Cervix

What is your cervix?

Your cervix is a muscular, tunnel-like organ. It’s the lower part of your uterus, and it connects your uterus and vagina. Sometimes called the “neck of the uterus,” your cervix plays an important role in allowing fluids to pass between your uterus and vagina. It enables a baby to leave your uterus so that it can travel through your vagina (birth canal) during childbirth. The cervix is also a common site for cell changes that may indicate cancer.

Getting regular Pap smears allows your provider to screen for irregularities that may be signs of disease.

Who has a cervix?

People who are designated female at birth (DFAB) have a cervix. DFAB people include cisgender women — people who are DFAB and identify as women — and some transgender men and nonbinary individuals. Some intersex individuals have cervixes, too.

What is the purpose of your cervix?

Your cervix is a passage that allows fluids to flow inside and out of your uterus. It’s also a powerful gatekeeper that can open and close in ways that make pregnancy and childbirth possible.

Your cervix plays important roles in the following:

• Menstruation: The period blood you shed each month as part of your menstrual cycle has to pass from your uterus and through your cervix before exiting your vagina.
• Pregnancy: During penis-in-vagina sex, or intercourse, your partner may ejaculate (release) sperm into your vagina. The sperm has to travel through your cervix to reach your uterus and fallopian tubes to fertilize an egg.
• Fertility: Your cervical mucus plays a role in how easily you can become pregnant. Around ovulation (when your body releases an egg), your cervix secretes mucus that’s thinner and less acidic than usual, making it easy for sperm to pass through to your uterus. As a result, sperm can reach your egg and fertilize it more easily.
• Vaginal delivery: Your cervix controls when a baby exits your uterus during childbirth. During pregnancy, your cervix secretes a mucus plug that seals entry to your uterus. Once it’s time for the baby to be born, the mucus plug dissolves, and your cervix becomes softer and thinner. Your cervix widens (dilates) so that the baby can exit your uterus. Your provider can estimate how long it will take for your baby to be born based on how much your cervix has dilated.
• Protecting your uterus: Your cervix prevents objects inserted into your vagina, such as tampons or diaphragms, from slipping inside your uterus.

Where is your cervix located?

Your cervix is an important part of your reproductive anatomy. Your cervix is located inside your pelvic cavity, anywhere from 3 to 6 inches inside your vaginal canal. It begins at the base of your uterus and extends downward onto the top part of your vagina. This place where your cervix bulges onto the uppermost part of your vagina is called your ectocervix.

Your vagina, cervix and uterus are located behind your bladder and urethra (organs that allow you to pee) and in front of your rectum and anus (organs that allow you to poop).

What does your cervix look like?

The word “cervix” comes from the Latin word meaning “neck.” Like a neck, your cervix is shaped roughly like a cylinder or tube and connects important body parts. While your neck connects your head to the rest of your body, your cervix connects your uterus to your vagina. Your cervix is wider in the middle and narrows at both ends, where it opens into your uterus (top) and vagina (bottom).

Your cervix consists of the following parts:

• Internal OS: The opening that leads to your uterus. Your provider may refer to your internal OS during pregnancy.
• Endocervical canal: A tunnel that extends from your Internal OS to your ectocervix.
• Ectocervix: The part of your cervix that bulges onto the top of your vagina.
• External OS: The opening that leads to your vagina.

The place where the endocervical canal overlaps with the ectocervix is called the transformation zone (TZ). The TZ is the part of your cervix where cell changes happen most. It’s the most common site for abnormal cells to grow in your cervix, indicating conditions like cervical dysplasia or cervical cancer.

How big is your cervix?

Your cervix is about an inch long. Cervical sizes vary, though. Generally, your cervix is larger if you’ve given birth. The cervix is larger among people in their reproductive years than those who’ve gone through menopause. Your cervix gets significantly shorter during childbirth to allow a baby to easily exit your uterus and enter your vagina.

Can you touch your cervix?

Yes, depending on the timing of your menstrual cycle. If you insert your longest finger into your vaginal canal, you should eventually reach a barrier preventing your finger from sliding in further. This barrier is your cervix. It may feel firm and tight, or it may feel soft and spongy. The location and texture of your cervix change depending on whether or not you’re ovulating. It’s the softest and hardest to reach during ovulation.

Take care that you only attempt to touch your cervix when you’ve washed your hands thoroughly with mild soap and warm water. Otherwise, you could expose your cervix to bacteria and cause infection.

What is your cervix made of?

Your cervix consists of strong fibromuscular tissue. Two main types of cells line your cervix:

• Glandular cells: These cells line the endocervical canal, the innermost part of your cervix.
• Squamous cells: These cells cover the ectocervix, the outermost part of your cervix, and your vagina.

These different cell types meet at the TZ, where cell changes frequently take place. This area is of particular interest to your provider during screenings for cervical cancer.

What are the common conditions and disorders that affect your cervix?

The most concerning cervical conditions involve the human papillomavirus, or HPV. HPV is a sexually transmitted infection (STI) that sometimes leads to cervical cancer.

