Cervical erosion: does it exist?
Erosion vs ectopy: which one needs treatment, and why cauterising ectopy can do harm.
Cervical erosion: does it exist?
For many doctors, cervical erosion or ectopy is like a red rag to a bull: they see it, they want to cauterise it.
Together with an obstetrician-gynecologist and podcast host, we look at whether this actually needs to be done and how erosion differs from ectopy. And we finally settle which of them needs treatment (spoiler: erosion).
Erosion vs ectopy
Erosion is a small wound on the surface of the uterus. You need to find what caused it and treat it.
Ectopy is when cells that would ideally sit inside the cervical canal are located on the surface of the cervix. This is normal. It does not need treatment.
Why is ectopy sometimes treated?
Ectopy is often called erosion, and treatment gets prescribed. This is an outdated practice: radical methods used to be valued, and it was easier to remove something than simply to monitor it.
If you hear about "erosion" every time you see a gynecologist, starting from your very first visit, it is most likely ectopy. Get a second opinion from another specialist.
Treating or cauterising ectopy is not only unnecessary but harmful.
Cauterisation can "close off" the very area where malignant processes usually develop, and those processes are important to monitor at routine check-ups.
Treat the cause, not the erosion
Possible causes of erosion:
1. Active inflammation of the cervical mucosa
2. Malignant processes (and any pathological conditions, wounds, growths)
3. Injury (for example, from a speculum during an exam)
4. Atrophy of the mucosa during menopause
If erosion is found, you need to get tested for STIs, including HPV, and have a cytology smear (ideally a Pap test)*. In some cases, a cervical biopsy will be needed.
Treatment can be medication or surgery.
- A Pap test is a diagnostic method that can detect atypical cells on the mucosa of the cervical canal.
It is important for people with a reproductive system to have routine check-ups: a gynecological exam, cervical screening after 25-30, and, if erosion is found, testing for STIs, including HPV, plus a cytology smear (ideally a Pap test). In some cases, a cervical biopsy will be needed.
