8 overlooked symptoms of cervical cancer: what women should watch for

What if your body was trying to warn you about something serious, but the signs were so subtle you missed them?

In South Africa, cervical cancer is the leading cause of cancer deaths among women aged 15 to 44, according to the National Cancer Registry.

Often called the “silent killer”, it develops slowly and can go unnoticed for years. By the time symptoms appear, the disease may already have spread, making treatment more complex.

Most cervical cancers are linked to persistent infection with high-risk types of the human papillomavirus (HPV), a very common virus transmitted mainly through sexual contact.

While most HPV infections clear naturally, some persist and cause precancerous changes in cervical cells. Left unchecked, these changes can progress to cancer.

Importantly, risk isn’t confined to sexually active women. “Given the nature of cervical cancer, women, even those who are not sexually active, should undergo screening,” says Tyron Hansen, business development manager at BioSmart.

This aligns with World Health Organisation (WHO) guidelines, which recommend regular screening for women aged 30 and older (or earlier if at higher risk), regardless of sexual history.

Why do so many women miss the warning signs?

Early cervical cancer symptoms mimic everyday health issues: irregular periods, pelvic discomfort, or fatigue. Women often normalise these signs or blame stress, hormonal changes, or lifestyle factors.

Unfortunately, this delay in recognising the signs can lead to late-stage diagnosis, when treatment becomes more challenging.

Below, we'll explore some unusual signs and symptoms of cervical cancer, why women might miss them, and why awareness is critical.

1. Unusual vaginal bleeding: Unusual bleeding is one of the earliest and most common symptoms of cervical cancer. Tumours on the cervix can cause the lining to become fragile, leading to bleeding.

Vaginal bleeding that is not related to your menstrual cycle, including bleeding after sex, between periods, or after menopause, should never be ignored.

Often, many women assume irregular bleeding is due to hormonal imbalances, stress, or birth control side effects.

2. Unexplained pelvic or back pain: Persistent pain in the lower pelvis, lower back, or even leg pain that doesn’t seem related to physical activity or injury. This type of pain is often attributed to menstrual cramps, overexertion, or conditions like endometriosis or fibroids.

Women may delay seeking help, thinking the pain is a normal part of life or will resolve on its own.

3. Changes in vaginal discharge: Cervical cancer can cause changes in discharge due to tumour growth, infections, or necrosis (tissue death). If the discharge becomes persistent, has a strong odour, or is mixed with blood, it’s a concerning sign that should not be ignored.

Many women experience changes in discharge throughout their menstrual cycle, which they may assume is harmless. Vaginal infections like bacterial vaginosis or yeast infections are common and can cause similar symptoms, so women may self-diagnose and treat at home.

4. Pain during or after sex (Dyspareunia): Women may attribute pain during intercourse or spotting afterwards to vaginal dryness, hormonal changes, or psychological factors such as stress or anxiety.

Sexual health issues may feel uncomfortable to some people when discussed with a healthcare provider.

5. Unexplained fatigue: Fatigue in cervical cancer can result from chronic inflammation, anaemia caused by prolonged bleeding, or the body’s efforts to fight the disease. If fatigue feels unrelenting and is accompanied by other symptoms (like bleeding or pain), it may be a red flag.

Persistent exhaustion that doesn’t improve with rest or sleep.

Fatigue is often dismissed as a side effect of a busy lifestyle, stress, poor sleep, or anaemia.

6. Swelling in the legs: Advanced cervical cancer can block lymphatic drainage or compress blood vessels, leading to fluid buildup in the legs. This symptom is particularly concerning if it occurs alongside pelvic pain or other signs of cervical cancer.

More often than not, swollen legs are attributed to physical strain, weight gain, or circulatory issues like varicose veins. Women may not associate leg swelling with cervical cancer.

7. Frequent urination or urinary complaints: Needing to urinate more frequently, discomfort during urination, or a sense of incomplete emptying. Urinary symptoms are commonly linked to bladder infections, dehydration, or an overactive bladder.

Women may try home remedies or over-the-counter treatments before consulting a doctor.

8. Unexplained weight loss: Cancer can cause metabolic changes that lead to unexplained weight loss. When combined with other symptoms like fatigue or unusual bleeding, it may signal a more serious underlying issue.

Unexplained weight loss is often missed because many people view weight loss as a positive change and may not consider it a symptom of illness.

And women might attribute it to stress, dieting, or increased physical activity.

Many symptoms of cervical cancer overlap with common conditions like PMS, infections, or hormonal changes. Women often normalise or self-diagnose these issues without seeking medical advice.

Talking about gynaecological health can feel uncomfortable or embarrassing, leading some women to avoid the conversation entirely.

Educational campaigns often focus on later-stage symptoms, leaving early warning signs underdiscussed.

Early detection of cervical cancer significantly improves outcomes, and the best way to catch it early is through regular Pap smears and HPV testing. If you notice any of the symptoms above, especially if they’re persistent or unusual for you, don’t ignore them. Trust your instincts, and consult a healthcare provider.

Remember: cervical cancer might be silent, but your body isn’t. Pay attention to the whispers before they turn into shouts.

“Whilst these might not always mean cancer, they do warrant a conversation with a healthcare provider.

“Unfortunately, when it comes to screening, which can identify precancerous changes and is one of the most effective forms of prevention, many women delay or avoid traditional testing altogether,” notes Hansen.