can you tell me what this means, please?

[bklyngirl]

Hi,

Because I was diagnosed with high risk types of HPV, my doctor performed a colposcopy, the results did come back negative for cervical cancer, but my biopsy determined that I have active chronic cervicitis with squamous metaplasia.  Can you tell me what this actually means? My doctor just explained it as inflamation (inflammation) and prescribed metrogel to try and alleviate it.  

I read that most cervicitis is caused by chlamydia or gonorrhea--I did test negative for these. Is it possible that the HPV lesions that are now healing caused this, or could it be from another type of infection?  

Thanks for your time.

[H. Hunter Handsfield, M.D.]

The causes of cervicitis are mysterious.  Chlamydia and gonorrhea indeed are common causes, but they explain only a minority of cases.  A few cases may be caused by a recently (10 yr) discovered organism called Mycoplasma genitalium, but cause of most cases remains unknown.  Many cases are accompanied by bacterial vaginosis, a bacterial overgrowth in the vagina; Metrogel is a treatment for BV and therefore perhaps worth a try.  Most likely HPV is not part of the problem in most cases, but your provider is in a better position than I am to advise you about that possibility in your cases.  (I hesitate in part because squamous metaplasia is often a sign of HPV, so you might ask your doc specifically about it.)

If your cervicitis persists, I suggest you request referral to an ObG with training (or at least lots of practical experience with) infectious diseases.  Such specialists usually can be found at major medical centers in industrialized countries.  But in the meantime, don't worry about it too much.  Nobody has ever documented serious complications due to cervicitis; unlike those associated with chlamydia or gonorrhea, infertility, PID, or other complications seem not to occur.

Good luck--  HHH, MD

[bklyngirl]

I guess my main question is, when the biopsy comes back with the diagnosis of active chronic cervicitis, are further tests done to determine the reason (ie: chlamdyia/gon, herpes, etc.)?

Thanks.

[H. Hunter Handsfield, M.D.]

You say you had negative tests for gonorrhea and chlamydia.  I cannot say what other tests your provider did or didn't do.  But in most cases like yours, no specific cause can be found.  Herpes is theoretically possible, but uncommon.  Your provider might try treatment with an antibiotic.  The good news is that in the long run, most cases clear up and there do not appear to be any complications.  Follow your provider's advice, but don't lose a lot of sleep over it.

Good luck--- HHH, MD