Cervical Health and Fertility: What You Need to Know

This January as part of Cervical Cancer Awareness Month, we explore how to improve your cervical health to prevent cervical cancer, enhance your fertility and improve your overall reproductive health.

Quick facts:

• Your cervical health plays a crucial role in fertility and your overall reproductive health. 
• Your cervix has an important biological role that supports conception and pregnancy.
• It’s important to get your smear test when you’re invited to ensure your cervical health and prevent against cervical cancer. 
• There are also several lifestyle factors you can implement to promote good health for your cervix.

Understanding cervical health

Cervical health refers to the health and functioning of the cervix, the lower part of the uterus that connects to the vagina.

To check your cervical health, you need to attend regular cervical screenings, (known as the smear test), and ensure you have your HPV vaccination.

Your cervical fluid changes throughout your menstrual cycle and understanding these changes can give you insight into your fertility.

Knowing what your cervical fluid looks and feels like throughout your menstrual cycle can help you identify your optimal fertile window (when you’re most likely to get pregnant). Usually, it becomes more slippery, slimy like egg white around ovulation, to help the sperm swim up towards the cervix.

Cervical cancer

Every year, more than 3,200 people are affected by cervical cancer in the UK. Two women lose their lives to cervical cancer every week and nine more receive a life-changing diagnosis.

Despite this, 1 in 3 people don’t attend their smear test. Yet, if it’s caught early, cervical cancer can be treated. Some countries, like Sweden, predict that they will have eliminated cervical cancer by 2030, while the UK aims to eliminate it by 2040.

Ensuring that you have your HPV vaccination and also attending your Cervical Screening when you’re invited is the best way to protect against cervical cancer.

With the NHS, you should be invited to a smear test every 3 years between the age of 25-49, and every 5 years after that until to turn 64. The frequency may increase depending on if you have any abnormal results.

These cervical screenings check the health of your cervix. It’s not a test for cancer, but it’s a test to help prevent cancer. They are crucial in spotting any changes in the cervical cell which could be signs of an infection or cervical cancer. 

Cervical cancer often remains undetected because not everyone will always experience symptoms so ensuring your cervical screening is up to date is an important preventative measure.Symptoms like a change in your vaginal discharge, bleeding between periods, or during or after sex, unexplained pain in your lower back or pelvis, or pain and discomfort during sex can all indicate cervical infection or cervical cancer.

Cervical cancer awareness month

Cervical Cancer Awareness Month aims to encourage more people to attend their cervical screening appointment and take their HPV vaccinations, (in case they haven’t already got it) to prevent cervical cancer as well as raise awareness about common signs and symptoms.

You know your body better than anyone. Becoming attuned to it will empower you and help you spot anything out of the ordinary.If you notice anything that doesn’t feel normal (symptoms like bleeding between periods, or unusual vaginal discharge, for example) when it comes to your reproductive health, especially if you’re trying to conceive or plan to have a baby in the future, speaking to a healthcare professional and getting the necessary tests early in the process is key.

The connection between cervical health and fertility

First, let’s talk about the cervix and how it’s related to your fertility. 

Your cervix is a narrow, cylinder-shaped passage, this is where all the uterine lining will pass through during your period. It is the mouth of the uterus and connects it to your vagina.

When in labour, the cervix is also the part that dilates, so the baby can be delivered, but it’s more than just a passageway.

The cervix plays a key role in conception. When you ovulate, your cervical fluid (sometimes called cervical mucus) becomes watery to help transport the sperm from the vagina towards the cervix and to the egg to become fertilised (the first step of conception).

Your cervical health can affect your fertility in various ways. Infections, cervical cancer and structural abnormalities can lead to your cervix not functioning properly. Without the cervical fluid that helps to transport the sperm, and the protective barrier your cervical fluid creates during pregnancy, a poorly functioning cervix could have led to complications.

After ovulation, your cervical fluid becomes sticky and thick, acting like a barrier to the sperm. If this happens around the time of ovulation, it could inhibit sperm from reaching the egg, preventing fertilisation and conception. If you do become pregnant, poor cervical health can cause miscarriage or preterm labour.

