Gynecological Health Lecture Hall 2024 Latest Edition

There is no "universal maintenance formula" suitable for all women. 90% of the gynecological health remedies and contraindications circulated on the Internet have no evidence-based medical basis. The core of health decision-making is always "individual matching + formal examination first".

Last Tuesday, when the outpatient clinic was about to get off work, a little girl who had just entered her third year of college came in. Her face turned red from holding herself in, and she hesitated for a long time before saying that her lower body had been itchy for almost a week and she couldn't even sit still in class. I checked her leucorrhea, and it was just a simple imbalance of the flora. When I asked her, I found out that she posted a short video saying, "Girls need to wash their private parts with lotion every day to make them clean." I bought the most expensive antibacterial model and washed it even into the vagina, destroying the originally good flora environment. Don't tell me, I encounter more than a dozen people in this situation every month, ranging from teenage students to aunties in their fifties and sixties, all of whom have been tricked by various rumors.

The issue of HPV vaccination that many people struggle with the most is that there is currently no completely unified conclusion in the academic community: one group, based on large-sample follow-up data in the past 10 years, believes that even if you have had sexual intercourse or have even been infected with a certain type of HPV, vaccination can still protect against other uninfected types. If the vaccine has a protective effect of more than 70%, even if it is given under 45 years old, there will be clear benefits; the other group believes that for people who have been infected with multiple high-risk HPV types, the gain efficiency of the vaccine will indeed decrease. My own suggestion is, as long as you are within the age range and can get an appointment, go for it. After all, having an extra layer of protection is better than nothing. Don’t worry about whether you have “missed the best age.” Oh, by the way, the latest screening guidelines in 2024 have also changed: TCT every three years is enough for sexually active women over 21 years old. TCT+HPV combined screening can be done every five years for women over 30 years old. There is no need to check every year, which is a waste of money and unnecessary.

There is also an old saying that has deceived countless people: "Cervical erosion must be treated or it will become cancerous." In fact, this term was deleted from obstetrics and gynecology textbooks as early as 2008. The essence is columnar epithelial ectopia caused by hormonal changes, which is a normal physiological phenomenon. Last week, there was a 42-year-old sister who cried as soon as she came in with a physical examination report from a private hospital. She said that her cervical erosion was 2 degrees and would become cancerous if it was not treated, and she wanted me to open a surgical procedure for her. I did TCT and HPV tests on her, and they were both negative, and she didn’t have any uncomfortable symptoms. I persuaded her for almost 20 minutes before she felt relieved, saying that the private hospital asked her to spend 8,000 yuan for minimally invasive surgery, but luckily she didn’t. However, we should not go to extremes here: if it is just an ectopic finding in the physical examination, and there is no contact bleeding or abnormal leucorrhea, don't worry about it at all; but if you already have symptoms of intercourse bleeding and repeated yellowing of leucorrhea, then you need to intervene symptomatically and don't take it hard.

Recently, many people asked me backstage. They said on the Internet that soy milk contains estrogen and that drinking too much will cause breast cancer and breast nodules. Can I drink it? This is also a controversial point in the academic circles: the mainstream consensus is that the isoflavones in soybeans are phytoestrogens, and their activity is only one thousandth of human estrogen. Drinking 1-2 cups of light soy milk a day will not reach the amount that affects hormone levels. On the contrary, it can relieve the symptoms of hot flashes in perimenopausal women. There are benefits; but some studies suggest that if you already have estrogen-dependent diseases (such as a history of endometrial cancer, severe atypical breast hyperplasia), it is indeed not recommended to drink large amounts of thick soy milk and eat royal jelly and other foods with high estrogen activity. It is perfectly fine to drink a cup occasionally. I drink a cup of freshly ground soy milk every morning, and my breast examination and other tests are normal, so I really don’t need to worry too much.

There are also those menstrual taboos that have been passed down for decades, such as not washing your hair, not eating cold food, and not exercising. How can there be so many rigid rules? When I have my period, as long as I don't feel uncomfortable, drink iced milk tea, wash my hair, and run and jump without delay, nothing will happen. But if you have menstrual cramps so painful that you break into a cold sweat, and the pain becomes worse when you touch something cold, then of course you don’t have to carry it hard. You can find it as comfortable as you want. Your physical feeling is the first priority. There is no need to impose other people’s standards.

In fact, I have been practicing gynecology for almost 18 years. My biggest feeling is that many girls’ gynecological problems are not caused by illness, but by fear: either they blindly follow the popular science on the Internet, or they listen to the "experiences" of relatives and friends. Really, nothing is more important than your own feelings, and there is no standard answer that suits everyone. If you really feel uncomfortable, don’t scare yourself by searching online for a long time. Go to a regular public hospital to get a gynecology number. It costs more than ten yuan, which is more reliable than anything else.