22/01/2020 By AskAwayHealth

Discussing in the Dr’s Corner – What is the remedy for a closed cervix?

Doc's corner: Remedy for a 'Closed Cervix'?

Discussing in Doc’s Corner


Welcome to the Dr’s corner, where Dr Sylvia tackles interesting questions from the mailbag, some What’s App groups, or our other social media channels. This week, it’s all about the medical condition known as a Closed Cervix.


What is a Closed Cervix?

The cervix is part of the womb, usually known as the neck of the womb.

It is the narrowest part of the womb and acts as ‘a gate’ into the womb from the vagina.

It is also a muscular structure whose entrance is called the os’.

Image of the womb showing the opening called the 'os'.
The os is the opening to the neck of the womb.

Usually, this opening is a tiny hole in the middle of the cervix but because the cervix is a muscle it can open and close (e.g open up to 10cm to allow the baby through at labour). 

Normally, the os is closed by mucus to protect the womb from infection but throughout a woman’s cycle, the os changes slightly for different reasons,


How Your Womb (Cervix) Changes Each Month

Here’s a cool article for how the cervix looks on different occasions.

It’s a bit graphic but you can see the os change from looking like a small circular hole to a wider curved line during different conditions.

The shape of the os can vary from whether a woman has delivered a baby vaginally or not.

And it’s shape could depend on the time of the month according to her menstrual cycle.

For example, it looks different when you are ovulating; have just had sex, or are menstruating etc.   

A closed cervix is one that cannot do all this.

This is because that opening we mentioned, the os, is either very narrow or blocked/closed off. 

There may be many causes for this and therefore the remedy depends on the cause in each instance.


What are the Causes of a Closed Cervix?

Straight off the bat, the most common but essentially natural cause is:

  • Pregnancy – where there is normal closure of the os protecting the womb and baby till labour starts.
  • Other abnormal causes of the closed cervix are listed below:
    • Congenital (from birth) – Some women are born with a narrowed os, or completely blocked. Here, a failure of development of the structure for one reason or another means that from birth the os is abnormal.
    • Polyps – these are small growths from the inner lining of the womb. If they grow very close, they could cause a blockage to the os.
Source: Fibroid Treatment Collective
  • Cysts – These can happen anywhere in the body – they are sacs or bags that may contain fluid or other material.
  • Endometriosis which is when womb tissue develops outside the womb; or Fibroids where there are benign growths of the womb muscle (middle layer).
    • In either of these cases, a blockage to the opening; or narrowing may occur.
  • Cancer of the cervix – is a cause that can lead to blockage of the entrance to the womb as cancer spreads within the cervix.
  • Surgery to the womb or surrounding area can lead to complications like adhesions which cause narrowing or blockage to the os.
  • Radiation treatment for cancer to (the pelvic area) can also affect the os – the radiation may lead to inflammation and scar tissue forming around or close to the os; leading to blockage.
  • Side effects from special treatments to the cervix like ablation treatments, cone biopsy or laser treatment.
    • Each of these methods involves local treatment to the womb and a complication to the treatment may be narrowing or closure of the cervix.

What are Some Implications of a Closed Cervix?

The closed cervix can lead to significant problems including:

  • Haematometra – this is where menstrual blood is trapped within the womb.
    • The woman may have no periods; or pain in the pelvis/abdomen.
  • Pyometra – when blood collects within the womb without an outlet, infection of the womb contents is possible.
    • With this condition,one may experience severe pelvic pain, as well as other features of infection – fever, vomiting etc.
  • Infertility – as semen is unable to enter through the closed os, insemination and, thus pregnancy is not possible.

So How is a Closed Cervix Treated?

Treatment depends on:

  • the cause,
  • on the woman’s age and
  • whether or not she is trying for pregnancy.

If the problem is not due to endometriosis or fibroids or cancer – instruments called dilators could be used to to open up the os. 


Conclusion

But the main thing is to work out *why* the condition has happened.

The cause can be different from one woman to another.

So, I’d encourage any woman with symptoms suggesting a closed cervix to be seen by a competent medical practitioner to guide on the appropriate treatment.


Got any comments or questions for the Dr’s corner?

Write below or send an e-mail.

More Reading:

Doc’s Corner – Adhesions following Myomectomy.

More Doc’s Corner – Pregnant Despite Contraception.


Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly

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