100 popular science knowledge about gynecological health

HPV infection ≠ cervical cancer, pelvic effusion is mostly a physiological phenomenon, cervical erosion is not a disease, routine gynecological examination once a year is enough, private parts do not need to be washed every day, ibuprofen is more effective than drinking hot water for dysmenorrhea, the contraceptive failure rate is as high as 30% during the safe period, most uterine fibroids do not need to be cut, yellow leucorrhea is not necessarily inflammation, and low menstrual flow is normal as long as it is more than 20ml. These 10 sentences are what I have said at least 20 times a day during my 12 years of outpatient service, covering 80% of patient consultations. We will talk about the remaining details slowly.

I just received a 22-year-old girl last week. She cried for almost half an hour at the door of the clinic with the physical examination report. She said that the doctor at the private hospital told her that the cervical erosion was 2 degrees and that if she delayed, it would become cancerous. She wanted her to undergo LEEP surgery immediately, which would cost more than 8,000 yuan. I took her report and looked at it. TCT and HPV were all negative, and there was no inflammation. It was just normal cervical columnar epithelial ectopia - what everyone used to call "cervical erosion". It was deleted from the list of gynecological diseases in 2008. It's a disease. When the estrogen level is high, the columnar epithelium in the cervix grows to the outside and looks red and rotten. When the estrogen level decreases as you get older, it will go back on its own. It has nothing to do with whether your private life is chaotic or whether it will become cancerous. I gave her a health education sheet worth 0 yuan and asked her to do whatever she wanted to do when she got home. The girl was stunned for a long time and said that she had bought more than 2,000 sterilizing pills before and asked me if she wanted to throw them away. I said that if you throw them away and feel bad, just use them as a placebo.

Oh, by the way, speaking of being cheated, the first reaction of many people when they find out they are HPV positive is that the sky is falling. Are they going to get cervical cancer soon? Not really. 80% of women with normal immunity will be infected with HPV once in their lifetime, and most of them will be cleared by their own immune system within 1-2 years. Only those who are continuously infected with the same high-risk HPV for more than 12 months will have the risk of cancer. Various "HPV negative conversion drugs" and "anti-HPV interferons" currently on the market have actually been controversial in academic circles: the mainstream view is that the effect of these drugs is not much different from placebos. What is really useful is not to stay up late, exercise more, maintain a regular schedule, and rely on immunity to clear the virus. ； Some doctors also believe that using some interferon can at least give patients psychological comfort and prevent excessive anxiety from affecting immunity. As long as you don't spend tens of thousands of dollars on the "magic medicine" sold by micro-businesses, there is no harm in using it. My general advice to patients is that if you don’t have money, you can use it. If money is tight, use the money you spend on interferon to get a fitness card, and the effect will be better.

Another question that has been asked a lot recently is whether vaginal probiotics are an IQ tax? This also depends on the situation. If bacterial or fungal vaginitis has been diagnosed, the first thing to do is to use symptomatic antibiotics or antifungal drugs. Probiotics alone cannot cure vaginitis at all. Those who say that vaginitis can be cured without drugs and only probiotics are basically deceptive. However, microecological research in recent years has indeed found that for patients with recurrent vaginitis who relapse more than 4 times a year, after standard medication, 1-2 courses of vaginal lactobacilli with national drug approval can reduce the recurrence rate by about 40%, which is a useful auxiliary method. But please note that what I am talking about is vaginal medicine approved by the National Drug Administration, not the oral probiotics or the private parts care gel sold by WeChat merchants. Those that are eaten enter the digestive tract and cannot reach the vagina at all. It is purely IQ tax.

Let me tell you from my personal experience, the number of patients with vaginitis in outpatient clinics can double in summer. Most of them are caused by wearing tight shark pants and ice silk safety pants. When I was working a 24-hour shift, I was so busy that I didn’t even have time to drink water. I sat for eight or nine hours, and I also suffered from vulva itching. In this case, I really don’t need to take medicine and antibiotics when I go home. I change into loose cotton underwear for two days when I go home. I rinse my vulva with warm water before going to bed. Don’t use lotion or pads. It will be basically cured in two days. Oh, by the way, when washing, just wash the vulva. Don't blindly reach into the vagina and wash it. The vagina itself has a self-purifying function. If you wash it back and forth, you will wash away the normal flora, which will make you more likely to get sick.

Many young girls think that gynecological examinations are only done by those who are married and have sexual intercourse. This is not true. Last month, we admitted a 19-year-old patient who had no sex life and suffered from stomach pain for half a month. He took painkillers at home to endure the pain. Finally, he fainted from the pain and was sent here. It was found that the ovarian cyst had torsion of the pedicle and almost cut off one ovary. Even if you have not had sex, if you have persistent lower abdominal pain, missed menstruation for more than 2 months, unbearable itching of the vulva, and menstrual flow so light that even half a sanitary napkin is wet, you can definitely come for a gynecological examination. We have transabdominal B-ultrasound, and there are also ways to check vaginal secretions without going through the vagina. There is no need to be shy, and there is no need to hold on.

There is another misunderstanding I must say, don’t blindly search for your own symptoms. Last time, there was a 30-year-old patient who had abdominal pain during ovulation and said she had late-stage ovarian cancer. She cried at home for three days and couldn't eat. She came to my place and spent 15 yuan to register. She had a B-ultrasound and nothing happened. She left happily. Really, there is a mixed bag of information on the Internet, and many of them are deliberately written to scare people in order to sell medicine. If you feel uncomfortable, go to a regular hospital to register, which is 100 times better than trying to figure it out at home.

Oh, by the way, I will add a few more details to the 10 core points I just mentioned: If the amount of pelvic effusion is less than 3cm and there is no other discomfort, no treatment is needed at all. A small amount of effusion will occur during ovulation and menstruation, which is normal.； As long as the uterine fibroids do not exceed 5cm, and there are no symptoms of menorrhagia or abdominal pain, a review once every six months will be enough. They will shrink by themselves after menopause. ； Both safe periods and in vitro ejaculation are the most unreliable methods of contraception. The failure rate can reach 30%. Either wear a condom or take short-acting contraceptive pills. Don’t make fun of your body. ； If the yellowish leucorrhea does not itch or smell, it is probably due to drinking less water or getting angry. Drinking more water will help, and there is no need to take anti-inflammatory drugs.

This is the first of 100 popular articles on gynecological health. I will slowly update the questions that people ask the most later, such as the side effects of short-acting contraceptive pills, whether polycystic cysts should be treated, and how to deal with various discomforts during pregnancy. If you have any questions, you can leave a comment. I will give priority to the most frequent ones.