Latest gynecological health knowledge

There is no standard template for gynecological health. All "symptom matching" that is divorced from individual circumstances is pseudo-science. Excessive anxiety and unauthorized medication are more harmful than "minor abnormalities".

Don't believe it, I went out to the outpatient clinic last week and met three patients in one morning who had caused problems by themselves. The most exaggerated thing is that a 22-year-old girl who just graduated came across a short video saying that "yellow leucorrhea is vaginitis." She secretly bought lotion and suppositories and stuffed them for a week. Originally, her secretions turned slightly yellow due to eating hot pot and drinking too little water for three days, which suddenly messed up the vaginal flora. She was so itchy that she couldn't sit still before she came to register. After checking the leucorrhea, there were no pathogenic bacteria. After stopping the medicine and drinking more water, she was fine within two days.

Let’s first talk about the HPV infection issue that everyone is most anxious about. In the past two years, too much science popularization has been done, but a new problem of “HPV panic” has emerged. It is now clear that 90% of HPV infections are transient, and people with normal immunity can clear it on their own in an average of 8-10 months. There is no need to cry and think that you are going to get cervical cancer as soon as you are tested positive. As for the screening program, there are currently two different suggestions in the academic community: one group believes that women under 25 years old do not need to check for HPV separately. The probability of transient infection in this age group is too high, and detection will only increase anxiety. Only TCT screening is enough. ； The other group believes that if you have multiple sexual partners, immune deficiency and other high-risk factors, you can start joint screening as early as the age of 21. Both opinions are supported by large sample clinical data, and you can make a choice based on your own living situation and communicate with your doctor. Last month, a 30-year-old patient was found to be HPV16 positive. She cried in the clinic for half an hour while holding the report. She had a colposcopy biopsy and there was no problem at all. I told her not to stay up late and exercise more. After half a year, the reexamination turned negative. You see, mentality is sometimes more effective than taking medicine.

After talking about HPV, let’s talk about the private parts care that everyone asks about most. In the past, we always said “you should never douche the vagina.” Now the latest consensus is actually more flexible: you really don’t need to douche in a healthy state. The vaginal flora is like the property in the community. It can maintain a good balance by itself. If you wash it with water or lotion, it is equivalent to driving away the real property, and pathogenic bacteria will naturally take advantage of it. But if you have been diagnosed with vaginitis and the doctor prescribes a medical rinse, it is absolutely fine to follow the doctor's instructions for short-term use. There is no need to stick to the rigid rule of "never flush". As for whether private parts care solution can be used, there is no standard answer: If you don’t feel uncomfortable, washing your vulva with warm water every day is enough. ； If you tend to sweat in the summer, or you always feel stuffy and smelly during menstruation, it is perfectly fine to choose a regular medical-grade weakly acidic care solution to wash your vulva occasionally. You don’t need to kill all care products with one stick. There is a nurse sister next to me who likes to use mild care solutions. She has used it for five or six years without any problems. On the contrary, there is a girl who rubs her vulva with alkaline shower gel every day, and she came to see a doctor after she developed vulvitis.

There are still many girls who compare themselves with the "standard menstrual chart" online and feel that their menstruation is irregular after one or two days. In fact, the latest guidelines have already relaxed the standards: as long as your menstrual cycle is stable between 21-35 days, every 3-7 days, and the bleeding volume is 20-60ml (about the amount of soaking 1-3 daily sanitary napkins), it is completely normal, and there is no need to insist on a "perfect cycle" of 28 days. As for whether you should take painkillers for dysmenorrhea, you don’t have to listen to the elders who say you are dependent on them. The current clinical consensus is that as long as there are no contraindications such as peptic ulcers and severe liver and kidney dysfunction, taking NSAIDs such as ibuprofen during dysmenorrhea will not only prevent addiction, but also avoid the risk of pelvic congestion caused by long-term pain. It is much better than sweating profusely in pain and being unable to go to work.

Oh, by the way, there are also "ovarian maintenance" and "pelvic repair" that have been asked a lot recently. Let me reiterate: they are all IQ taxes. The ovaries are deep in the pelvic cavity and cannot be touched by pressing on the belly for a long time. The so-called essential oil massage either rubs the fat on your belly, or is an inferior product with added estrogen, which may disrupt your endocrine system. As for postpartum pelvic repair, most people's pelvic floor muscles can recover on their own half a year after giving birth. At most, they can do Kegel exercises. If you really have a problem with pelvic floor muscle relaxation, going to a regular hospital for pelvic floor rehabilitation is much more reliable than repair packages that cost tens of thousands of dollars from outside institutions.

In fact, during the ten years I have been working as a clinician, my biggest feeling is that many women’s gynecological problems are not “diseases” but are frightened by fragmented popular science on the Internet. If you apply other people's symptoms to your own, if they are a little different, you will panic. You will buy medicines and do projects blindly, which will cause problems to your good body. If you really feel uncomfortable, go to a regular hospital to register. The registration fee of more than ten yuan is much more effective than spending a night reading popular science and guessing. After all, your body and your own feelings are the most accurate reference standards.