Recognize Cervical Cancer Symptoms

Cervical cancer is a cancer of the cervix (the lower part of the uterus). It can happen to women at any age, but it usually occurs in midlife in women between 20 and 50. The overwhelming majority of cases are found in women who do not receive routine medical care and regular pap screenings. Fortunately, cervical cancer is a very curable disease when it is found early and treated. The major symptoms you should look for are abnormal vaginal bleeding and pain. Symptoms usually do not begin until precancerous or abnormal cells have grown into an invasive cancer. So, call your doctor as soon as you notice the changes. Regular screenings with PAP smears and HPV tests can help you discover precancerous lesions early, before they can become cervical cancer.

Steps

Knowing the Symptoms

1. Keep a good record of your menstrual periods. If you are premenopausal or perimenopausal, use a calendar to keep track of when your menstrual period will come and how long it will last. If you are menopausal, know when your last period was. A major symptom of cervical cancer is abnormal vaginal bleeding. It is good to know what is normal for you and other women like you.
   • You will usually have regular menstrual cycles if you are premenopausal. Each woman is different, but a normal cycle will be 28 days, plus or minus 7 days.
   • You will have irregular menstrual periods if you are peri-menopausal. This phase normally starts between the ages of 40 and 50. This transition occurs when your ovaries gradually begin to produce less estrogen. It can last anywhere from several months to 10 years before menopause is fully reached.
   • You will no longer have menstrual periods if you are menopausal. Your hormone levels have reached a point where you no longer ovulate or release eggs. You can no longer become pregnant.
   • You will not have menstrual periods if you have had a hysterectomy. You no longer have a uterus and you will no longer shed the lining of your uterus. You should not be bleeding. If you still have ovaries that work, you are not menopausal.
2. Look for spotting in between your menstrual periods. When you have spotting, there is much less bleeding and the blood may have a different color than your normal menstrual flow.
   • It is normal for a premenopausal woman to have an irregular cycle, occasionally. Spotting could be seen. Many factors like illness, stress or strenuous exercise can interfere with your cycle. Seek medical attention if your menstrual period remains irregular for several months.
   • Spotting could be a normal part of your peri-menopausal phase. Be vigilant and look for other symptoms of cervical cancer.
3. Take note of menstrual periods that are longer or heavier than usual. During every menstrual period, your flow can change in amount, color, and consistency. Call your doctor if this pattern changes significantly.
4. Call your doctor if you unexpectedly start having your menstrual period again. Just remember that no amount of vaginal bleeding is normal if you are menopausal or if you have had a hysterectomy.
   • Do not assume your cervix has been removed because you have had a hysterectomy. Your entire uterus, including your cervix, is removed during a total hysterectomy. A supracervical hysterectomy is often performed for non-cancerous conditions. Your cervix is left in place and you can develop cervical cancer. Ask your gynecologist which type you have undergone.
   • Consider yourself menopausal if you completely stopped having menstrual periods for 12 straight months.
5. Look for vaginal bleeding after normal activities. These activities include vaginal sexual intercourse, douching, and even a pelvic exam by a doctor. Talk to your doctor about the nature of the bleeding, spotting versus a heavy flow.
   • When a doctor performs a pelvic exam, she inserts two gloved fingers into your vagina while her other hand presses on your lower abdomen. She can examine your uterus, including your cervix, and ovaries looking for signs of problems or disease. It should not cause heavy bleeding.
6. Take note of any unusual vaginal discharge. The discharge may be bloody and it occurs in between menstrual periods. It could be foul-smelling, as well.
   • The cervix produces mucus that changes in consistency during the menstrual cycle to either prevent or promote pregnancy. It should not be bloody in between periods.
   • Menstrual blood may accumulate in the vagina and smell foul if it is left there for a long time, especially more than 6 to 8 hours. This is different from a discharge smelling bad.
   • Seek medical treatment. Discharge that is foul smelling could be caused by other conditions like infection which can cause pain and bleeding, or by precancerous lesions or cancer.
7. Tell your doctor about pain after sex or new pelvic pain. Pain during sex may be normal; 3 out of 4 women have had pain during intercourse at some point. However, if it occurs frequently or is very severe, talk to a qualified medical professional about painful sex. Differentiate between your standard menstrual cramps and pain in your pelvis or lower abdomen.
   • Menopausal and peri-menopausal women can develop changes in their vaginal walls because of dropping estrogen levels. Vaginal walls become thinner, dryer, less elastic, and may become irritated (atrophic vaginitis). Sometimes sex becomes painful due to these vaginal changes.
   • Sex may also be painful if you have certain skin conditions or are having sexual response difficulties.

