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Shen Li Wen
Obstetrics and Gynecology
About me
Engaged in obstetrics and gynecology work for more than twenty years, serving as the deputy chief physician of the obstetrics and gynecology department. Familiar with the diagnosis and treatment of common and frequently-occurring diseases in obstetrics and gynecology.
Proficient in diseases
- Uterine fibroids, ovarian cysts, cervical cin lesions, HPV infection, dysfunctional uterine bleeding, gynecological inflammation. Report interpretation, pregnancy care, gestational hypertension, gestational diabetes, breastfeeding, postpartum care and health.
Voices
Does uterine prolapse affect menstruation?
In most cases, uterine prolapse does not affect the normal menstrual cycle in women. However, in very rare instances where the symptoms of uterine prolapse are severe, part of the uterus may prolapse outside the vagina, such as external cervical protrusion. This can cause the cervical tissue to rub against the underwear, leading to local ulcers and even infections. At this point, this can result in the presence of purulent vaginal discharge or bleeding in women. If a woman's immune resistance decreases, the infection can ascend, causing inflammation of the uterine lining. This condition can affect the menstrual cycle, with some women experiencing increased menstrual flow. Additionally, some women may exhibit irregular cycles, irregular vaginal bleeding, and abdominal pain.
Can cervical erosion lead to natural childbirth?
Women with cervical erosion can also have natural childbirth. Cervical erosion is a physiological phenomenon caused by the downward migration and eversion of the columnar epithelium of the cervix and does not affect the normal elasticity and toughness of the cervix, nor does it impact the dilation of the cervix during labor. As long as the fetal position is normal and the pelvic measurements are normal, natural childbirth is generally possible. In a few cases, women may experience infections on the eroded surface of the cervix during pregnancy, making the surface more fragile and prone to bleeding when touched, which could lead to cervical lacerations during childbirth. Therefore, after delivery, a thorough examination is necessary, and if there are serious lacerations, timely suturing is required.
What should I do if the menstrual pain is very severe?
When the symptoms of dysmenorrhea are very severe in women, it is important to actively search for the causes of dysmenorrhea. For example, routine gynecological examinations are conducted along with some relevant ancillary tests. For instance, vaginal ultrasound, hysteroscopic examinations, and blood tests for CA125, etc., are used to understand the causes of dysmenorrhea. If it is primary dysmenorrhea, prostaglandin synthetase inhibitors can be taken orally during menstruation to relieve the symptoms of dysmenorrhea. Short-acting contraceptive pills can also be taken orally to inhibit ovulation and improve the symptoms of dysmenorrhea. For secondary dysmenorrhea, women often have organic lesions in the reproductive system. For example, those with submucosal uterine fibroids or endometrial polyps often require surgical treatment. (The use of medicines should be carried out under the guidance of a professional doctor.)
How to diagnose polycystic ovary syndrome?
When suspecting polycystic ovary syndrome in females, it is essential to first inquire about the woman's menstrual history and menstrual cycle. A detailed observation of the woman's body type should be made, as some women may appear somewhat overweight and have increased body hair, such as small mustaches around the lips, and some may even have acne on their faces. In addition, a thorough physical examination should be conducted, including a gynecological examination, where some women may find an increased volume in both ovaries. Hormonal tests can also be conducted, showing elevated levels of androgens, or an imbalance in the levels ratio of luteinizing hormone to follicle-stimulating hormone. Some women may exhibit insulin resistance, with abnormalities in blood glucose and lipid levels. Ultrasound examination can show many small follicles in both ovaries on the same plane, without a dominant follicle, and the number of small follicles generally exceeds 12.
Symptoms of cervical polyps
Most women with cervical polyps may not show any clinical symptoms. When the size or number of polyps increases, resulting in an enlarged surface area of columnar epithelium, the amount of secretion may increase, manifesting as thick and abundant vaginal discharge. When an infection coincides, the discharge can appear purulent. Due to the fragile texture of the polyp’s surface, it can easily bleed when touched, which is why some women might experience vaginal bleeding during gynecological examinations or after intercourse. In some women, cervical polyps are a manifestation of cervical cancer, which can then lead to uncontrollable vaginal bleeding and foul-smelling vaginal discharge. If it progresses to a late stage, signs of metastasis, such as cancer spreading to the bladder causing hematuria, may occur.
Can endometrial polyps be cured?
Women with endometrial polyps can be completely cured. First, endometrial polyps are benign lesions, which may be due to abnormally high levels of estrogen in women, leading to proliferative lesions. It is possible to completely remove the polyps through hysteroscopic endometrial polyp electrocision surgery. However, after surgery, some women may experience recurrence. To prevent this, periodic oral progestogen medication can also be administered to prevent recurrence. Some women may have endometrial inflammation, leading to the recurrence of endometrial polyps. In this case, broad-spectrum antibiotics can be used for anti-inflammatory treatment to prevent recurrence. (The use of drugs should be carried out under the guidance of a professional doctor.)
Are uterine polyps and endometrial cancer the same?
Endometrial polyps and endometrial cancer are different. First, both can be induced by hormonal imbalances in the body, but endometrial polyps may also involve inflammatory elements, leading to the formation of polyps. Additionally, the age of onset differs; endometrial polyps are more common in women of reproductive age, whereas endometrial cancer typically occurs after the age of 45. Furthermore, their clinical manifestations vary. Women with endometrial polyps mainly experience changes in menstrual cycles and infertility, and generally, endometrial polyps grow slowly. In contrast, women with endometrial cancer mainly experience abdominal pain, heavy vaginal discharge, or bleeding. In advanced stages, women may exhibit signs of cachexia. These two conditions can be differentiated through diagnostic curettage.
Can you get pregnant with menstrual disorder and amenorrhea?
When women experience menstrual disorders such as amenorrhea, most of them are unable to conceive. This is because the ovarian secretion of hormones is abnormal during this period, and there is an ovulation obstacle, usually resulting in the absence of eggs. Thus, sexual intercourse during this time generally does not lead to conception. However, a very small number of women may experience occasional ovulation during amenorrhea. If they have normal sexual relations without contraception during this time, conception could still occur. Nonetheless, many women have abnormal hormone levels during amenorrhea, so even if pregnancy occurs, the abnormal hormone levels in early pregnancy could lead to complications such as missed abortion and miscarriage. It is recommended that women who want to conceive should first undergo regular treatment to restore normal menstrual cycles and resume ovulation before actively trying to conceive.
How is uterine fibroid surgery performed?
When a woman has uterine fibroids, the surgical method should be decided based on the specific location, size, number of fibroids, age, and fertility requirements. If the uterine fibroid is relatively large, pretreatment can typically be carried out before the surgery. For example, using GNRHA-type drugs can reduce the size of uterine fibroids and lower the risk of surgery. Submucosal fibroids can be treated with hysteroscopic electroresection. Intramural or subserosal fibroids can be removed via laparoscopic surgery.
Will sexual intercourse cause bleeding in cases of uterine prolapse?
When women suffer from uterine prolapse, bleeding usually does not occur during intercourse. Bleeding only occurs in certain special circumstances, such as when a woman suffers from severe cervical erosion or acute cervical inflammation, where the cervical surface exhibits congestion and edema. Furthermore, some women with severe symptoms of uterine prolapse might have the cervix protruding outside the vaginal opening; the friction between the cervix and undergarments can lead to local ulcers, and even infections. In such cases, intercourse might cause bleeding from cervical trauma. Generally, the amount of bleeding is relatively small, which may manifest as blood streaks in vaginal discharge.