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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
Symptoms of benign ovarian cysts
When women develop benign ovarian cysts, the clinical symptoms are somewhat related to the number and size of the cysts. For example, when the cysts are relatively small in diameter, they usually exhibit no clinical manifestations and are often only discovered during routine gynecological exams or ultrasound screenings. As the cysts grow in size, some women may experience heaviness and pain on one side of the lower abdomen, along with a sore back. These abdominal symptoms can worsen with excessive fatigue, staying up late, or during intercourse. Some women may also experience abnormalities in their menstrual cycle, such as changes in the amount of menstrual bleeding, duration of menstruation, or irregular vaginal bleeding.
Is surgery necessary for endometrial cancer?
When a woman suffers from endometrial cancer, the primary treatment method is surgery, but there are some special circumstances. For example, if the lesion in the woman is relatively minor, it is atypical hyperplasia, which is a precancerous condition, or it is in the late stage of the disease, or in cases of recurrent endometrial cancer. At this time, treatment can be administered using progestogen drugs, applying high-dose long-term oral intake of effective progestogens, which can suppress the cancerous transformation of the endometrial lining and inhibit the further proliferation of cancer cells. Generally, it involves continuous oral administration for 12 weeks, which is three months, followed by a diagnostic curettage to evaluate the therapeutic effects of the drug. In addition, radiation therapy can also be considered.
Why do I have scanty menstrual flow and dysmenorrhea?
When women experience reduced menstrual flow and dysmenorrhea, it is important to ask in detail about their menstrual history, including whether they have had any intrauterine procedures. For instance, some women may experience reduced menstrual flow and dysmenorrhea after undergoing late-term abortions, multiple childbirths, diagnostic curettage, or abortion surgeries. At this time, it is essential to consider whether there are any uterine factors, such as intrauterine adhesions that could cause these symptoms. Besides affecting menstruation, these conditions can also lead to infertility in women. A hysteroscopic examination can be performed for diagnosis. Additionally, some women might exhibit these symptoms without any abnormal medical history; in such cases, the causes could be endocrine disorders or primary dysmenorrhea.
Is cervical erosion serious?
Cervical erosion is actually a physiological phenomenon and is not alarming. It is caused by the increased levels of estrogen in the body, which causes the columnar epithelium inside the cervical canal to descend and evert. During gynecological examinations, this part of the cervical canal appears red and granular, like eroded protrusions, as if it has decayed. However, this is not the case. When the estrogen levels in a woman's body decrease, this tissue will retract back into the cervical canal and will no longer be visible. In most cases, treatment is not necessary. Treatment is only required if the erosion is combined with an infection, or if there is bleeding after intercourse, or if there is an increase in thick, sticky vaginal discharge that affects sperm passage. Additionally, some women may have cervical cancerous changes that also appear as erosive growths. Therefore, when a woman notices cervical erosion, it is advisable to undergo a TCT screening to rule out the possibility of cervical intraepithelial neoplasia and precancerous lesions of the cervix.
Can you have sexual intercourse with uterine prolapse?
When a woman experiences uterine prolapse, it generally does not affect normal sexual activity, as symptoms might improve in a supine position, regardless of the type of prolapse. For instance, with moderate uterine prolapse, where the cervix protrudes beyond the vaginal opening, it might retract back into place when lying down. However, during sexual activity, cleanliness and hygiene should be considered. When uterine prolapse is severe, part of the uterus may be exposed at or outside the vaginal opening. Prolonged walking or other activities can cause friction, leading to possible cervical erosion and infections. Therefore, during intercourse, actions should not be too rough as it may exacerbate erosions or cause bleeding.
Will intercourse worsen uterine prolapse?
Uterine prolapse in women can be categorized into mild, moderate, and severe based on the symptoms. It occurs due to damage to the pelvic floor muscles, causing the uterus to descend from its original position and protrude through the vagina. Normal sexual activity does not affect the function of the pelvic floor muscles nor exacerbate the symptoms of uterine prolapse. However, in certain cases, such as severe prolapse where part of the uterus extends beyond the vaginal opening, like when the cervix is exposed outside the vagina, friction between the cervix and underwear might occur during normal walking or activities. This friction can cause small ulcers that may bleed or become infected, producing purulent discharge during sexual intercourse.
How to treat functional uterine bleeding that has lasted for more than ten years?
If a woman has been suffering from dysfunctional uterine bleeding for more than ten years, a detailed examination should first be conducted to understand the causes of the bleeding. Blood tests can be done for hormonal profiles, thyroid, and adrenal functions, as well as blood glucose levels to identify any issues, such as potential ovarian dysfunction, which can be treated with short-acting oral contraceptives. Long-term irregular vaginal bleeding can lead to anemia, requiring a blood test to assess the severity of the anemia. If the anemia is not severe, oral iron supplements can be taken to correct it. Some women might experience infections due to prolonged bleeding, in which case broad-spectrum antibiotics can be prescribed to treat the infection. (Specific medications should be taken under the guidance of a physician.)
What are the symptoms of functional uterine bleeding?
When women experience dysfunctional uterine bleeding, the clinical symptoms are varied. For example, some women still have a relatively regular menstrual cycle, occurring monthly, but exhibit bleeding between periods, such as the most common ovulatory bleeding. Other women experience vaginal bleeding before or after their period, such as when there is an abnormality in the function of the corpus luteum, leading to brown vaginal discharge clearly related to the menstrual cycle. Some women have irregular menstrual cycles, with no predictability of when menstruation will occur, characterized by intermittent spotting or irregular vaginal bleeding. If such conditions persist, they can lead to anemia from blood loss in women, manifesting as dizziness, fatigue, sleepiness, and loss of appetite.
Can ovarian teratomas affect menstruation?
Women with ovarian teratomas, when they are relatively small, usually do not affect the menstrual cycle. However, as they grow larger, they may compress the normal ovarian cortex, leading to abnormal ovulation, abnormal hormone secretion levels, disruption of the menstrual cycle, and can also cause difficulties in getting pregnant. Additionally, ovarian teratomas belong to germ cell tumors, which are multi-layered but can also develop into a single layer. Some teratomas are highly single-layered and can secrete certain hormones that affect women's endocrine system, thereby affecting the menstrual cycle.
Is cervicitis the same as cervical erosion?
Cervical inflammation is not cervical erosion. Firstly, cervical erosion is merely a physiological phenomenon, where elevated estrogen levels in a woman's body cause the downward and outward movement of the columnar epithelium of the cervix. This condition is mainly seen in women of childbearing age. For instance, postmenopausal women generally have lower levels of estrogen, making cervical erosion less common. For example, during pregnancy, elevated estrogen levels can increase the area of cervical erosion. After childbirth, as estrogen levels gradually return to normal, the area of cervical erosion might reduce and might even become invisible. However, cervical inflammation is caused by pathogenic microorganisms. For example, a common scenario is vaginal inflammation spreading to the columnar epithelium of the cervix in some women. Additionally, some women experience sexually transmitted diseases, like the common infection of Neisseria gonorrhoeae, which causes inflammation of the columnar epithelium. Therefore, there is a fundamental difference between cervical inflammation and cervical erosion; cervical inflammation is a pathological change, while cervical erosion is a physiological change.