

Shen Li Wen

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

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.

What is the cause of the pain from a teratoma?
Female teratomas are cystic-solid tumors located on the ovaries. When they are small in size, they generally do not cause pain. However, as they grow larger, due to gravitational pull, they stretch the surrounding ligaments, causing women to experience hidden pain on one side of the lower abdomen. This pain is bearable and only intensifies after vigorous activities or intercourse. Some women may experience increased pain if they have a pelvic infection or during menstruation. Because teratomas are uneven in texture, if they are not adherent to surrounding structures and are relatively mobile, and their stalk is thinner, they might twist under certain circumstances, such as rolling over, spinning hula hoops, or during pregnancy, when the uterus grows and changes the position of the teratoma, leading to acute lower abdominal pain from torsion of the teratoma’s stalk. Therefore, when a woman experiences abdominal pain from a teratoma, it is essential to conduct a gynecological examination and pelvic ultrasound to understand the specific cause of the pain.

Does functional uterine bleeding cause abdominal pain?
When women experience dysfunctional uterine bleeding, if this occurs during an anovulatory period, such as in adolescent or menopausal women, they generally do not experience abdominal pain. Some women have relatively regular menstrual cycles and only exhibit irregular bleeding between periods; these women still ovulate, and they may experience painful menstruation when their period comes. Furthermore, if dysfunctional uterine bleeding persists, it can lead to a decrease in a woman's immunity. Some women may develop concurrent gynecological inflammation, such as inflammation of the endometrium or adnexa. Even if menstruation does not occur, these women may experience abdominal pain, presenting as unilateral lower abdominal pain or heaviness, and the pain may intensify during menstruation.

Is functional uterine bleeding related to a previous miscarriage?
Functional uterine bleeding in women, also known as dysfunctional uterine bleeding, occurs not due to organic lesions in the reproductive system but due to abnormalities in the function of the gonadal axis, leading to hormonal imbalances and dysfunctional uterine bleeding. This condition is generally unrelated to procedures like abortion or curettage. In some cases, it is triggered by issues such as delayed recovery of ovarian function following an abortion, excessive fatigue, or abnormalities in thyroid and adrenal gland functions, causing dysfunction of the gonadal axis. To address this issue, it is essential to first conduct tests, including a hormone panel and assessments of thyroid and adrenal gland functions, to identify the cause of the dysfunctional uterine bleeding and provide appropriate treatment.

What foods should be avoided with functional uterine bleeding?
When women suffer from dysfunctional uterine bleeding, they should be particularly careful with their diet. For example, most women at this time have pelvic congestion, so it is best not to eat cold or uncooked foods, as these can aggravate pelvic congestion, leading to increased bleeding or prolonged bleeding duration. Additionally, it is advisable to avoid foods that promote blood circulation and remove blood stasis, or some proprietary Chinese medicines, such as the commonly seen saffron, which can also increase menstrual flow and vaginal bleeding. Most women with dysfunctional uterine bleeding, if prolonged, can affect their immunity, leading to infections. Therefore, it is best to avoid spicy foods during this period to prevent exacerbating infections.