Latest gynecological health knowledge

Don't believe in the anxiety created by pseudo-popular science. Nursing care follows the principle of "less intervention is better than fussing around". All diagnosis and treatment plans give priority to individualized conditions. There is no unified "standard answer".

I just met a 23-year-old girl in the clinic last week. I saw a blogger on a certain platform who said that "yellow leucorrhea is vaginitis." I secretly bought lotion and suppositories and stuffed them for a week. Originally, the yellow leucorrhea was caused by not drinking enough water, which destroyed the vaginal flora. When I came, I was so itchy that I couldn't sit still. To be honest, many people’s understanding of gynecological health is still stuck in the pseudo-science of ten years ago, and they even take the “nursing care concepts” promoted by many commercial organizations as the truth, which in turn creates problems.

Speaking of which, I have to mention the pitfalls of private parts care that everyone is most likely to step into. The private parts care guidelines just updated by the China Maternal and Child Health Association in 2024 clearly state that only washing the vulva with warm water is enough for daily cleaning. Regardless of whether there is inflammation or not, it is not recommended to do vaginal douching by yourself. However, many beauty institutions on the market have been promoting "private deep cleansing and detoxification care" projects. In clinical practice, we encounter two or three patients every month who suffer from fungal vaginitis and contact dermatitis after undergoing such projects. To put it bluntly, forced washing destroys the acidic microenvironment of the vagina itself. The barrier that can fight against bacteria is removed by your own hands, and instead makes way for pathogenic bacteria.

As common as this misunderstanding is everyone's excessive panic about HPV infection. A while ago, a 30-year-old female patient came over with a physical examination report. She cried as soon as she entered the door and said that she had found out that she was HPV16 positive and whether she would soon get cervical cancer and need a hysterectomy. In fact, it has long been clear: 80% of women with normal immunity will be infected with HPV at least once in their lives, and more than 90% of them can be cleared by their own immunity within 1-2 years, so there is no need to be overly nervous. There are indeed two different clinical ideas for the treatment of HPV positivity: one is to use interferon and local immunomodulatory drugs to assist in negative conversion, and the other is to strictly follow evidence-based medical evidence, believing that as long as there are no abnormalities in TCT/colposcopy, even if it is a high-risk positive, only 6-12 months of follow-up is required, without additional medication. Both views are supported by their own clinical data. You can choose according to your own needs and the doctor's advice, without worrying about which one is "right".

Oh, by the way, there is another question that people ask a lot: What is normal for menstruation? Some people have always said before that "menstruation must come once every 30 days. Delayed and early periods are due to endocrine disorders, and small amounts are due to poor detoxification." In fact, the latest obstetrics and gynecology guidelines clearly indicate that the menstrual cycle is between 21-35 days, each fluctuation does not exceed 7 days, the menstrual period is 3-7 days, and the bleeding volume is between 20-60ml, all of which are within the normal range. My college classmate is 28 years old. Her menstrual cycle has been 33 days since she was a child. Every time it was delayed by two or three days, she panicked. She bought motherwort granules and drank them. One time, she fainted and was sent to the emergency room for heavy menstrual flow. All six hormone tests were normal, and she was just messing around. As for questions like "Will drinking ice cause menstrual cramps?" and "Can I wash my hair during menstruation?" there is really no unified answer. If you drink ice, just drink it if you don't feel uncomfortable, and wash your head if it doesn't give you a headache. Your feelings are more important than all "uniform rules."

There are still many people who are so scared that they need surgery when they detect uterine fibroids or breast nodules. The current thinking of diagnosis and treatment has long changed: if there is no need to prepare for pregnancy for uterine fibroids that are asymptomatic and less than 5cm, annual follow-up observation is enough. There is no need to take medicine or surgery. Women who are about to undergo menopause will even shrink on their own as estrogen levels drop. As for whether to take traditional Chinese medicine to activate blood circulation and remove blood stasis, there is indeed a difference in the views of traditional Chinese medicine and western medicine. Traditional Chinese medicine believes that symptomatic medication can delay the growth of fibroids, while western medicine believes that there is no clear evidence-based evidence to support that medicine can eliminate fibroids. Everyone can choose according to their own situation, and there is no need to compete.

As for the details of daily care that everyone is concerned about, they are not that particular: just wash the underwear with ordinary laundry detergent and dry it thoroughly. When you are not sick, there is no need to boil water or soak in disinfectant solution. On the contrary, the residual disinfectant may irritate the vulva mucosa.； As long as the sanitary napkin is of a regular brand and is non-allergenic, you don’t need to listen to other people’s advice about which brand is better and change it frequently, let alone believe that so-called “medicated sanitary napkins” can cure inflammation. ； It is enough for women who are not sexually active to have an abdominal B-ultrasound every year. There is no need for a vaginal ultrasound or cervical cancer screening. For those who are sexually active, a TCT every 3 years before the age of 30 is enough. After the age of 30, a TCT+HPV combined screening every 5 years is enough. If you don’t need to check every year, it will easily lead to over-medical treatment.

In fact, to put it bluntly, gynecological health is really not that mysterious. The body itself has a very strong ability to self-purify and regulate. It will be more effective than any health products and care solutions if you don’t fiddle around with it, use less pseudo-science that creates anxiety, and don’t label yourself as a “gynecological disease”. If you really feel uncomfortable, go to a regular hospital to see a doctor. Don’t sentence yourself to death after searching Baidu. It’s really unnecessary.