ervical cancers effects around 13,000 women each year in the U.S. and just over 4,200 women passed away from the disease in 2017 alone. Fortunately, cervical cancer is highly preventable thanks to the human papillomavirus (HPV) vaccine. HPV is an extremely common virus that is transmitted through direct sexual contact. In addition to HPV, causes of cervical cancer include:

• Smoking
• Multiple sexual partners
• Contraceptive use
• History of sexual transmitted infections (STI)
• Having multiple children
• HIV
• Organ transplant

Thanks to the Pap Smear test and the Gardasil 9 vaccine, the death rate from cervical cancer has decreased by more than 50 percent over the past 40 years. Cervical cancer does not typically cause noticeable symptoms in its early stages. Once the cancer is more advanced, women may start to experience the following warning signs of cervical cancer:

1. Abnormal Vaginal Bleeding

The most common cervical cancer warning is abnormal vaginal bleeding. This typically occurs after the cancer has spread to nearby tissue. Although spotting can be harmless, it’s important to see your doctor if you experience bleeding between menstrual periods, heavier or longer menstrual periods, bleeding after sex,  menopause, or a pelvic exam, or bleeding resulting in anemia-causing fatigue.

2. Fatigue

We all experience fatigue sometimes, but when should you start paying closer attention to it? Cancer patients often describe feeling tired, exhausted, lethargic or weak, and having little drive to participate in activities. For those suffering from fatigue, even the simplest tasks can seem draining. The more advanced the cancer, the more likely you are to experience fatigue.

3. Loss of Appetite or Unexplained Weight Loss

As with many other types of cancer, loss of appetite or unexplained weight loss are warning signs of cervical cancer. This can be especially evident if the weight loss persists regardless of your food consumption.

4. Foul Smelling Vaginal Discharge

This warning sign is also very common with the onset of cervical cancer. If cervical cancer lacks oxygen, some cells may die off, infecting the tumor. The infection is what creates a foul-smelling vaginal discharge. If the discharge is continuous and appears to be pale, watery, brown, or mixed with blood, you should contact your doctor.

5. Pain During Sexual Intercourse

Pain during sexual intercourse can occur in women with advanced cervical cancer. The tumor growth throughout the tissues and reproductive organs is what causes this pain and if experienced, should not be ignored.

6. Lower Back, Pelvic or Appendix Pain

Lower back or pelvic pain can be linked to issues with the reproductive organs, such as the cervix. Pelvic pain, especially pain that is continuous, is a tell-tale warning sign of cervical cancer. Pain near the appendix does not usually occur unless the cancer is in an advanced stage. Pelvic pain will generally follow other cervical cancer red flags.

7. Leg Pain

As the cancer progresses and reaches more advanced stages, it can start to press against nerves in the pelvic wall, resulting in leg pain and swelling. Swelling accompanied by leg pain could be a warning sign of cervical cancer, however on their own could be symptoms of various medical issues.