Cervical Endometriosis

| Bloomin' Uterus
Sprinkle-covered donut
…not really a cervix, but you get it… 😉

So, WordPress shows me a lot of the searches that people run that lead them to my site.  One has recently come up again and again.  “Cervical Endometriosis” and “Endometriosis on Cervix.”

Seeing as I’ve never touched up on that particular location, I figured I would today!

What are the symptoms? How are you diagnosed?  What’s the treatment?

Some people with cervical Endometriosis don’t have any symptoms and they’re diagnosed during a visual cervical examination (if the lesions are visible).  Others may develop spotting and/or bleeding after sex…and in some cases, severe vaginal bleeding.  Pelvic or cervical pain may be indicative of Endometriosis in the pelvis, but from what I’m reading, cervical Endo isn’t painful.  Women may be misdiagnosed with cervical myoma, masses, cysts, polyps, melanoma, or cervical cancer; only to receive the Endometriosis diagnosis once the tissue is biopsied.  There are several studies that state proper diagnosis must take place.  Get a second or third opinion, even.  With that being said, though, it’s been written that cervical Endometriosis is very rare…and there are definitely other causes for spotting/bleeding.  This isn’t meant to scare you.

Some physicians believe that cervical Endometriosis may be one of the leading causes of abnormal bleeding.  Some also believe that cervical Endometriosis may develop after cervical procedures, such as a punch biopsy, loop/leep procedures, and laser treatments.  That being said, some patients are diagnosed with cervical Endo after never having received any of the aforementioned procedures.

As far as treatment?  A 2011 publication stated that if women with cervical Endometriosis have symptoms, the lesions should be excised (can be done using the loop/leep procedure and local anesthesia).

If you’d like to see examples of what cervical Endometriosis looks like, feel free to watch this video:

An article published in 2004 identifies two women who both had pelvic Endometriosis and each had undergone hysterectomies (removing the uterus and the ovaries, but leaving the cervix).  Both women underwent hormone replacement therapy (HRT) and received estrogen treatment.  AND both women developed cervical Endometriosis.  As many of us EndoSisters are aware, estrogen tends to feed Endometriosis…as well as a hysterectomy may not cure you of your symptoms.

A 2005 study discusses a 32-year-old woman had been spotting for the past 8 months, although she did not have any painful periods or painful sex.  She had gone to three gynecologists before one thought to thoroughly examine her cervix.  She had been on a birth control pill, prescribed by her two prior gynos, to control her bleeding; it didn’t work.  The last gyno found two lesions on her cervix, one of which was slightly bleeding.  These two lesions were punch biopsied, found to be Endometriosis lesions, and they were then burnt off.  Three years after the procedure, she had no relapse or recurrence.  The authors stress that more physicians must become familiar with examining the cervix, and have a full understanding of the different appearances of Endometriosis lesions.

In 2008, a study was published about a 37-year-old woman who had been spotting since her last period for about 15 days.  A week later, she began to have “severe vaginal hemorrhage” – she was bleeding A LOT.  An examination found a small laceration on the inside of her cervix; and an ultrasound found she had a cyst which was bleeding.  A pelvic MRI confirmed the 2cm cervical cyst, as well as Adenomyosis of her uterine wall.  A biopsy of the cyst’s tissue revealed Endometriosis.  They could not stop the bleeding with sutures or tamponade (what? Google says it’s “the surgical use of a plug of absorbent material;” guess we know where “tampon” came from), so they had to do what’s called a uterine artery embolization, where they block the artery, cutting off the blood supply to the laceration.  After the procedure, the woman continued to “have Endometriosis,” but her vaginal hemorrhaging had stopped.

