What Is a Silver Nitrate Treatment and Why Is It Going on My Cervix?
"You're putting what on where?" I thought after I first heard of a silver nitrate treatment—an intense-sounding solution to some minimal bleeding on my cervix seen during a regular Pap screening. My doctor gave me a half-assed explanation of why I was receiving the treatment and left me in the dark as to what was going on below the belt. I wouldn't find out until later that it was because of lesions from HPV.
When the treatment was applied to my cervix, a sudden warm sensation began to wash over me until I was profusely sweating and light-headed. When I was instructed to sit up, I immediately slumped over and passed out in my gynecologist's office.
This was more than 10 years ago, and Googling this treatment wasn't as easy as it is now. So when I did rush home to my desktop computer, the answers I found on forums were slim. Now, a quick Reddit search will show that I'm not alone, but that it's also not a monolithic experience. User u/mimined wrote six months ago, "I was not feeling well after the procedure and barely remember anything that the doctor said after that." I, too, experienced a blurry recollection of my doctor's words before I collapsed in the chair.
Since roughly the 13th century, silver nitrate—an inorganic chemical—has been used as a cauterizing agent to target wounded areas and obstruct vessels (i.e., stanch the bleeding). Carolle Jean-Murat, M.D., an OB-GYN from San Diego, said that bleeding of the cervix is usually asymptomatic and can be found during a routine Pap smear. She added that cervical bleeding, on some occasions, "may cause increased vaginal discharge and spotting after intercourse, necessitating an intervention."
A common reason for bleeding of the cervix is a condition called cervical ectropion, which is when glandular cells that line the inside of this part of the body spread to the outside and can cause abnormal bleeding. The condition isn't harmful and most people are asymptomatic. Other reasons for cervical bleeding include STIs, warts or lesions, and infection from a surgical procedure or after a biopsy. In my situation, I had lesions on my cervix from HPV—something I wasn't even aware I had contracted—and my doctor went ahead and treated the lesions with silver nitrate without giving me any warning.
During a cauterization, the doctor uses a silver nitrate stick that is "the size of a long wooden match," with no anesthesia, explained Jean-Murat. With silver nitrate and potassium nitrate on the tip of the stick, this match-like instrument is placed on the area of the cervix that needs to be treated. The compounds are activated when they contact moisture.
Patients may experience slight discomfort a few hours after their cautery—similar to period pain—according to the Northern Lincolnshire and Goole Foundation Trust. For most people, the cautery will sting "like a mosquito bite," said Jean-Murat, "and the patient will observe a brownish vaginal discharge for a few days, requiring a panty liner." My experience, however, was more like a bee sting, including heavy cramping that prevented me from being able to sit up or stand for a good hour after the application. For days afterward, I felt soreness in my pelvic area and spent most of my time lying in bed recovering.
The good news is that silver nitrate cauterization is usually harmless. Long-term side effects don't include pregnancy issues or adverse effects on the cervix.
The scab on the cervix from the cautery will fall off after around 10 to 14 days, which may cause some additional light bleeding. I had light bleeding for two weeks following my cautery.
Amy, 34, an aesthetician from Knoxville, Tennessee, recalled her cautery last year as "very confusing." She said, "After I was diagnosed with HPV, I went in for a checkup to make sure it had cleared up. During the screening, I felt light-headed and sick to my stomach. After my doctor was done, she said they applied a treatment." Amy was furious that her doctor didn't allow her to consent to the procedure first. "I still really don't understand what the procedure or the treatment is. They explained it to me when I was light-headed and dizzy, so all I wanted to do was have my boyfriend take me home."
Over the next few days, Amy tried Googling for answers but found nothing substantial. "I didn't know if it would affect any future pregnancies, how long it would take to heal, if I should work out—I didn't know anything about it," she explained. Like Amy, I was confused and terrified of having an invasive treatment without properly understanding the side effects.
The good news is that silver nitrate cauterization is usually harmless. Long-term side effects don't include pregnancy issues or adverse effects on the cervix. However, some precautions have to be taken while healing. Tampons should not be used for two months after cautery to avoid infection. Since the cervix is healing, it's necessary to avoid sex for four weeks or until the discharge has stopped.
However, my experience, along with Amy's, is not a universal reaction. Many patients have few, if any, side effects and can carry on with their day with no additional concerns—everyone's body, and cervix, is unique.
New York—based editorial assistant Lauren, 22, said her experience was mostly painless. "I didn't know I was going in for a cauterization, but I didn't have many side effects that bothered or impacted me in a negative way," she explained. After the silver nitrate was applied, Lauren felt some slight cramping but was able to carry on with her day normally. "I had some bleeding that wouldn't stop after my IUD insertion. When I went in, they explained they were applying a generic treatment. It was a pretty easy experience." Afterward, Lauren said, discharge was minimal and she was able to heal within a week.
If the discharge after your cauterization lasts more than six weeks, or if heavy bleeding continues, chat with a doctor to make sure there isn't an infection. The majority of the time, cauterization is safe and effective, but if the bleeding is persistent, a doctor may have to repeat the treatment.
Any abnormal bleeding can leave room for worry—especially after a medical procedure like a biopsy or a reaction to an STI like HPV. Even though my body reacted negatively to the application of the treatment, side effects beyond the initial exposure have been nonexistent. So, if your doctor mentions the chemical treatment next time you're in the stirrups, know that you're in good company. If your doctor mentions silver nitrate—or any other unfamiliar procedure—don't hesitate to ask questions about what this means and how it can impact your body. If a procedure is performed without your knowledge, you are within your rights to complain. Having full transparency and understanding can create a better visit and a healthier relationship with your doctor.
"Afterward, I realized silver nitrate is something that a few of my friends have experienced," Lauren said. "My trust in my doctor and their choice of treatment helped calm my nerves. And now, I don't have to deal with bothersome bleeding anymore."