Latest gynecological health knowledge

There is no one-size-fits-all secret recipe for gynecological care. All health decisions must be based on individual physical symptoms. Priority should be paid to various rumors and "common sense" that are widely circulated. Formal clinical guidelines are always prioritized over folk remedies, popular science from internet celebrities, and the talk of beauty salons.

I just met a 28-year-old girl in the clinic last week. She saved up half a month's salary to buy an Internet celebrity private parts care kit. She washed and put a plug every day for half a month. She was so itchy that she couldn't sit still. It was found that the lactobacilli were almost completely eliminated. The imbalance of the flora caused severe vulvovaginal candidiasis (also commonly known as fungal vaginitis). When it comes to cleaning the private parts, which is the worst-hit area, different academic opinions have always existed: the conventional consensus of Western medicine is that just flushing the vulva with warm water is enough for daily cleaning. The flora in the vagina is like a balanced small ecology. Filling it with random things is equivalent to pouring sewage into the lake. When the ecology collapses, problems will naturally arise. Unless you use medicinal lotions as directed by your doctor during a vaginitis attack, do not use any "antibacterial lotions" or "private perfumes" on sensitive parts. ； Some schools of traditional Chinese medicine also mentioned that for people with damp vulva and recurring symptoms of itching, using traditional Chinese medicine to boil water for a sitz bath under the guidance of syndrome differentiation can indeed improve the local environment. The two views do not conflict. The key is not to mess around on your own.

After chatting about cleaning, I would like to mention the recent hot topic about the HPV vaccine. The latest clinical research has made it clear that the nine-valent HPV vaccine still has clear protective effect for women aged 27-45 years old. It does not mean that vaccination after the age of 26 is in vain. Of course, there are also practical disputes here: At present, some domestic centers for disease control and prevention still set the upper age limit for vaccination at 26 years old according to the drug instructions. Different regions have different implementation policies. If you can’t get an appointment with the nine-price vaccine, you don’t have to wait. The protective effect of the two-price and four-price vaccines can already cover more than 80% of high-risk HPV infections. There is no need to delay the vaccination opportunity just to wait for the nine-price vaccine. In addition, getting vaccinated does not mean entering a safe. After having sex, you still need to do a TCT+HPV combined screening every 3-5 years. I treated a 31-year-old patient last year. After taking the nine-price test, I thought everything was fine. After 6 years of no screening, it was found to be a CIN grade 2 lesion. Fortunately, it was discovered early and did not develop into cervical cancer.

The problem of "uterine cold" that many people are concerned about is also a place where the views of Chinese and Western medicine differ greatly: In the traditional Chinese medicine system, there is indeed a syndrome differentiation of uterine cold, which corresponds to symptoms such as abdominal pain during menstruation, cold hands and feet, black menstrual blood with blood clots, etc. It is indeed effective to treat it through moxibustion at the Guanyuan point, adjusting work and rest, and taking meridians-warming traditional Chinese medicine.； However, there is no concept of "uterine cold" in Western medicine. The corresponding symptoms often point to primary dysmenorrhea, poor pelvic blood circulation, endometriosis and other problems. If the pain is so severe that it affects normal life, it is absolutely fine to give priority to taking non-steroidal anti-inflammatory drugs such as ibuprofen. There is no so-called "dependence", and there is no need to endure cold sweats or even shock. A special reminder is not to buy Sanwu Warming Patch or Private Protective Gel to stick on the stomach or stuff into the vagina. Last month, I just received a patient who used the "Warming Palace Detox Pill" bought on WeChat Moments. The stuffing caused the vaginal wall to burn and ulcerate, which was a serious sin.

Oh, by the way, a patient once asked me whether taking soy isoflavones and doing ovarian massage can help maintain the ovaries. Let me just say a few words here: soy isoflavones are phytoestrogens. If you don’t have estrogen-dependent diseases (such as breast nodules and endometrial polyps), eating them in moderation can indeed relieve the symptoms of perimenstrual hot flashes. But for young women, as long as they have a normal work and rest schedule, there is no need to take extra supplements.； As for the ovarian massage that is so popular in beauty salons, it is purely IQ-the ovaries grow deep in the pelvic cavity and cannot be touched outside the abdomen under normal circumstances. The technicians pressed back and forth to either press the intestines or press hard to break the corpus luteum. Last year, a girl was rolling in pain after an ovarian massage. The emergency room examination showed that the corpus luteum was ruptured and bleeding. It cost less than 10,000 yuan to cure it. It was really a waste of money.

In fact, I have been practicing medicine for almost 10 years. My deepest feeling is that there is really no unified standard answer to gynecological health. The methods that apply to others may be a trap for you. For example, some people drink iced milk tea and their aunt is completely fine, while some people are so painful that they can’t get out of bed when they touch something cold. There is no need to impose other people’s “health standards”. There is another misunderstanding that many people are embarrassed to say: You can get gynecological diseases even if you don’t have sex. Problems such as polycystic ovary syndrome and ovarian cysts have nothing to do with whether you have sex. If your aunt doesn’t come for two or three months and you have inexplicable pain in your lower abdomen, don’t be embarrassed to see a gynecologist. Nowadays, there are examination methods such as transabdominal ultrasound and anal ultrasound, which will not damage the hymen at all. Don’t wait until the problem becomes serious before you come to see a doctor. Finally, I would like to say something to you. It’s been hot lately. Don’t wear tight jeans or chemical fiber underwear every day. They are stuffy and can easily cause problems. Don’t think I’m verbose.