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Signs and Symptoms of Cervical Cancer

9 min read

By Katherine George

Medically Reviewed by Dr. Andrea Eisenberg, MD

According to the American Cancer Society, there are an estimated 12,340 new cases of cervical cancer in America each year. Sadly, approximately 4,000 women die each year from this silent killer. Women of all ages are at risk for cervical cancer once they begin having intercourse and the human papillomavirus (HPV) is the most common reason why malignant cancer cells start to develop in the tissues of the cervix.

As the second most common type of cancer for women worldwide, it’s also one of the most treatable and preventable cancers. This is why regular Pap smears and vaginal exams are a necessity, especially if you encounter any of these symptoms because it could save your life…

No Symptoms

One of the scariest things about this silent killer of women is that it’s a serious disease that often presents with no symptoms at all in its early stages. If you’re at heightened risk of cervical cancer, it’s a good idea to have regular checkups with your doctor and undergo screenings for the preliminary signs of the disease.

Risk factors include HPV infection and sexual activity with multiple partners or with a partner who has other sexual partners. HPV is listed as the most common cause of cervical cancer. Smoking and exposure to secondhand smoke also increases your risk, as does having an impaired immune system as the result of other medical conditions.

As the cancer advances, you will likely experience noticeable early warning signs. These include pelvic pain, abnormal bleeding, and urinary abnormalities. It’s recommended that you have these symptoms checked out by a doctor immediately if they develop.

Pelvic Pain

Many women experience cramps at the start of their monthly menstrual cycle, and these cramps in and of themselves are normal and do not normally indicate the presence of cancer or any other serious condition. What you want to watch out for is unusual cramping, which usually follows one of two patterns. The first is pain that occurs at unusual times, and the second is the sudden onset of cramping.

If you start to experience significant pelvic pain and cramping during other times of the month, it can indicate the presence of a cancerous tumor. Similarly, women who do not normally experience menstrual cramps often start to have them once a cervical tumor develops. In both cases, you should schedule a visit with your doctor to find out whether or not something is amiss. Like other forms of cancer, your prognosis improves significantly if cervical cancer is detected in its early stages.

Abnormal Bleeding

One of the most common warning signs of cervical cancer is abnormal bleeding outside of the normal menstrual cycle. Of course, this varies from woman to woman; some women experience light spotting, while others may develop heavy bleeding that seems to come and go with no explanation. You should always consider unexplained vaginal bleeding to be a symptom of a potentially serious condition and pursue a diagnosis from your doctor.

However, vaginal bleeding can indicate a number of other conditions, or it may have an entirely benign (not cancerous) root cause. Other medical conditions known to cause vaginal bleeding include hormonal imbalances, pelvic inflammatory disease (PID), or an infection in your pelvic organs. The use of birth control pills can also cause vaginal bleeding, particularly when you first start to use them.

Painful Urination

Painful urination (known clinically as dysuria) can indicate a problem with the cervix, but like many other symptoms of cervical cancer, it can also indicate a number of other problems. The type of pain associated with cervical cancer will usually seem to originate in the bladder or present as a dull ache that only occurs during urination. These symptoms can indicate that the cancer has already spread and is affecting your bladder.

However, these symptoms usually have other less serious causes. Urinary tract infections (UTIs) can cause similar symptoms, and they are commonly seen in sexually active women. Yeast infections and sexually transmitted infections (STIs) can also cause these symptoms; pelvic pain is associated with STIs, including gonorrhoea, chlamydia and genital herpes. Your doctor will likely screen you for these conditions when you go for your checkup, if you’ve been complaining about this type of pain.

Unusual Discharge

Abnormal vaginal discharge can indicate cervical cancer. The type of discharge associated with cervical cancer has several definitive characteristics, including unusual textures, colors, and odors. The discharge may contain high concentrations of mucus, which contribute to their thickness and foul, pungent odor. If you experience this symptom, you should report it to your doctor immediately and have its cause investigated.

The color of your vaginal discharge can give you clues about its root cause. The mucus in the discharge caused by cervical cancer will give it a yellowish or greenish hue, but it’s important to keep in mind that similarly colored discharge can result from a chlamydia or gonorrhea infection. A watery or white discharge is typically caused by yeast infections, while a white or grey discharge is often the result of bacterial vaginosis (BV) infections. Many healthy women will experience yeast or bacterial infections of the vagina over the course of their lives, and these conditions are easily treated with noninvasive interventions and medications.

Abnormal Menstrual Cycles

Most women have experienced abnormal bleeding or spotting between menstrual periods, which can happen for a variety of reasons. It can result from a range of non-serious illnesses, or it can happen after sexual intercourse, following a Pap smear, or during periods of intense physical, emotional, or psychological stress. However, regular bleeding between menstrual cycles can indicate irritation of the cervix and possibly cervical cancer.

You’ll want to watch out for two particular characteristics of vaginal bleeding that are not associated with your menstrual cycle. First, you should be on heightened alert if it occurs regularly (for a period of three months or more). Second, you should pay close attention if you start experiencing vaginal bleeding when it has not previously been a part of your normal menstrual cycle. Sudden changes in regular patterns can indicate a serious problem when bleeding is involved, so don’t take these symptoms lightly.

Pain or Bleeding After Sex

Even those of us with healthy cervixes can experience some spotting after sexual intercourse, particularly if you use intrauterine contraception devices or latex condoms. Condoms can irritate the tissues in your vagina, particularly if their exteriors are not lubricated before penetrative sex.