A 2010 report reviewed the literature of several cervical Endo cases from 1970 to 1999:

  1. One 48-year-old woman complained of vaginal bleeding and she had uterine fibroids.  She underwent a hysterectomy and removal of a Fallopian and ovary.  Her biopsy revealed fibroids, Adenomyosis, and cervical Endometriosis.
  2. A 41-year-old woman had a longstanding history of pelvic and abdominal pain.  She had a previous surgery for uterine fibroids.  Upon an exploratory laparoscopy, they found “dense adhesions,” ovarian cysts, and her ovary was stuck to her Pouch of Douglas and rectum.  They performed a total hysterectomy and removed both her ovaries and Fallopian tubes.  They also found, upon biopsy, that she had Endometriosis deep in her cervix.
  3. A 29-year-old woman had a routine pap smear with the result of abnormal cells on her cervix. She had no other symptoms.  The cells were removed via the loop procedure.  Once the cells were removed and biopsied they discovered hemorrhagic Endometriosis glands.
  4. A 40-year-old woman had been diagnosed with Endometriosis in 2000 and went to her physician for ongoing abdominal pain.  She had undergone several unsuccessful IVF treatments, as well as a loop procedure to remove some abnormal cervical cells for post-coital bleeding.  She continued to bleed after the loop procedure.  So, in 2008 she underwent a speculum examination of her cervix.  Her physician saw several brownish spots on her cervix, which were removed via the loop procedure.  Upon biopsy, cervical Endometriosis was confirmed.

A January 2017 published article was about a 41-year-old woman who had an abnormal pap smear: the presence of clusters of glandular cells.  She had a colposcopy and endocervical biopsy performed – the colopsocopy was normal, but the biopsy revealed tissues surrounded by endometriosis.  She received her cervical Endometriosis diagnosis.  The authors warn that come cervical biopsies may be diagnosed as atypical or glandular neoplasia, when it is in face Endometriosis.  Always pursue a biopsy.

A 2019 article published in Modern Medicine discusses a 24-year-old Romanian woman who was seeking a second opinion. Two months prior, she was diagnosed with glandular cervical dysplasia. A pap smear biopsy revealed possible cervical endometriosis and she was referred to a specialist. She had a history of painful periods, chronic pelvic pain, and infertility. They took a peek inside at her cervix via speculum and found “2 violet macular [small blisters] lesions” on her cervix’s surface. The pelvic examination revealed diminished uterine mobility, a shortened vaginal cul-de-sac, and their probing and pushing caused her pain. A colposcopy was normal, as was the transvaginal ultrasound. A laparoscopic surgery was performed and found her rectum was adhered to her uterus and cervix. Once they shifted the rectum back to its normal positioning, a large endometriosis nodule was found on the cervix and rectum and was and was excised. Pathology confirmed Endometriosis. There was no other Endometriosis located within her pelvic cavity.

But what causes it?  Just like everything else we’ve heard : they don’t know.  There are theories: it could be a transfer from other surgical procedures or examinations, it could transfer from menstrual discharge, it could develop from cellular changes.  Nobody knows.

Before recently, I’d not heard of cervical Endometriosis, nor its symptoms.  I’m fascinated, as usual.  And if YOU have been diagnosed with cervical Endometriosis, what was your experience? Did you have the lesions removed? Did your symptoms return? ALL THE THINGS…!  Let us know in the comments below.

Concerned about your cervix?  Talk to your gynecologist.  That’s the first step…

*Updated September 3, 2020*

Resources:

American Journal of Obstetrics & Gynecology – (Abstract; July 2008) A Severe Vaginal Hemorrhage Caused by Cervical Endometriosis

American Journal of Obstetrics & Gynecology – (Abstract; Nov. 2011) Cervical Endometriosis: Clinical Character and Management Experience in a 27-Year Span

Archives of Gynecology and Obstetrics – (Abstract; Dec. 2005) Cervical Endometriosis: a Diagnostic and Management Dilemma

Journal of Cytology – (Abstract; Jan. 2017) Endometriosis Mimiking Glandular Atypia in a Cervical Cytology

Journal of Gynecologic Surgery – (Abstract; July 2004) Cervical Endometriosis Stimulated by Estrogen Therapy Following Supracervical Hysterectomy

