Short answer

Cervicitis, inflammation of the cervix, announces itself inconsistently: mucopurulent discharge, bleeding after sex or between periods, pelvic aching, painful intercourse, or burning urination when it announces itself at all.

Silent cervicitis is common, which is why evaluation pairs what the clinician sees (speculum examination) with what the laboratory finds (endocervical NAAT testing), rather than relying on symptoms.

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Symptom patterns and what they suggest

No single symptom identifies cervicitis, but patterns raise suspicion.

  • Mucopurulent discharge (yellow-green, pus-like) is the classic sign.
  • Postcoital or intermenstrual bleeding reflects a friable, inflamed cervix that bleeds on contact.
  • Pelvic discomfort or dyspareunia (painful intercourse) suggests deeper involvement.
  • Dysuria occurs when inflammation extends to the urethra.

Frequently, though, there is nothing at all. Which is why exposure history and routine screening catch what symptoms miss.

The examination, step by step

Evaluation usually completes in one visit.

  1. Speculum visualization lets the clinician assess discharge character and cervical friability (bleeding when touched).
  2. Endocervical sampling collects NAAT swabs for chlamydia, gonorrhea, and trichomoniasis.
  3. Bimanual examination maps tenderness. Cervical motion tenderness (pain when the cervix is moved) suggests PID ascent and escalates care urgently.
  4. Pregnancy assessment runs alongside, since pregnancy modifies both urgency and treatment.

Laboratory workup explained

Endocervical NAAT is the core test. Highly sensitive for the three main STI causes.

Wet mount and pH testing sort yeast and BV overlap.

HIV and syphilis co-screening follows risk assessment. For persistent cases after standard treatment, M.

genitalium-specific NAAT enters the picture.

Each test answers a different question, which is why the panel runs together rather than stepwise.

Care pathways by cause

  • STI causes get organism-directed antibiotics with simultaneous partner treatment, abstinence through clearance, and retesting per STI schedules.
  • Non-infectious findings (irritants, latex sensitivity, vaginal products) resolve with irritant removal and observation.
  • PID ascent signs trigger PID-protocol treatment without delay. Fertility damage tracks delay, not severity.

See When Pelvic Pain Needs Urgent Evaluation.

When to seek care

For discharge, postcoital bleeding, or pelvic ache; after partner STI diagnoses (evaluation regardless of symptoms); urgently for fever with pelvic pain, which reframes the visit as PID evaluation.