Cervical cancer can develop silently over a long period. In the early stages, many people have no symptoms at all, which is also why regular screening with an HPV test or a Pap smear is so important.

When symptoms do appear, unusual changes in vaginal bleeding, discharge or pelvic pain are signs that should not be ignored.

One important point: having one of these signs does not mean you definitely have cervical cancer. Infections, polyps, hormonal changes and many other gynaecological conditions can also cause similar symptoms.

7 signs of cervical cancer you should not ignore

1. Bleeding after sex

Vaginal bleeding after sex is one of the signs most often mentioned in connection with cervical cancer.

You may notice:

• A small amount of blood after sex
• Blood-stained vaginal discharge
• Bleeding that recurs repeatedly

A single episode of light bleeding is not enough to conclude that something serious is wrong. But if this keeps happening or becomes heavier, you should have a gynaecological examination to find the cause.

2. Bleeding between periods

Blood or spotting appearing before your period is due is a form of abnormal vaginal bleeding.

Cervical cancer can cause bleeding between periods, but this symptom can also occur with hormonal disorders, the use of contraceptive pills or other gynaecological conditions.

What is worth noting is when this pattern of bleeding is different from your normal cycle.

3. Periods that are heavier or longer than usual

If your cycle has always been regular but recently:

• Menstrual blood loss has clearly increased
• Your periods last more days
• Abnormal bleeding appears outside your cycle

you should note the change and discuss it with your doctor.

The NCI lists periods that are heavier or longer than usual among the symptoms that can appear in early-stage cervical cancer.

4. Bleeding after the menopause

After the menopause, any new vaginal bleeding should be assessed medically.

Cervical cancer is one of many possible causes of bleeding after the menopause.

Do not assume it is simply “a hormonal change that comes with age”.

5. Abnormal vaginal discharge

Vaginal discharge can change with the menstrual cycle and with hormones.

However, you should take notice if the discharge:

• Becomes markedly heavier
• Is watery and persists
• Has an unusually strong smell
• Is mixed with blood

Watery vaginal discharge, discharge with a strong smell or discharge mixed with blood is one of the symptoms the NCI records in cervical cancer.

That said, vaginitis and other gynaecological infections can also cause abnormal discharge, so an examination is needed to tell them apart.

6. Persistent pelvic pain

Pelvic pain is pain or discomfort in the lower abdomen, between the hip bones.

You should see a doctor if the pain:

• Occurs frequently
• Is persistent
• Has no clear link to your period
• Is getting worse

Pelvic pain has many causes, from period pain and ovarian cysts to other gynaecological conditions. It is not a sign specific to cervical cancer alone.

7. Pain during sex

Deep pelvic pain during or after sex is also a symptom worth noting.

Both the NCI and the American Cancer Society list pain during sex among the symptoms that can occur in cervical cancer.

But as with the other signs, pain during sex can also be linked to:

• Vaginal dryness
• Infection
• Endometriosis
• Certain other pelvic conditions

If the symptom is new, persistent or getting worse, it should be checked.

Do new symptoms mean you need a Pap smear or an HPV test?

This is an easy point to get confused about.

Pap smears and HPV tests are primarily screening tests, that is, they are used to look for risk or pre-cancerous changes before symptoms appear.

If you already have abnormal vaginal bleeding, pelvic pain or abnormal discharge, the goal at that point is not simply to “go for a Pap test”.

Your doctor may need to carry out:

• A gynaecological examination
• Inspection of the cervix
• An HPV test or Pap smear where appropriate
• Colposcopy
• A biopsy if a suspicious area is found

It is the biopsy that determines whether a lesion is cancer or not.

Screening is still needed when there are no symptoms

This is the most important part of this article.

Do not wait for one of the 7 signs above before having your cervix checked.

Cervical cancer and pre-cancerous lesions can be present without yet causing symptoms. A Pap smear can detect pre-cancerous cell changes, while an HPV test looks for the high-risk HPV that can cause those changes.

When pre-cancerous lesions are found and treated appropriately, they can be prevented from progressing to cancer.

When should you see a doctor sooner?

You should book a gynaecological appointment if you have:

• Bleeding after sex
• Bleeding between periods
• Bleeding after the menopause
• Persistent unusual changes in your periods
• Blood-stained discharge or discharge with an unusual smell
• Persistent pelvic pain
• Pain during sex

These symptoms more often have benign causes than cancer, but only a proper examination and assessment can identify the cause.

Booking a women's health check on Halza

Through Halza, you can look up and book gynaecological consultations, HPV tests, Pap smears and other cervical cancer screening services at partner hospitals and clinics.

Saving your results across several check-ups also makes it easier to follow your HPV and Pap smear history and your follow-up visits.

Do not wait until your body shows clear signs before paying attention to your cervix. Early-stage cervical cancer is usually silent — which is exactly why regular screening matters.

The information in this article is for reference only and does not replace the advice, diagnosis or instructions of a doctor.

Frequently asked questions

Does early-stage cervical cancer cause symptoms?

It can, but there are often no clear symptoms.

According to the National Cancer Institute, when early-stage symptoms do appear they may include abnormal vaginal bleeding, abnormal discharge, pelvic pain or pain during sex.

Does bleeding after sex mean cervical cancer?

Not necessarily.

Bleeding after sex can be caused by cervicitis, polyps, injury to the vagina and many other conditions. However, it is also one of the symptoms recorded in cervical cancer, so if it keeps happening you should see a doctor rather than monitoring it yourself for a long time.

If you have had the HPV vaccine, do you still need screening?

Yes.

The HPV vaccine reduces the risk of infection with the main HPV types that cause cervical cancer, but it does not remove the risk completely. People who have been vaccinated should still be screened according to the appropriate guidance.

References

• National Cancer Institute – Cervical Cancer Symptoms
• CDC – Symptoms of Cervical Cancer
• American Cancer Society – Cervical Cancer Signs and Symptoms
• National Cancer Institute – Cervical Cancer Screening
• CDC – Cervical Cancer Prevention and Screening