Journal of Obstetrics and Gynaecology Research – (Article; July 2010) Cervical Endometriosis: Case Series and Review of Literature

Medscape General Medicine – (Article; April 2005) Cervical Endometriosis, a Case Presenting with Intractable Spotting

Modern Medicine – (Article 2019) Cervical Endometriosis – Case Report and Review of Literature

The Global Library of Women’s Medicine – (Article; Nov. 2015) Diagnosis and Therapy of Benign and Preinvasive Disease of the Cervix

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

21 thoughts on “Cervical Endometriosis”

  1. I had/have cervical endometriosis. They found it when they went in for my lap, along with endo on my bladder uterus and ovaries. They removed it all. My doc said he rarely finds it on the cervix (and all he does is endo surgery). Before removal of the cervical endo I did have unexplained spotting the second half of my cycle.

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  2. I just posted about unexplained bleeding, but I have no way of knowing yet if it’s endo-related. If it continues though, I’m definitely going to print this post about cervical endometriosis and give it to the doctor I’m referred to!

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    1. I hear ya. Sometimes I feel like I blame EVERYTHING on my Endo, which I may, but I also like to pursue other options 😉 And I’m afraid that my doctor will one day think I’m a hypochondriac…but I just want to be thorough. After 20 years of pain, thinking it’s normal, I’m now asking him about anything that is out of the ordinary…like unexplained spotting or bleeding. And then I get really afraid that I’m making it all up…like when you have a scratch that doesn’t hurt until you actually notice it’s there, but it’s been there for 3 days? Then I have to convince myself that it’s not the case.

      Ugh. Good luck with your bleeding!

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  3. Hi, I am going to the docs on Friday (21.10.16) I have had a little spotting and missed a smear test in February. After checking out photos of cervixs on line. I bought myslef a speculum and decided to have a look myself!! I think I have found nabothian cysts and endo on my cervix (hopefully its not something more sinister). I feel really empowered being able to look myself and never ever imagined that it was possible – my beautiful cervix is a wonderful site. I would really recomend all woman get familiar with their bodies so that we can fix any abnormalities asap. Thanks for this site – it’s so nice to find information out there – I’ll keep you updated with my actual diagnosis when it comes through (probas about 3/4 weeks). Cheers

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  4. Hi I was diagnosed with cervical endo in 2015. Been bleeding for a year now and progesterone only pill not working. felt suicidal, don’t know what to do. Gutted that at 38 won’t ever be a mum. Oh well glad not just me.

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    1. Hi Emma. I’m hoping your doctor’s can find a solution to your bleeding soon. Do you have another appointment on calendar to talk about next options? And the knowledge that children are likely not in our future can be devastating. I’m 37 and feel ya…if you EVER need to talk, my email is ladrayton@gmail.com

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  6. hi, I came across your site as I’m trying to quiet my brain (by googling, not a good idea!) after just getting back from the drs after a pap smear.
    The Dr noticed a red spot on my cervix today, right at the spot where I had a Lletz procedure done for a pervious abnormal smear. The lletz was successful but I hemorrhaged and bleed for days, nothing would stop the bleeding till they cut off the blood supply to the area through the artery.
    This was 10 years ago. Clear Pap smears since then. I am wondering if the red mark could be cervical endo? I looked up a paper on cervical issues, which said red spots could be this issue..,which then googling that…led me to your page. Can I say fingers crossed that it’s this issue & not cancer? I hope so! Thanks for your site x

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    1. Hi Rachel! I hope you’ve been able to quiet your brain today! My advice? Sit back, try to relax, and wait for the pap results from your doctor. It could be *ANYTHING*, even just a bit of discolored scarring from your LLETZ so long ago. If you get a call from your doc that your pap is normal, (and if I were you) I’d schedule an appointment with him/her just to be able to look at that red spot a little better. Possibly take a sample to biopsy. If it IS Endo on your cervix, a biopsy would confirm it. But it could be many, many, many other things. If it isn’t Endo, a biopsy may find other answers. Peace of mind is a glorious thing. And I’m sorry if my blog sent you into a tailspin of worry 😦 And yes, I’m totally crossing my fingers and toes that it’s not cancerous. Seriously, though, in the meantime try your best to let this go and not think about your little red spot. There’s absolutely nothing you can even consider doing until then. ❤ And please…keep us posted. Yours, Lisa

