A scar is the body’s natural response to injury; fibrous tissue grows at the wound site to repair softer tissue. Even our cervices can grow scar tissue. Some women make more scar tissue than others and there isn’t a way to predict who will grow scar tissue and who won’t. Cervical scarring may affect fertility, pregnancy and labor.
What can cause cervical scarring?
- Cone and punch biopsies – removal of abnormal cervical tissue
- Cryosurgery – freezing of cervical tissue to treat cervicitis or cervical dysplasia
- LEEP and LLETZ procedures - tissue removal by wire loop that cauterizes site
- Dilation and Curettage (D & C) - dilating cervix and scraping or suctioning out contents of uterus after miscarriage or as abortion
- Cervical tears during childbirth – related to manual dilation, premature pushing or an exceptionally large fetal head or shoulders
- Some sexually transmitted infections or untreated bacterial or viral infections of the cervix
- Pelvic Inflammatory Disease
- Asherman’s syndrome
Cervical scarring can slow, stall or prevent dilation during labor. Contrastingly, it can cause incompetent cervix, premature labor, or need for cerclage. Rarely, it may cause cervical stenosis if the endocervical canal becomes obstructed or narrowed blocking the flow of menstrual fluid or the entrance of semen.
What does scarring feel like?
Reach a clean finger into your vagina and get familiar with your cervix. It is normal for the cervix to feel harder during certain times of the month and softer near ovulation. Scar tissue may feel thicker, denser or lumpier than the surrounding tissue of the cervix.
What can I do if I have scarring?
- Cervical Self-Massage (for non- pregnant women) – Use your finger to apply firm pressure or small circular strokes to your cervix. Consider Evening Primrose Oil as a lubricant since it has natural prostaglandins that can soften the cervix. Take deep breaths. You may actually feel the adhesions breaking up under your fingers. Do as many sessions as needed.
- Find a local massage therapist, sexilogical bodyworker, acupuncturist or midwife who is trained to help women release scar tissue via internal massage, such as myofascial release technique.
- If pregnant, ask your midwife or doctor about scar tissue massage during late pregnancy – based on your history and risk factors, she may advise for or against softening the tissue before labor begins. Ask her about taking Evening Primrose Oil orally or as a vaginal suppository in the last weeks of pregnancy.
- Ask your doctor or midwife to massage your scar tissue when they check your dilation during labor especially if your dilation stalls – often it will release allowing complete dilation. This may increase your chances of having a vaginal birth.
Please remember that many women who have these common procedures or infections do not have issues with cervical scarring. Also, many times, once the scar tissue is broken up, it will not return and subsequent pregnancies and dilation may progress smoothly.