Gynecological health guidance

Clinical data shows that 90% of common gynecological problems (inflammation, menstrual disorders, benign hyperplasia, etc.) are directly related to three common misunderstandings: "excessive cleaning, endocrine fluctuations caused by disordered work and rest, and neglect of regular screenings." As long as you avoid these pitfalls and follow standardized care and examination principles, most people do not need to be overly anxious about gynecological health.

Don’t think it’s an exaggeration. I just received a 22-year-old girl in the clinic last week. She just graduated and started working. I read online that private parts lotion can inhibit bacteria, remove odors, and prevent inflammation. She has to rinse her vagina every day after taking a shower. She is also used to wearing antibacterial pads during work days to avoid leaking secretions. As a result, she was so itchy that she couldn’t sit still. Her leucorrhea was like tofu. When I came to check the routine for leucorrhea, I found that the lactobacilli that maintain vaginal health were almost gone. Miscellaneous bacteria and mold spores were everywhere in my field of vision. Speaking of which, there must be someone who wants to criticize me. Is there really no problem with someone using lotion around me? To be objective here, some antibacterial lotions are indeed suitable for short-term use according to the doctor's advice during the treatment period of inflammation. However, the guidelines of the Obstetrics and Gynecology Branch of the Chinese Medical Association clearly state that daily vulva care only requires washing with warm running water. The microecological environment of the vagina itself is more delicate than you think. Indiscriminate washing, use of washing products with antibacterial ingredients, and long-term pads will kill all the beneficial bacteria that protect you, which is equivalent to actively opening the door to pathogenic bacteria. This is the core reason why many girls who love cleanliness suffer from vaginitis repeatedly. Oh, by the way, there is also the pink and firming gel for private parts that has become popular online recently. I just met a patient last week whose vulva was burned after using it. The pain lasted for almost a week before he dared to come to the hospital. In all likelihood, corrosive ingredients or hormones are added to these products, so don’t touch them blindly.

Many people think that gynecological problems are either caused by poor hygiene or chaotic private lives. This is really a huge prejudice. Last month I received a diagnosis from a 30-year-old Internet operator. The girl lives a very regular life and does not have a chaotic private life. She has been busy with projects for three consecutive quarters and stayed up until two or three in the morning every day. Her menstruation was delayed for more than ten days for two consecutive months. When she came for a B-ultrasound, she found a 3cm cyst on her left ovary. She cried on the spot, thinking that she needed an operation to remove the ovary. Here we have to talk about the different views of the academic community: It is true that some clinicians will recommend direct surgical resection to avoid malignant transformation when encountering ovarian cysts. However, in fact, as long as it is discovered for the first time, B-ultrasound shows no echo, clear border, and normal tumor markers, it is most likely a physiological luteal cyst. There is no need to take medicine or surgery, adjust your work and rest, do not stay up late, and the reexamination after 2-3 months of menstruation will basically eliminate it. On the contrary, taking medicine randomly and being anxious will make the hormones more disordered and the cysts will disappear more slowly. This girl later listened to my advice and handed over part of her project. She tried to go to bed before 11 o'clock every day. She also signed up for a yoga class on weekends to relax. After two months of re-examination, the cyst was indeed gone. She specially brought me a cup of milk tea, saying that she was so scared that she couldn't sleep well for half a month.

Speaking of which, I have to mention the screening question that many people tend to ignore. Don’t think, “I don’t need to check if I’m not feeling well.” Last year, a 42-year-old sister accompanied her best friend for a gynecological examination. I persuaded her to do a TCT+HPV joint screening. She also said that she usually doesn’t feel anything, so she must be fine. The result was found to be HPV16 positive, and TCT showed HSIL. (High-grade squamous intraepithelial lesion) is a precancerous lesion of the cervix. Fortunately, if it is discovered early, it can be completely cured by a cervical conization. If it is delayed for another two or three years, it is likely to develop into invasive cervical cancer. By then, not only will the uterus be removed, but it may also be life-threatening. There are currently two common misunderstandings about screening: one is that taking the nine-valent HPV vaccine eliminates the need for screening. This is completely wrong. The nine-valent HPV vaccine can only cover 9 high-risk subtypes, and there are many other subtypes that may cause disease. Therefore, even if vaccinated, women who have sex after the age of 25 still need to undergo joint screening every 3-5 years. ； The other is that the more frequent gynecological examinations are, the better. If you are in your early 20s and have no symptoms, you should have TCT every year. In fact, it is not necessary. Women who have no sexual life after the age of 25 can only have an abdominal gynecological B-ultrasound every year without excessive medical treatment.

There are also a few small details that I usually talk about in the outpatient clinic until my lips are broken. By the way, I would like to remind everyone: don’t hoard sanitary napkins for half a year and put them in the toilet. The toilet is moist and can easily breed mold. If you use them, you will easily get fungal vaginitis.； Wear less tight shark pants and low-waisted jeans. The private parts will be stuffy and airtight. When the temperature is high, the bacterial flora is easily disrupted. ； You can actually take a shower and wash your hair during menstruation, as long as you use warm water and don't catch a cold. However, if you don't pay attention to cleaning during menstruation, it is easier for bacteria to breed when menstrual blood is stuffy. Oh, by the way, there is also the question that people often ask about whether sex is allowed during menstruation. There is currently no unified conclusion in the academic community. One school of thought believes that as long as you are clean and there is no discomfort, it is OK. The other school believes that the cervix opens during menstruation, which can easily induce pelvic infection. My suggestion is to look at your personal situation. If you are prone to dysmenorrhea and have poor immunity during menstruation, don’t take this risk. As long as there is no discomfort, both parties are well cleaned, and there is no need to have too much psychological burden. There is no absolute "no".

In fact, after being an obstetrician and gynecologist for so many years, my biggest feeling is that many women's gynecological problems are not caused by diseases, but by unnecessary anxiety and wrong perceptions. Either a small inflammation will make them feel that they have an incurable disease, or they clearly have high-risk factors but never get screened, and only regret it when something goes wrong. You really don’t need to think about gynecological health too complicated. Don’t believe in messy Internet celebrity products. If you feel uncomfortable, go to a regular hospital to register an obstetrics and gynecology number. The registration fee of more than ten yuan is much more useful than searching for half a day on the Internet.