What is cervical ectopy?

An ectopy is a common and normal finding on the cervix. It can also be called an ectropion, an eversion, or historically it may have been referred to as an erosion. These words all mean the same thing.

The cervix is the part of the body located at the lower, narrow end of the uterus that forms a canal between the uterus and vagina. It is made up of two different types of cells, glandular and squamous cells. The squamous cells are found on the outside of the cervix and are pale pink in colour. These cells are tough and can be likened to the cells on the outside of your face. The glandular cells are found inside the cervix and are more fragile, like the cells in your mouth.

An ectopy is an area of glandular cells that have migrated to the outside of the cervix. This can occur at certain times of your life and reproductive cycle. The delicate glandular cells look very different to the squamous cells.

As the glandular cells are soft, they can bleed easily, especially when having a speculum examination, during sexual intercourse, or during a human papillomavirus (HPV) screening sample – also known as a smear test. This bleeding does not mean the cells are abnormal.

What causes an ectopy?

Most are caused by hormonal changes. This means you are more likely to have an ectopy if you are:

• going through puberty
• pregnant
• taking the combined oral contraceptive pill.

How will I know I have an ectopy?

An ectopy can be seen when you have a HPV screening sample and can sometimes cause concern.

If your HPV screening sample is normal there is nothing to worry about.

Should I be worried about my ectopy?

An ectopy is common and harmless. It is not linked to cervical cancer or any other condition that causes cancer.

Sometimes you may be referred to the colposcopy clinic for a closer look if your practice nurse or GP is unsure.

What can I do about my ectopy?

You don’t need to do anything as an ectopy is normal. We do not need to treat a normal ectopy that doesn’t cause symptoms as it is part of normal human biology.

Stopping the combined oral contraception pill can reduce the size of an ectopy after several months but it rarely disappears completely.

If an ectopy causes symptoms of bleeding with sex, it can be distressing. This can be treated with cold coagulation in the clinic, also known as cautery, where heat is used to burn away the glandular cells on the outside of the cervix.

This is a short procedure performed under local anaesthetic, meaning you will be awake but the area being treated will feel numb. Before considering cold coagulation for ectopy we will need to take biopsies to confirm the tissue is normal.

Sometimes this will stop the bleeding without the need for further treatment.

It may also be worth considering the position you are having sexual intercourse in. The cervix can be knocked more or less in different positions.

What are the risks during Cold Coagulation?

• 1 in 10 women will have bleeding and/or infection
• The treatment may not work
• Symptoms may return months later
• Narrowing (stenosis) to the opening to the cervix which may cause problems in labour or with taking future smears
• Damage to vaginal tissues is rare.

Further information

Further information can be found at:
https://eveappeal.org.uk/

Patient Advice & Liaison Service (PALS)

The team are available to help with any concerns, complaints or questions you may have about your experience at the Trust. Their office is in the Main Foyer (Gate 4) of Doncaster Royal Infirmary. Contact can be made either in person, by telephone or email.

The contact details are:
Telephone: 01302 642764 or 0800 028 8059
Email: dbth.pals.dbh@nhs.net