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  7. Lately I have been spotting for a week leading up to my period. I had chalked it up to the fact that I have a paragard, but in the past month I have begun to suspect that I may have endometriosis. It just seems like the missing link between all these symptoms I’ve had for years. Anyway, today I was thinking about the spotting and how sometimes it’s triggered by sex, and I began to wonder if I had a cervical lesion or something. And so I found your site. I have an appointment for a pap smear and to talk about my IUD a week from Wednesday, so hopefully that clears things up a bit…

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  8. I’ve been spotting between periods for nearly one year but have had multiple normal Pap smears and tested negative for STI’s. I get horrendous period pain some months and then nothing the next, and I don’t get a regular cycle.

    I have significant post coital bleeding. Like…rose coloured waterfalls! It gets worse the closer I get to my period (hormone level related? Likely as my ersteogen levels drop) and I’ve been the hospital for hemorrhaging but they didn’t find anything wrong. I’ve been diagnosed with ectropion but I’d like to know how’s that’s different to cervical endo?

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    1. I’m on physician and haven’t heard of Ectropion. I googled it and it sounds like the tissue sloughs off and travels. Endometriosis lesions are different as they cause of lot of pain and inflammation. It may be that the activity is happening with your pelvic cavity and not the exterior of your cervix. The only way to truly know if you have Endometriosis is with surgery. Is it something you have discussed with your doctors previously?

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      1. I had a laparoscopy in November 2018 where the surgeon performed an ablation on the endometriosis. My uterus was stuck to my pelvic wall, full of adhesions (scar tissue). After the surgery I did not feel any relief from the pain and symptoms. I had a laparoscopic hysterectomy August 2019 where the surgeon performed an excision. Again, tons of adhesions and endo. Some endo had to be left behind as it is sticking my cervix and bladder together. I am scheduled with a third surgeon who is more advanced in the laparoscopic excision to remove what was left behind. My symptoms now are mostly affecting the bladder and bowel. Yet there is still some pain during intercourse, which is expected all considering where the endo is located.

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        1. I am so glad that you continue to pursue answers and treatment. And wish you all the best of luck with the upcoming surgery! Please please please keep us posted and let us know if you need anything.

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  9. I have recently had a colposcopy following an abnormal cervical screening. A biopsy was taken as I had slightly inflamed area on my cervix. This came back as endometriosis. The gynaecologist said the area has been removed and nothing further is required. Unless I have symptoms of endometriosis… but you can a severe case with no symptoms. Whaaat?! Does cervical endometriosis mean you have endometriosis? Are they the same? Or can you/do you have one without the other? So confused right now… will be booking in with a doctor.

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    1. I’ve read plenty of cases of women with cervical endometriosis, but no pelvic endometriosis. And women with cervical endometriosis and pelvic endometriosis. Every persons case is so individual. Your doc shouldn’t have assumed you don’t have endometriosis elsewhere
      ..but there’s only truly one way to find out: surgery. It’s all about your quality of life, your symptoms (if any), and what you want. ❤ if you do have surgery, try to find a surgeon who is very familiar with Endometriosis and practices excision rather than ablation. ❤

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      1. Thank you for your reply. I thought it seemed from my own research surgery is the only way to really know. Any pain I do have certainly isn’t terrible, but I do want to get pregnant and am worried there may be something stopping me that I don’t know about. Will see what the doctor thinks.

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  10. I have cervical endo and it IS very painful. Serious pain meds, heating pad and tens machine will not touch the pain of cramping and anything that touches the cervix makes it very painful.

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