Under normal circumstances, these symptoms happen on occasion, not with regularity. If you start to experience regular pain and bleeding during or after sexual intercourse, it can indicate an underlying health issue, such as cervical cancer. This is particularly true if pain and bleeding are accompanied by other symptoms, such as thick, foul-smelling vaginal discharge and changes in urinary habits, including painful urination and an increase in the frequency and urgency of urination. In such cases, you should have your cervix examined by your doctor.

Urinary Incontinence

Sudden, unexplained changes in urinary habits can indicate the possible presence of cervical cancer. You may experience changes in urination including increased urgency and frequency or urine leakage that occurs during unrelated activities; for example, you might leak a little urine if you jump or sneeze. In extreme cases, patients experience a complete loss of bladder control. These symptoms typically indicate that the cervical cancer is spreading to another area and is affecting the bladder or other parts of the urinary tract.

You may also notice small amounts of blood in your urine. This condition is known as hematuria, and cervical cancer may be the cause, especially if you’re experiencing some of the other symptoms on this list. While mild urinary incontinence and changes in urinary habits are a regular part of aging, you should always have them checked out and explained by your doctor.

Back Pain

Lower back pain is another symptom of cervical cancer. This pain may shoot down the patient’s legs, and in extreme cases, it can also cause swelling in the legs known as “edema.” These symptoms suggest that the tumor is spreading or has reached a relatively large size. It’s important to note that this symptom has a very particular presentation; the pain will be constant and will usually increase in intensity over time. It won’t normally “come and go,” and it will only temporarily respond to the use of over-the-counter pain medications.

The bottom line is this, if you’re an adult woman and you notice any unusual changes or symptoms affecting your reproductive organs, be sure to visit your doctor and get them checked out. Your chances of successfully treating cervical cancer are much higher if the disease is detected in its earliest stages.

Fatigue

Cervical cancer is tricky to diagnose because it often doesn’t begin to present symptoms until it’s already in the advanced stages. According to Taraneh Shirazian, MD, a gynecologist at NYU Langone Health, who spoke to Women’s Health about cervical cancer, fatigue is one of the symptoms that might not show up until it’s too late.

Why do women feel fatigue along with cervical cancer? Women’s Health explains that it is because cervical cancer also causes vaginal bleeding. The loss of red blood cells and oxygen in the body leads to this fatigue. If you’re feeling completely depleted of energy without any explanation, especially in addition to other symptoms on this list, contact your doctor and have him or her check your iron and red blood cell levels.

Changes in Bowel Movements

While it might not be pretty, a quick peek at your bowel movements can tell you a lot about your health, especially when it comes to cancer. Prevention writes that frequent urination or even the constant urge to have to go pee could be an important warning sign pointing toward cervical cancer. The same rings true for frequent stool movements.

Joshua Cohen, MD, a gynecologic oncologist at UCLA, told Prevention that the emphasis here is on “persistent.” Anyone who experiences any of these symptoms for less than a week shouldn’t be running to the doctor or stressing about whether or not they have cancer. But if you experience several of these symptoms at the same time along with changes to your usual bowel movements, take note on how long they last. If they stick around long enough or seem to get worse as time goes on, it should warrant a visit to the doctor.

Nausea

Suffering through constant waves of nausea isn’t pleasant, but then again, none of the symptoms of cervical cancer are pleasant. According to Women’s Health, nausea or any kind of indigestion is a common sign of many different cancers, including cervical cancer. WebMD backs this claim up by listing a “swollen abdomen, nausea, vomiting, and constipation” as four key symptoms of cervical cancer.

The reason cervical cancer leads to nausea is because “when advanced, cervical cancer can cause the cervix to swell into the abdominal cavity, compressing the gastrointestinal tract and stomach to cause or even acid reflux,” says Shirazian to Women’s Health. However, because nausea is such a common symptom that could be caused by a number of different things, you should consult with your doctor before booking an appointment with the gynecologist.

Weight Loss

Weight loss is definitely linked to nausea, another symptom of cervical cancer. Nausea might lead to unintentional weight loss, because you’re unable to keep food down or even work up enough of an appetite to consume a meal. “A loss of appetite and unexplained weight loss can be symptoms of a number of cancers, including cervical cancer. It is a particularly telling sign if weight loss persists, no matter how much food is consumed,” says Jan Schaefer, MD, Chief Medical Officer at MEDIGO, while talking to Cosmopolitan.

Women’s Health advises patients who lose up to 5 to 10-percent of their body weight in less than six months to consult a doctor.

Sore Legs

Back pain and pelvic pain are common warning signs of cervical cancer, and unfortunately they aren’t the only pain you’ll experience. Cervical cancer can also cause sore legs. “When cervical cancer grows, it might start to press against the nerves in the lower back, which can lead to leg pain and some swelling,” says Dr. Schaefer to Cosmopolitan. It’s important to point out that when experienced together, leg and back pain can be a symptom of cervical cancer, but if experienced on their own, they could indicate something entirely different.

Sore legs are most common in advanced cases, says Eloise Chapman-Davis, MD, a gynecological oncologist at Weill Cornell Medicine and New York-Presbyterian, who told Women’s Health, “You might have things like back pain or leg pain, but that’s typically associated with very advanced cases because the cervix isn’t really affecting a lot of nerves.”

MD, Obstetrics and Gynecology

Andrea Eisenberg, MD is a board certified OB/GYN in the Metro Detroit area. She has dedicated her life to caring for women through all stages of their lives -- from adolescence, to delivering babies, and later into menopause. Her special interests include minimally invasive surgeries, adolescence, family planning, infertility, and menopause. In her spare time she writes about the human side of medicine on her blog and has several essays published in a variety of journals. To decompress, she enjoys trail running and baking.

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