Performance of gynecological health

There are no abnormal symptoms in daily life, the basic rules of menstrual cycle, and regular gynecological screening indicators are normal. There is no need to worry about yourself in response to the fragmented popular science on the Internet. Most of the time, your physical feelings are much more reliable than various "standard comparison tables".

Last week, I met a post-00s girl in the clinic. She came in with an album of pictures of leucorrhea. Her face turned red and she said she must have vaginitis. I looked through it and found out that it was either a clear, stringy discharge during ovulation, or a slightly thicker milky white leucorrhea during the luteal phase. The routine of leucorrhea is normal, but I read popular science and said "leucorrhea must be colorless and odorless, egg white-like", and I was scared for half a month because of my occasional yellowish discharge.

It's interesting to say that many popular sciences now like to set "unified standards" for leucorrhea, but in clinical practice we rarely judge whether it is healthy or not by looking at the characteristics of leucorrhea alone: ​​during ovulation, the leucorrhea becomes more frequent, thinner and stringy, becomes thicker and yellowish during the luteal phase, and may have some brown discharge before and after menstruation. These are normal changes caused by hormone fluctuations. As long as there are no discomforts such as itching, burning, fishy odor, and sexual intercourse pain, you don't need to worry about it at all. On the contrary, many people use lotion to flush the inside of the vagina every day in order to "clean" it. A good vaginal flora is like a balanced micro-ecology, and lactobacilli are the dominant "good residents". If you flush it randomly, it is equivalent to driving away all the good residents. Pathogenic bacteria will take advantage of it and cause diseases even if there is no disease.

Oh, by the way, there is another misunderstanding that has been asked eight hundred times: Is dark color in the private parts unhealthy? Don’t be fooled by the messy personal care advertisements. Pigmentation is related to heredity, natural skin color, and hormone levels, and has nothing to do with the frequency of sexual life. Those who advocate that "powder in private parts is healthy" are either bad or want to earn your IQ tax for making you famous.

When it comes to menstruation, which everyone is most familiar with, there is actually no “standard answer”. Many people think that it is normal to have a period every 28 days, 5 days at a time, bright red and no blood clots. In fact, as long as your cycle is fixed - for example, every 32 days every time, or every 24 days, each fluctuation does not exceed 7 days, and the amount of bleeding each time is between 20-80ml (roughly the amount of 1-4 daily sanitary napkins), you are considered healthy. It can also be mentioned here that the judgment standards of different medical systems are indeed different: Traditional Chinese medicine may pay more attention to whether the dark color of menstruation and the presence of blood clots are related to body cold and qi stagnation, and will recommend adjusting work, rest and diet. ； However, the judgment logic of Western medicine is that as long as there is no severe menstrual cramps that require painkillers to work and live normally, no menstrual period is prolonged for more than 10 days, and there is no non-menstrual bleeding, even if there is a small amount of small blood clots, there is no need to deliberately intervene, and there is no need to take hormonal health products indiscriminately to make up for the "28-day standard cycle". I met a 25-year-old girl two years ago. In order to adjust her 35-day cycle to the "standard 28-day period", she took internet-famous menstruation pills for half a year. In the end, she suffered from irregular bleeding and her hormone levels were messed up for several months before they were adjusted back. It was completely worth the loss.

Many people think, "I don't feel any discomfort, so it must be fine." This is actually not entirely true. There was a 34-year-old patient who had never had a gynecological screening in 5 years of marriage. She said that she usually had no pain or itching and was definitely fine. Later, she had bleeding in the same room and the TCT showed CIN level 2. Fortunately, she was discovered early and had a conization and it was no big deal. Therefore, regular screening is really the gold standard that cannot be avoided: women over 21 years old who are sexually active should have a TCT examination every 3 years. ； Over the age of 30, you can do TCT+HPV combined screening every 5 years, and you don’t need to stop after menopause. These screenings can help you find early lesions when you don’t have any symptoms, which is much more reliable than you feel.

Of course, there is no need to be overly nervous. I have seen too many people cry when they find out that they are HPV positive, thinking that they are going to get cervical cancer. In fact, 80% of HPV infections are transient, just like you have a cold. If your immunity is good, it will turn negative on its own in 1-2 years. As long as there is no problem with TCT, you can check it regularly. There is no need to take random antiviral drugs. There is currently no specific drug for HPV. Eating well, sleeping and exercising are better than anything else.

To put it bluntly, there is never a 100-point perfect template for gynecological health. You don’t need to rely on minor abnormalities to rely on serious diseases, and you can’t just rely on the fact that you have no symptoms to skip screening at all. If you are really unsure, go to a regular hospital and get a gynecology number. It costs more than ten yuan, which is much more reliable than reading Xiaohongshu for self-diagnosis all night.