Conditions that affect your cervix include:

• Cervical cancer: Malignant cell growths on your cervix, most often resulting from an HPV infection.
• Cervical dysplasia: A condition that involves abnormal cell growth, most often resulting from an HPV infection. Cervical dysplasia is sometimes called cervical intraepithelial neoplasia (CIN). Cervical dysplasia sometimes--but not always--leads to cervical cancer.
• Cervicitis: Inflammation of your cervix caused by an STI or skin irritation. Infectious causes include chlamydia, gonorrhea, herpes, and trichomoniasis. Reactions to contraceptives can also cause your cervix to become inflamed.
• Cervical polyps, fibroids and cysts: Harmless fleshy or fluid-filled growths on your cervix. Nabothian cysts are the most common type of cervical cyst.
• Cervical ectropion: Harmless condition where the glandular cells on the inner portion of your cervix become visible from the outside.
• Pregnancy conditions involving your cervix include:
• Cervical insufficiency: A pregnancy complication that occurs when your cervix opens too early. It can lead to miscarriage and premature birth. This condition was once called incompetent cervix.
• Placenta previa: A condition where the placenta (the organ that supplies nutrients to a fetus) completely or partially covers the opening of your cervix. These pregnancies usually require cesarean deliveries (c-section).
• Cervical pregnancy: Rare pregnancy complication where an egg implants in the endocervical canal instead of the lining of your uterus.

What are common signs or symptoms of conditions affecting your cervix?

Many conditions affecting the cervix don’t cause symptoms. For instance, cervical dysplasia and early-stage cervical cancer often don’t produce noticeable signs. This is why it’s so important to get regular Pap smears to test for any irregular cell growth.

If you do notice signs, they may include:

• Abnormal vaginal bleeding, including heavy menstrual bleeding or bleeding between periods.
• Vaginal discharge that may be watery or bloody, odorless or smelly.
• Feeling fatigued, uncomfortable, or generally unwell.
• Pain when you pee.

How do I know if something is wrong with my cervix?

You may not know. Often, you won’t know that something’s wrong until your provider notices irregularities during a pelvic exam or Pap smear. Don’t wait for symptoms to seek care. Get screened regularly.

What are common tests to check the health of your cervix?

Regular pelvic exams and Pap smears are the most common tests to check your cervix. Your provider may order other tests depending on your condition.

Common tests include:

• Pelvic exam: Your provider inspects your cervix visually and manually (with fingers) to check for abnormalities.
• Pap smear: Your provider scrapes cells from your cervix and sends them to a lab to test for signs of precancer and cancer cells. Your provider performs a similar procedure during an HPV test, which tests cells for signs of HPV.
• Colposcopy: Your provider uses a special lighted microscope to take a close look at the tissue lining your cervix. Your provider can take tissue samples of any concerning areas and test them in a lab.
• Pelvic imaging. Your provider may order an imaging procedure to take a closer look at your cervix. Ultrasounds are the most common imaging procedures used to check your cervix. Still, magnetic resonance imaging (MRIs) and computed tomography (CT) scans can be used, too.
• Biopsy. Your provider may remove cervical tissue and test it for signs of cancer. Loop electrosurgical excision procedure (LEEP), conization (cone biopsy) and endocervical curettage (ECC) are all biopsy methods your provider may use.

What are the common treatments for your cervix?

Antibiotics can treat most cases of cervicitis caused by bacteria. Many of the tests used to check for abnormal cells that may be signs of cancer — LEEP and cone biopsy — are also treatments. They involve removing the tissue that contains cancer cells.

Depending on your condition, your provider may destroy abnormal cells in your cervix using extreme cold (cryotherapy), heat (thermal) or electricity. Cervical cancer treatments may include surgery, radiation treatment, chemotherapy treatment, targeted drug therapy and immunotherapy.

Simple lifestyle tips to keep your cervix healthy

• Get the HPV vaccine. The FDA has approved three vaccines that prevent the types of HPV that lead to cervical cancer: Gardasil®, Gardasil 9® and Cervarix®. Getting the vaccine greatly reduces your risk of cervical cancer.
• Get screened for HPV and cervical cancer regularly. General guidelines recommend that you have your first Pap smear at 21 and repeat every three years through your twenties. You should have a Pap and an HPV test every five years between ages 30 to 65. Talk to your provider about how often you should get tested based on your unique health situation.
• Practice safer sex. Use condoms or dental dams any time you have intercourse, anal sex or oral sex. Avoid sharing sex toys, and limit your number of sexual partners. Taking these steps can reduce your risk of becoming infected with an STI like HPV that puts you at risk of cervical cancer.
• Avoid tobacco products. Research suggests that HPV is more likely to progress to cancer if you smoke or use tobacco products.

A note from Cleveland Clinic

Your cervix is a tiny organ that plays a big part in pregnancy and your overall health. Take care of your cervix by getting the HPV vaccine and seeing your provider for regular Pap smears. Usually, your body doesn’t show signs or symptoms to alert you that your cervix has abnormal growths. Getting screened regularly can ensure that your provider catches any abnormalities early.