Seeking Medical Attention

1. Make an appointment with a doctor as soon as your symptoms appear. A delay could lead to more advanced disease and lower your chances of obtaining a cure.
   • Your doctor will talk to you about your personal and family history as well as your symptoms. She will talk about risk factors such as having many sexual partners, early sexual activity, being diagnosed with other sexually transmitted diseases, signs of a weak immune system, and a history of smoking.
   • Your doctor will perform a perform a physical examination to determine your general state of health. She will perform a Pap smear and HPV test if they have not previously been performed. These are screening tests (looking for signs of cervical cancer) and not diagnostic (confirming the presence of cervical cancer).
   • Diagnostic studies are performed when you have an abnormal Pap smear and/or symptoms consistent with cervical cancer. A colposcopy is performed; this instrument, which opens the vagina like a speculum, also magnifies the cervix so that your doctor can visualize any abnormal areas on the cervix. Scrapings of the endocervix (the part closest to the uterus) and/or cone-shaped biopsies will be taken. A pathologist looks under the microscope to make the diagnosis of pre-cancerous or cancerous changes in the cells.
2. Undergo regular cervical cancer screening before you notice symptoms. There are two tests you can have at your doctor's office to help detect pre-cancerous lesions: the Pap smear and the HPV test.
3. Get a regular Pap smear. The Pap smear, or Pap test, identifies pre-cancerous cells that could become cervical cancer if they are not treated early and appropriately. The Pap smear is recommended for all women between the ages of 21 and 65 years old. It can be performed in the doctor’s office or in a medical clinic.
   • A speculum, an instrument used to widen the vagina, will be inserted by the gynecologist. As the doctor examines the vagina and cervix, cells and mucus are collected from the cervix and the surrounding tissue. These samples are placed on a slide or in a bottle of liquid and sent to a laboratory. They will be checked under a microscope, looking for abnormalities.
   • You should get a regular Pap smear even if you are not currently sexually active and even if you have gone through menopause.
   • In the US, Pap smears are covered under the Affordable Care Act, so most insurance plans must cover them at no cost. If you don't have insurance, you may be able to find a free or low-cost test from a local community health clinic.
4. Get an HPV test. This test looks for the virus, human papillomavirus, that can cause pre-cancerous cell changes in the cervix. Most cervical cancers are caused by HPV infection. The HPV virus is passed from person to person during sexual intercourse. The cells collected during the Pap smear can be tested for HPV as well.
   • The cervix is the cylinder neck-like passage at the lower end of the uterus. The ectocervix is the part of the cervix the doctor sees during the speculum exam. The endocervix is the tunnel through the cervix into the uterus. The transformation zone is the overlapping border between the endocervix and the ectocervix. This is where most cervical cancers develop. Samples of the cervical cells and mucus are taken from here.
   • If you are 30 or older, you can usually have a Pap smear and HPV test together every 5 years.
5. Talk with your doctor about how often you should have a Pap smear and HPV test. The frequency at which you are screened or need follow-up is based upon factors like your age, your sexual history, your previous history of an abnormal Pap smear, and your previous history of HPV infection.
   • Most women between 21-29 should get a Pap smear every 3 years. Women between 30-64 should get a Pap smear every 3 years, or a Pap smear + HPV test every 5 years.
   • If you have a weakened immune system, you are HIV-positive, or have ever had abnormal Pap results, you should ask your doctor whether you need a Pap smear more frequently.
   • Cervical cancer is one of the most common in women worldwide, but is much less common in countries like the United States where cervical cancer screening, Pap smear and HPV testing, is routine.
   • Get your diagnosis and treatment early. Pre-cancerous cervical cells with more severe changes are at a greater the risk of changing into cancerous cells. This transformation from normal to abnormal to invasive cancer can happen over a period as long as 10 years, but it could happen sooner.

Related Articles

• Prevent HPV Infection (Human Papillomavirus Infection)
• Help Prevent Ovarian Cancer
• Recognize HPV in Women (Human Papillomavirus)
• Prevent Uterine Cancer
• Lower Your Chances of Getting Cancer
• Test for HPV

Sources and Citations

See also

• Get an Abortion (USA)
• Heal Vaginal Tears
• Increase Estrogen
• Diagnose Vaginal Discharge
• Cure Irregular Menstruation
• Eliminate Vaginal Odor
• Appreciate Curves on a Woman
• Know What to Do About Your Period
• Stand to Pee With a Device
• Have a Healthy Vagina

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