What's that? You've never given much thought to your cervical height? Is it high? Is it low? Does it change? POPSUGAR asked Nicole Sparks, MD, an ob-gyn and ambassador for The Hello Cup, to shed some light on what we need to know about our cervix.
What and Where Is the Cervix?
In case you didn't know what your cervix was in the first place, it's a firm cylindrical piece of tissue located at the top of your vagina, just below the base of your uterus — it connects the two. The opening of the cervix, known as the external os, resembles the shape of a tiny doughnut. You may have heard of the cervix in relation to giving birth, that it dilates to 10 centimetres in order for the baby's head to pass from the uterus, through the vagina, and out into the world. The cervix will also open slightly when you have your period, so your flow can pass through, which explains why you may feel some cramping.
You can have a low, high, or average-height cervix. Dr. Sparks explained that a low cervix means that your cervix sits lower in the vagina, and a high cervix means that your cervix is higher in the vagina. It's normal for your cervical height and position to change throughout your menstrual cycle, and it's unique to each person, she said.
How Can I Tell If I Have a Low or High Cervix?
You can measure the height of your cervix by checking for yourself. While you have your period, wash your hands then insert your index or middle finger into your vagina to feel for your cervix — it feels soft and round like the tip of your nose. Note how far your finger is inside, pull out your finger, and measure this length with a ruler. You have a high cervix if the length is 55 millimetres (2.25 inches) or higher. Your cervix is average height if the length is between 45 millimetres (1.8 inches) and 55 millimetres (2.25 inches). If the distance is 44 millimetres (1.6 inches) or lower, you have a low cervix.
How Does Cervix Height Change in Regards to Your Menstrual Cycle?
"The position, anatomy, and texture of your cervix will change depending on where you are in your menstrual cycle," said Dr. Sparks. This is necessary to prevent the passage of sperm and also to facilitate shedding of the endometrial lining (when you have your period).
During your period, your cervix is normally low and hard, and slightly open to allow the blood to flow out. At the end of your period, your cervix remains low and hard and the opening to the uterus remains closed. The cervix is usually thick and impenetrable to sperm until right around the time of ovulation.
As you approach ovulation, which is almost halfway through your cycle, and the time when you are most likely to get pregnant, Dr. Sparks explained that the hormone oestrogen increases and the cervix rises up to the top of the vagina. It becomes softer and moister, and the opening to the cervix will also open to allow sperm to enter. You may notice an increase in cervical fluid when you ovulate, which looks and feels like egg whites. This helps the sperm swim up the vaginal canal and through your cervix to your egg.
Does Cervix Height Change With Pregnancy, Birth, or Multiple Births?
Dr. Sparks explained that one cause of having a permanently lower cervix is if you experience a uterine prolapse, which is when the uterus descends beyond the vaginal walls. Risk factors include weakening pelvic-floor muscles due to getting older, high weight, family history, smoking, straining from constipation, heavy weightlifting, hernias, and having multiple children. Other childbirth-related risk factors for prolapse include having a baby with a high birth weight and experiencing a prolonged second stage of labour, when the patient is pushing. Many notice a lower cervix or prolapse after having multiple children.
How Does Cervix Height Affect Use of Menstrual Cups, Discs, or Tampons?
If your cervix is high, you can use whatever size or length menstrual cup, disc, or tampon that's comfortable for you. For people who have uterine prolapse, which would mean a lower cervix, as far as menstrual cups go, they may find benefit from using one that's shorter or one that has a shorter stem. Or try this one from The Hello Cup made specifically for those with a low cervix. It has no stem, so it doesn't hang outside the vagina.
If you have a low cervix and tampon insertion is difficult, or they tend to slip out, menstrual discs may also be a great option, as they sit just below the cervix. If you have questions or issues regarding your cervix or your period in general, it's best to talk to your healthcare provider or gynaecologist.