reproductive health content

It is by no means "fertility-related content" only for people preparing for pregnancy, but a universal health issue covering all age groups and all genders, including physiological status, psychological cognition, and social adaptation, and is directly related to everyone's quality of life.

I have been working in clinical obstetrics and gynecology for almost 8 years, and I have seen too many people take detours due to cognitive biases. I just received a 22-year-old girl last week. She had bloodshot eyes for two days during her ovulation period. She hid at home and cried for half the night. After searching on Baidu, she felt that she either had cancer or an "unclean disease." There was also a 38-year-old man who was consulted by a friend. He had been trying to get pregnant for two years without success. He refused to do a semen routine. He felt that having an andrology examination was "admitting that he was not good". In the end, it was found that he was only mildly weak in sperm. He took medicine for two months and the condition was cured. He had endured more than a year of psychological stress in vain.

When talking about this, some people may say, I don’t plan to have children in my life, so do I not have to worry about reproductive health? To be honest, when I was working as a missionary in the community, at least half of the young people who had just graduated had asked this question. In fact, there have always been two mainstream perceptions here: one is a more traditional view, which believes that reproductive health services are only for childbearing. Premarital check-ups, pre-pregnancy check-ups, and pregnancy tests are enough, and there is no need to worry about it at other times. This view actually has a very clear historical background. In the past, medical resources were limited, and giving priority to childbearing-related needs was the optimal solution. However, now it cannot keep up with everyone's requirements for quality of life. The other category is the concept of "whole life cycle reproductive health" that is currently promoted in the global public health field. It covers everything from confusion about the sexual development of adolescent children, contraception and sexually transmitted disease prevention for young people, dysmenorrhea and prostate discomfort in middle-aged people, to postmenopausal bleeding in middle-aged and elderly women, and the risk of prostate hyperplasia in men. All are covered by reproductive health.

Don't laugh, many middle-aged and elderly friends have more misunderstandings about this matter than young people. Last month, a 62-year-old aunt was brought here by her daughter. She had postmenopausal bleeding for three months. She thought she was "rejuvenating her body," but she was embarrassed to tell her family that by the time she came to be diagnosed, it was already early stage of endometrial cancer. Fortunately, it had not metastasized yet, and the prognosis was pretty good. There is also a 58-year-old uncle who had frequent and urgent urination for almost half a year. He thought it was a "normal phenomenon in old age." The prostate-specific antigen (PSA) level was found to be excessive. Fortunately, subsequent punctures eliminated the risk of malignancy, and the symptoms were quickly relieved after taking medicine. Speaking of which, PSA screening has been a controversial topic in recent years. In the past few years, Europe and the United States were still recommending annual screening for men over 50 years old. Later, a large sample study found that excessive screening will lead to many unnecessary puncture biopsies and reduce the quality of life. The current consensus in the industry does not say that it is necessary to check or not to check. Generally, it is recommended that everyone should take into account their family history and whether they have symptoms of abnormal urination, and then make a decision after communicating with the doctor. There is no need to compete with a "standard answer".

There is also the issue of the HPV vaccine that has been particularly hotly debated on the Internet. Many people say that "if you don't get the vaccine at the nine-price point, it means the vaccine is in vain." Others say that "if you get the vaccine, you don't need to do cervical cancer screening." Both of these opinions are quite extreme. In fact, WHO guidelines have always said that as long as you are within the appropriate age range, you should get whatever vaccine you can get. The bivalent vaccine covers the most risky HPV types 16 and 18, and can prevent more than 80% of cervical cancer. There is no need to wait for three or four years for the nine-price vaccine, but miss the best opportunity for vaccination. As for screening, it is indispensable. After all, the vaccine cannot cover all high-risk subtypes. Regular TCT+HPV combined screening is the most reliable protection.

People often ask in the clinic whether long-term use of condoms will destroy the vaginal flora? There is no absolute right or wrong in this statement. We have compiled clinical data and found that the incidence of reproductive tract infections among people who have regular sexual partners and use regular and qualified latex condoms is 37% lower than those who rely on emergency contraceptive pills and safe-period contraception. However, if you have sensitive skin and do experience itching or abnormal discharge after using it, you can just change to a polyurethane condom, or ask a doctor to evaluate and switch to other contraceptive methods. You don't have to listen to others who say "condoms are the best method of contraception".

Also, everyone has heard from their elders since they were young, "Just give birth to a child for dysmenorrhea and it will be fine." It is really not a universal formula. If there is no organic disease in primary dysmenorrhea, the cervix will relax after giving birth and the menstrual blood will be discharged more smoothly, which may indeed relieve it. ； However, if endometriosis and adenomyosis cause secondary dysmenorrhea, let alone giving birth, the disease will become more serious the longer it is delayed, which may affect fertility. There was a 29-year-old patient who had been suffering from pain for 10 years and believed this sentence. He planned to get pregnant before he came for a check-up. The adenomyosis lesions had grown very large. He had to undergo intervention for half a year before he could successfully conceive. He suffered a lot for nothing.

In fact, after all is said and done, reproductive health is not a topic that cannot be brought to the forefront, and there are not so many black and white rules. You don’t need to feel ashamed because you have a minor problem with your private parts, and you don’t need to scare yourself with the fragmented information on the Internet. If you really feel uncomfortable, it is much more reliable to go to a specialist in a regular hospital than to listen to the "experience talk" of relatives and friends - after all, your body is yours, and living comfortably is more important than anything else.