Infections of the cervix, such as sexually transmitted infections (STIs) can negatively impact fertility. Infections cause inflammation and scarring of the cervix, which can affect its normal function and increase the risk of infertility.

Common cervical health issues affecting fertility

Cervical infections can affect fertility

Infections of the cervix, such as sexually transmitted infections (STIs) can negatively impact fertility. Infections cause inflammation and scarring of the cervix, which can affect its normal function and increase the risk of infertility.

Cervical polyps can affect fertility

Cervical polyps are growths that can develop on the cervix. Polyps are usually (benign) harmless and do not often cause any symptoms, but they can sometimes cause fertility issues, or increase the risk of miscarriage. 

Once found, the treatment is usually to remove them. The process of removal depends on the size, type, location, visibility and number of polyps.

Cervical dysplasia can affect fertility

Cervical dysplasia is a cervical condition in which abnormal cells grow on the surface of your cervix. Cervical dysplasia (also known as cervical intraepithelial neoplasia or CIN) is not cancer but if left untreated, it can develop into cervical cancer and affect fertility. Early detection and treatment is key.

Cervical dysplasia is often termed “precancerous”, which can sound scary, but if you get timely treatment, most people who get it do not get cancer.

If you have abnormal cells from your screening test, you may be invited to have a colposcopy test to look closer at your cervix. The treatment you need for abnormal cervical cell changes depends on whether you have mild, moderate or severe changes.

How HPV affects cervical health

HPV is one of the most common sexually transmitted infections (STI) in the US and the UK. It is estimated that 80% of sexually active individuals will be exposed to it at some point in their lifetime.

It’s a viral infection that affects the skin and any mucous membranes (cervix, vagina, vulva, anus, and lining of your mouth and throat). Usually, the body can fight this infection on its own, however, in some cases, it may persist and increase the risk of developing various types of cancer such as cervical cancer.

Many people have HPV and don’t know because there aren’t any symptoms. There are lots of different types of HPV. Low-risk HPV usually goes away on its own within two years and it can lie dormant for years without affecting you. In a very small number of cases, a specific type of HPV, high-risk HPV, can cause cervical cancer. Low-risk HPV is known to cause genital warts (mucous membrane growths). While there’s no treatment for HPV itself, there is treatment available for the warts.

If you’ve had sexual contact, you can get HPV. It’s passed on through skin-to-skin contact. It can be passed on through vaginal, anal, or oral sex, by hands touching genitals and by sharing sex toys.

Even if you’ve had the HPV vaccination, it only protects you against some types of HPV (there are about 200 different types) and you’re still at risk of contracting the other types of HPV, so getting regular check-ups is vital.

Cervical cancer treatments can affect fertility

Unfortunately, most cervical cancer treatments like surgery and radiation can affect the structure and function of the cervix, potentially leading to fertility issues, by preventing the cervix’s ability to maintain a pregnancy. Poor cervical health can also affect fertility treatments like IVF (in-vitro fertilisation) and IUI (intrauterine insemination).

Cervical insufficiency can impact fertility

Cervical insufficiency, also known as a weak cervix or incompetent cervix might occur when the cervix won’t stay closed during pregnancy leading to preterm birth or miscarriage. This condition can be congenital (exist from birth) or result from cervical trauma, surgery or inflammation.

“Cervical-factor infertility” refers to fertility issues that are attributed to problems with the cervix—whether that’s cervical mucus issues, cervical structure abnormalities from infection or surgery or other cervical-related challenges.

Now we know the issues we can face with our cervix and how they affect fertility, how do we improve our cervical health?

Preventive measures and early detection

Early detection and treatment, and taking preventative measures are crucial for maintaining cervical health and preserving your fertility and reproductive health. The best way to keep your cervix healthy is by attending regular cervical screening and ensuring you are up to date with your HPV vaccinations.

A third of people who are invited don’t attend their cervical screening, and Cervical Cancer Awareness Month is all about encouraging more people to attend to spot abnormalities early and eradicate cervical cancer.

