closely. If the bleeding persists or worsens, further evaluation may be necessary to rule out any underlying conditions, such as polyps or fibroids.

5. When to Seek Further Medical Attention:
If you experience severe pain, heavy bleeding, or any other alarming symptoms, it is essential to seek medical attention promptly. Regular follow-ups with your healthcare provider are crucial, especially if you have a history of recurrent infections or abnormal bleeding patterns.

6. Preventive Measures:
Maintaining good hygiene, wearing breathable cotton underwear, and avoiding irritants such as scented products can help reduce the risk of infections. Additionally, consider discussing with your healthcare provider about the possibility of receiving the HPV vaccine if you have not done so already. This vaccine can help protect against certain strains of the human papillomavirus, which is linked to cervical cancer.

In conclusion, while cervical erosion and recurrent infections can be concerning, they are often manageable with appropriate medical care. Regular check-ups, open communication with your healthcare provider, and adherence to treatment plans are vital for your reproductive health. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support.

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