Cervical Cancer: Signs and Symptoms

Early cervical cancer, and the precancerous changes that come before it, usually cause no symptoms at all. This is the single most important fact about cervical cancer symptoms. By the time symptoms appear, the disease has often already progressed. This is exactly why Pap tests and HPV tests exist. They catch abnormal cells years before those cells would ever cause a symptom you could notice.

When cervical cancer does cause symptoms, abnormal vaginal bleeding is the most common one. This can show up in several ways:

• Bleeding after vaginal sex.
• Bleeding after menopause, when periods should have stopped entirely.
• Bleeding between regular periods.
• Periods that are heavier or last longer than usual.
• Bleeding after douching or a pelvic exam.

Any bleeding that does not fit your normal pattern is worth mentioning to a doctor, even if it seems minor or you can explain it away.

Unusual vaginal discharge is another common symptom. It may contain blood, appear watery, or have an odor. It can show up between periods or after menopause, when discharge should be minimal. Pelvic pain and pain during sex can also occur. Like the bleeding above, these symptoms can have many non-cancerous causes. Infections are one common example. That overlap is a reason to get checked, not a reason to assume it is nothing.

If cervical cancer has grown or spread further, additional symptoms can develop: swelling in one or both legs, problems with urination or bowel movements, and blood in the urine. These symptoms suggest the cancer may be affecting nearby organs or structures. They call for prompt evaluation.

Delaying care after noticing these symptoms can let the cancer grow. A more advanced stage lowers the chance that treatment works as well as it could. This is true of most cancers, but it is worth stating plainly here: if you notice abnormal bleeding, discharge, or pelvic pain that is new or persistent, do not wait to see if it resolves on its own. Call your doctor.

Early cervical cancer is usually silent. Symptoms work as a late-stage safety net. They are not the primary way this cancer gets caught. Routine Pap tests and HPV tests, done on the schedule your doctor recommends based on your age and history, find abnormal cells long before they would cause any of the symptoms above. If you are behind on cervical cancer screening, catching up matters more than waiting for a symptom to prompt you.

Reporting symptoms does not mean an automatic cancer diagnosis. It starts with a pelvic exam and a review of your history. If something looks abnormal, or if your Pap or HPV test came back abnormal, the next step is usually a colposcopy. A doctor uses a magnifying instrument to look closely at the cervix, often after applying a solution that makes abnormal areas easier to see. If an abnormal area is found, a small tissue sample, called a biopsy, is taken and sent to a lab. Some biopsies, like a cone biopsy or LEEP, can treat precancerous changes at the same time they diagnose them. If cancer is confirmed, imaging tests such as a CT, MRI, or PET scan help determine whether it has spread.

• Given my symptoms, do I need a pelvic exam, Pap test, or HPV test now, rather than waiting for my next scheduled screening?
• Could my bleeding or discharge have a non-cancerous cause, and how would we find out?
• Am I due for cervical cancer screening based on my age and history?
• If I have HPV, what does that mean for how often I should be screened?

• American Cancer Society — Signs and Symptoms of Cervical Cancer
• American Cancer Society — How Is Cervical Cancer Diagnosed?