A cervical screening test involves you visiting your GP’s surgery or clinic, and the doctor or nurse taking a swab from inside your cervix. The swab is sent off for testing and checked for “high-risk” types of HPV. 

If these types of HPV are not found, you do not need any further tests and will be asked to come for your next routine appointment in 3 or 5 years time. 

If these types of HPV are found, the sample is checked for any changes in the cells of your cervix. If there are no abnormal changes found, you will be asked to come for another cervical screening test in 1 year. If abnormal cell changes are also found, you will be recommended a different test to look at your cervix called a colposcopy.

Unfortunately, the smear test can be uncomfortable for some. It’s a transvaginal exam where an instrument (a speculum) will be used to widen your vagina to allow a brush to collect a small sample of cells from your cervix.

It’s a completely safe procedure. It can be uncomfortable for some, but it is usually over in five minutes. However, if you feel uncomfortable, voice your concerns to your doctor beforehand. Ultimately, this test can help in the early detection of cervical cancer and potentially save your life.

For women and those assigned female-at-birth (AFAB) in the UK, after the age of 25, you are invited to attend a smear test at your local GP or health clinic every three years until the age of 49. After this, you will be invited every 5 years until the age of 64. The frequency of testing might increase in case you have abnormal results.

Many women and those AFAB in the UK receive the HPV vaccination aged 12 or 13 at school or a community centre. For people who didn’t receive the HPV vaccination, those who are eligible can get the vaccination by requesting it from their GP.

The HPV vaccination reduces the risk of getting conditions linked to HPV like genital warts and cervical cancer. Since its uptake, cases of HPV have been greatly reduced.

Ensuring you have the HPV vaccination and regularly attend your smear test is the most effective way to stay on top of your cervical health and fertility.

Tips to improve cervical health

As well as attending regular cervical screenings and ensuring you have the HPV vaccination, there are also lifestyle changes you can make to prevent cervical cancer, improve your cervical health, and as a result, your fertility.

Practice safe sex for cervical health

To reduce the risk of sexually transmitted infections (STIs) like HPV, you should practice safe sex by using barrier methods of contraception like condoms. You should also get tested regularly, especially before and after having sex with a new sexual partner.

Maintain a healthy weight and exercise regularly

A balanced and nutritious diet rich in fruits, vegetables and whole grains, and regular exercise will support good cervical health. By getting enough important vitamins and minerals, you support your immunity. Obesity can also increase the risk of cervical cancer, so managing your weight with a balanced diet and regular exercise contributes to this too.

Stay hydrated to improve cervical mucus consistency

Staying hydrated by drinking at least two litres of water each day not only supports your overall health and well-being but contributes to the maintenance of your cervical mucus—an important component for your fertility and healthy pregnancy.

Quit smoking for cervical health

If you want a healthy cervix and to improve your fertility, you should quit smoking. It’s a risk factor for cervical cancer and can hinder the body’s ability to fight cervical infections. Scientists think this is because smoking damages the cells in your cervix and makes it easier for cancer to develop. Smoking also weakens your immune system and makes your body less able to fight HPV infections. Check out Smokefree.gov for tips on how to quit.

Track your menstrual cycle and cervical fluid

A healthy cervix will produce cervical fluid (sometimes called vaginal discharge) that you might notice in your underwear. By tracking your menstrual cycle, including your cervical fluid, and how it changes throughout each cycle, you can learn what’s normal for your body.

By understanding what’s normal for you, if something doesn’t look or feel right, you can get a check-up and speak to a healthcare professional about a potential cervical screening to catch or rule out any cervical health issues as early as possible.

Contact your GP if you’re experiencing symptoms

Contact a GP if you’re experiencing any of the following symptoms: bleeding between periods or after sex, pain during or after sex, unexplained lower back pain or unusual vaginal discharge. This can be a symptom of cervical infection or cervical cancer. You don’t need to wait for your next cervical screening if you have symptoms.

