Gynecological health career

At present, the core development direction of my country's gynecological health industry is not only to improve the diagnosis and treatment of gynecological diseases, but also to build an inclusive service system that covers women of all ages and runs through the entire cycle of prevention, science popularization, diagnosis and treatment, and follow-up. At the same time, it also breaks the social stigma attached to gynecological problems, so that every woman can obtain standardized and accessible health services without burden.

I spent three weeks at a community free clinic on the outskirts of the city recently, and I felt deeply about this. The people I met had all kinds of situations: a little girl who had just entered her second year of high school had irregular menstruation and was afraid to come for half a year. She was afraid that her mother would scold her for eating indiscriminately, and she was even more afraid of the doctor asking her if she had sex. ； Aunt Zhang, who is nearly 60 years old, has been bleeding after menopause for almost a year. She thought it was "rejuvenation". If the neighborhood committee hadn't knocked on her door and urged her to get free cancer screening, she would have tried to carry it out at home. ； There was also Sister Li who was delivering goods in the same city. She hesitated for half an hour at the free clinic stall with her medical insurance card before speaking. She said that her vulva had been itching for almost two months. She bought more than 300 yuan of "Private Parts Care Essence" in the live broadcast room. The more she used it, the more painful it became. She was afraid of spending money in the hospital and was also afraid of being laughed at by people around her for saying "she has an unclean disease."

In fact, there is no unified standard answer in the industry on how to promote this matter. Friends who work in public health always complain to me that the government sets coverage targets for two cancer screenings every year, but many people have not changed their minds and are unwilling to come even after being persuaded to go home. The pressure of the assessment is so great that they lose their hair. ； A friend who works as a high-end private maternity and child care provider also said that many women with good incomes don't care about spending more money now. They just want to find a place where they don't have to queue up and no one will disturb them as soon as the clinic door is closed. Even the consultation can be made in the evening without asking for leave. The demand gap for this kind of personalized service is actually very large. ； Even colleagues who do science popularization are divided into two groups. One group thinks that gynecological science popularization must be hard-core, and all data must be supported by SCI literature, and no down-to-earth jokes can be made, otherwise it will be imprecise and attract traffic. The other group thinks that even ordinary girls cannot understand what you write, so what is the use of publishing it in core journals? It is better to use the analogy of "high-risk HPV types are like bad guys who can cause big troubles, while low-risk types are just petty thefts at best." Even if it is a bit crude, as long as everyone can listen to it and remember it, it will be useful science popularization.

I personally feel that this matter should be let a hundred flowers bloom, and there is no need to argue about right and wrong. Last time I was explaining HPV screening to the aunts in the community. I started with a PPT and said that types 16 and 18 are high-risk subtypes and that continued infection may cause cervical cancer. All the aunts in the audience lowered their heads and watched short videos. Later I changed my statement: "These viruses are just like the bad guys we usually meet, and some of them steal wallets." , after a while, the immune system will drive them away. Some people want to rob banks, and they specifically harm the cervix. We vaccinate and do screenings every year, just to catch these bad guys who want to rob banks.” The audience suddenly became lively. After the show, several aunts pulled me and asked me where to get vaccinated. Isn’t this more effective than studying for a thesis?

Oh, by the way, there was some debate before about whether gynecological health is only relevant to women? I think this point of view is really outdated. I once treated a patient who had recurring fungal vaginitis for more than half a year. Each time, she was cured according to the course of treatment, but relapsed within two weeks of intercourse. Later, she persuaded her to bring her lover for a check-up. Sure enough, the man's foreskin was too long and was hiding candida. The two of them were treated together for half a month and the patient was completely cured. You said that if you only focus on treating women, wouldn’t it be a waste of effort? Now many places have begun to pilot male HPV vaccination and reproductive health education into supporting gynecological health services. In fact, they have really touched the pain points.

Of course, there are many problems now. For example, the gynecological diagnosis and treatment capabilities in remote areas still cannot keep up. I went to a free clinic in a western county last year. The gynecologist at the local health center did not even have vaginal microecology testing equipment. It is really not a joke to persuade a patient to have a uterus after being found to be HPV positive.； Pseudo science popularization is still flying all over the Internet. Rumors such as "use lotion to clean" and "you don't need to be screened if you get the HPV vaccine" have deceived many people. But overall, the progress is quite fast: many tertiary hospitals have opened gynecological clinics for girls and special menopausal clinics. There is no need to crowd with all the patients, and the privacy is much better. ； Two cancer screenings in many cities have covered migrant women, and they can do it for free without returning to their place of residence. ； Nowadays, many little girls feel uncomfortable. Their first reaction is not to search Baidu and scare themselves, but to know that they should go to a regular hospital to check for leucorrhea and do TCT. The change in this concept alone is worth so many years of investment.

To put it bluntly, the cause of gynecological health has never been a grand proposition that is out of reach. It allows teenage girls to ask about menstrual problems without blushing, and allows menopausal aunts to know that hot flashes and night sweats are not "old age," but a normal physiological reaction. It allows every woman, no matter how much she earns or where she lives, to say "I want to go for a gynecological examination" openly without being looked at strangely. If you do this, it is already a big step forward.