A woman has spoken out about the 'common' but painful condition she was diagnosed with that, despite affecting millions of women in the UK, many have never even heard of.
When Emily Storey, 29, went for a routine cervical screening (also known as a smear test) in November 2020, ‘abnormal cells’ were detected - something that isn’t out of the ordinary for many women here in the UK.
But little did Emily realise that these abnormal cells would lead to almost four years of uncertainty, anxiety, and finally, a diagnosis of a condition she didn't even know existed.
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Speaking to Tyla about the lengthy process, Emily explained how she was referred for a cervical biopsy when the abnormal cells were detected - a measure sometimes taken to find cancer or pre-cancerous cells on the cervix.
“The results led to a biopsy being taken,” Emily, from Hull, explained, before describing it as the ‘worst experience ever’.
“The biopsy was horrific. My mum couldn't even come into the hospital as it was Covid, so I just laid there fighting tears and my legs shaking for 20/25 minutes.”
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Pain relief wasn’t offered to Emily for the biopsy - a procedure that removes a small tissue sample from the cervix to be analysed - which is unfortunately the reality for women undergoing gynaecological procedures here in the UK.
Following the traumatic procedure, the secondary school teacher was informed that 'warty features' were found, and was told ‘nothing needed to be done’.
But things were far from over for Emily, who started experiencing bleeding and pain during and after sex.
She eventually went back to her GP for an examination in February of this year - but it's something Emily admits she put off due to the anxiety she experienced from the biopsy.
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It would be this examination that would finally give Emily the answers she had been looking for.
She was informed she had cervical ectropion which, like many other women, is something she had never heard of before.
What is cervical ectropion?
Also known as cervical erosion, it’s when glandular cells from inside the cervix grow on the outside, causing it to become red and inflamed.
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But as Jo’s Cervical Cancer Trust outlines, ectropion is in no way linked to cervical cancer, nor can the condition cause it.
Echoing this is Dr Deborah Lee, from Dr Fox Online Pharmacy, who spoke with Tyla to give further insight into the condition.
“The term cervical ectropion may sound scary but in fact, you can be heartily reassured,” Dr Lee says. “Having a cervical ectropion is so common, it's regarded as a normal finding. In some studies, cervical ectropion was found in up to 80 percent of young women.”
The symptoms
Common symptoms of cervical ectropion include:
- Bleeding and heavy discharge after sex
- Pain after sex
- Light bleeding or pain during a cervical screening
- Light bleeding in between periods
- Lots of discharge without an infection
However, the following should be checked out by a GP immediately:
- Abnormal vaginal bleeding – bleeding between periods, after sex or after menopause
- Abnormal vaginal discharge – if it is more than usual, thick, green or yellow, or smelly
- Itchy, soreness or discomfort in the genital area
- Any lumps, sores or ulcers in the genital area
- Painful sex
- Urinary symptoms
“A cervical ectropion can cause some of these symptoms, but it may be present incidentally and could well not be the main cause of the problem,” Dr Lee says.
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What causes cervical ectropion?
“Cervical ectropion is thought to be caused by oestrogen,” Dr Lee explains. “A woman produces her own oestrogen during the menstrual cycle, so ectropion is commonly found in women of reproductive age and is unusual after menopause.
“Any situation where you have additional oestrogen could result in an ectropion. This includes pregnancy and using hormonal contraception which contains oestrogen such as the combined pill.”
While the combined contraceptive pill can be a cause of ectropion in some women, Dr Lee stresses how there are numerous benefits from taking the pill, and having cervical ectropion is not a reason to discontinue using it.
“Even if you did do this, the cervical ectropion may not disappear,” she says. “If it is causing symptoms, it can be simply treated. Speak to your GP.”
Are there any health risks?
Because the condition doesn’t have any relationship to cervical cancer, there aren’t any serious health risks.
There is also no known link between cervical ectropion and pregnancy, as well as the birthing process.
The process of being diagnosed
Most often, a woman will find out she has cervical ectropion when she goes to the GP, the sexual health clinic, or has a routine cervical screening and needs to have a vaginal examination with a speculum.
Dr Lee stresses all women should have regular cervical smears from the age of 25, every three years. Women aged 50 to 64 should have a smear test every five years.
Treatment options
There are multiple treatment options for cervical ectropion, including:
- Silver nitrate - A silver nitrate stick being applied to the cervix, cauterising the area by causing a chemical burn. Anaesthetic is not needed and it is quick and easy, Dr Lee explains.
- Cold coagulation – A hot metal probe is applied to the cervix for 30-60 seconds after a local anaesthetic is first injected.
- Loop diathermy – An electric current is used to destroy the tissue on the cervix. While a local anaesthetic is used, some discomfort may be experienced, plus bleeding and discharge for 1-4 weeks afterwards.
While procedures such as the above can be incredibly daunting and frightening for many, the importance of going for cervical screenings cannot be stressed enough as they can ultimately be life-saving.
“At present, as many as one-third of women are not coming forward to have their smear test,” Dr Lee says. “This is heartbreaking. Sometimes women are worried about having a smear as they feel frightened, or embarrassed.
“Having a smear is just a normal part of being female. The staff are well trained and will do all they can to put you at their ease. All the female doctors, nurses and receptionists will have had smears too, so they know how you feel.”
It’s important to note that a smear test isn’t just a test for cervical cancer, it’s a test for abnormal cells on the cervix which could be precancerous. It can also pick up conditions such as cervical ectropion.
Dr Lee advises to those who may feel anxious or nervous: “It may be a comfort to remember you are in charge. You have to give consent – verbal consent – to have a smear.
“If at any point during the process, you want it to stop, you must say so, and the smear taker will stop. So don't think you can't change your mind, because you can.”
Regarding the lack of pain relief women are offered for gynaecological procedures, Deputy Chief Nursing Officer for Patient Safety and Improvement at NHS England, Charlotte McArdle, said in a statement to Tyla: “While intimate procedures can be of some discomfort no woman should have to experience pain – the NHS is committed to supporting women experiencing any pain and psychological distress it may cause, with staff offering essential support throughout a person’s care and the health service is developing specialist women’s health hubs which will help ensure patients concerns are met.
“NHS clinicians are trained to be able to offer advice on pain relief, so if you have concerns or preferences about your care, you should discuss this with your health professional.”
For more information on the NHS cervical screening process, and what to expect, click here. And for free, confidential advice and information, contact The Eve Appeal's nurse-led information service, Ask Eve: [email protected] or 0808 802 0019.
Topics: Health, NHS, Women's Health
Emily Puckering