If you’re affected by cervical cancer or have questions about cervical health, the following organisations offer support and resources:

• Macmillan Cancer Support shares information on cervical cancer and cervical screening.
• The Eve Appeal offers support for anyone affected by gynaecological cancers.
• Jo’s Cervical Cancer Trust (Jo’s Trust) has detailed information about cervical cancer, cervical screening, HPV and cell changes, including information for trans and non-binary people.

Cervical health awareness is crucial, particularly when it comes to your fertility as it directly impacts your ability to conceive and maintain a healthy pregnancy. Regular screening and early detection are important. Understanding your body by tracking your menstrual cycle and cervical fluid will empower you to know what’s normal, and importantly, when something doesn’t feel right.

Preventative measures to ensure good cervical health are to ensure you have the HPV vaccination, attend your smear tests, practise safe sex and make healthy lifestyle choices. A healthy cervix contributes to better reproductive health and well-being. Take your cervical health into your own hands to support your fertility.

Cervical health and fertility FAQs

How does cervical health impact fertility?

Your cervical health, related to the health of your cervix, plays an important role in fertility. Cervical fluid changes consistency to transport the sperm to the egg to be fertilised. This is why you may notice changes in vaginal discharge throughout your menstrual cycle.

And that’s not your cervix’s only job. Once you’re pregnant, your cervical fluid acts as a barrier to keep the foetus safely in the uterus. This is why good cervical health is crucial for your reproductive health.

Your cervical health can affect your fertility in various ways. Infections, cervical cancer and structural abnormalities can lead to your cervix not functioning properly. Without the cervical fluid that helps to transport the sperm, and the protective barrier your cervical fluid creates during pregnancy, a poorly functioning cervix could negatively affect your fertility or pregnancy.

If you have questions about how to improve your cervical health or fertility, speak with a fertility advisor, fertility counsellor or private gynaecologist to support you.

If your cervical fluid isn’t functioning as it should, it could inhibit sperm from reaching the egg preventing fertilisation and conception. If you do become pregnant, poor cervical health can cause miscarriage or pre-term labour.

What are the best practices for maintaining cervical health?

The best practices to maintain cervical health include:

• Ensuring you have the HPV vaccination to lower your risk of contracting the HPV virus that can cause cervical dysplasia and cervical cancer.
• Attending regular smear tests to detect any cervical abnormalities. When you turn 25, you’re invited to attend a cervical screening (smear test) every three years on the NHS. Early detection and regular screening are crucial to maintain cervical health.
• Adopting healthy lifestyle choices like balanced nutrition, cutting out or reducing alcohol and smoking intake, regular exercise, getting enough sleep each night and managing stress will support good cervical health.
• Tracking your menstrual cycle and cervical fluid will help you to understand what’s normal throughout your menstrual cycle, and notice when something feels different.
• If you notice symptoms, or something doesn’t feel quite right, see your GP as soon as possible to explain your symptoms and potentially request a cervical screening. Early detection is vital to good cervical health.

If you want to know more about how to improve your cervical health or fertility, speak with a fertility advisor, fertility counsellor or private gynaecologist.

How often should one undergo cervical health screenings for optimal fertility?

For women and those assigned female-at-birth (AFAB) in the UK, after the age of 25, you are invited to attend a smear test at your local GP or health clinic every three years until the age of 49. After this you will be invited every 5 years until the age of 64. The frequency of testing might increase in case you have abnormal results.

If you’re planning on getting pregnant, contact your GP or a healthcare professional to ensure you’re up to date with your cervical health screening. You can have a cervical screening at your local GP surgery or sexual health clinic.

Women and those assigned female-at-birth (AFAB) under 25 don’t need a cervical screening because cervical cancer is very rare in people under 25 and abnormal cells can often go back to normal over time in younger women.

Contact your GP if you’re experiencing symptoms like bleeding between periods, unusual vaginal discharge, unexplained lower back pain or pain or discomfort during sex. This can be a symptom that something isn’t quite right with your cervical health. You don’t need to wait for your next cervical screening if you have symptoms.

If you miss an appointment you don’t need to wait until you’re invited for your next. You can request one from your GP.Speak with a fertility advisor, fertility counsellor or private gynaecologist to support you with cervical health.