"Ouch! I'm bleeding heavily! Doctor!"
Looking in the direction of the sound, a woman with a sallow complexion slowly swayed in, supported by a middle-aged man.
"Hemorrhage? In waves?" I asked.
"Yes, I've been to the toilet more than ten times today..." The woman pulled at her pants, seemingly worried that they would leak.
"When was your last period?" I asked.
"Twenty days ago," the woman said weakly, rubbing her lower back, "Now I have to go to the toilet frequently, and it's inconvenient for me to go out!"
I then asked them if they had been intimate, and the husband complained, "We wanted a second child, but now she's been bleeding non-stop. It's been six months, and we haven't had a chance to be intimate. Even if we did, she wouldn't get pregnant..."
I noticed that the woman's eyelids appeared slightly swollen. She said that for the past few days she had been feeling dizzy, lightheaded, with chest tightness, lower back pain, and a strong odor from her genital area... She had been taking medication, but the symptoms were intermittent, and after six months, she still couldn't get rid of the problem completely. She was finding it unbearable to go to work.
Her husband cooked spinach and pork liver soup for her every day, but it didn't help much.
My heart sank when I heard this; it seemed the illness was quite serious.
It turns out it was that chubby little thing that was causing the trouble.
An urgent blood test was performed on this woman: hemoglobin 50g/L, WBC 5.8x10^9/L, hCG <5mIU/ml, and coagulation tests were normal. Pregnancy and threatened miscarriage can be ruled out first.
I performed a gynecological examination on her and found that there was a lot of dark red blood on the cervix, but no obvious abnormalities were felt in the uterus and adnexa.
Color Doppler ultrasound showed: uneven endometrial echoes, with two strong echoes about 1 cm in diameter; anteverted uterus, normal size and shape; uterine cavity line centered, thickness 12 mm.
Aside from the bleeding symptom, there doesn't seem to be anything special. However, a hemoglobin level of 50 g/L indicates that this woman has severe anemia and cannot withstand anesthesia and surgery. She usually needs a blood transfusion to bring her hemoglobin level to 80 g/L before surgery.
After the hemoglobin level reached 80 g/L, hysteroscopic exploration and diagnostic curettage were performed. The pathological examination results showed simple endometrial hyperplasia with endometrial polyps.
A large study (1,000 cases) of infertile women found that the prevalence of endometrial polyps was 32%, making it a common disease among infertile women.
If you are having trouble conceiving and can't find the cause, you can consider a hysteroscopy to examine your uterus and check for polyps.
Remember, it's a hysteroscopy!
A few days ago, a young woman who had been married for three years without conceiving and had irregular periods came to me, insisting on having a laparoscopy to see what was inside.
A study in mainland my country surveyed 9,951 women in 100 communities across 15 provinces and cities about common gynecological diseases. The results showed that the prevalence rates were as follows: reproductive tract infections (42.9%), menstrual disorders (34.5%), and dysmenorrhea (15.5%).
The incidence of endometrial polyps is 7.8%-34.9%, and it is highly prevalent among women of reproductive age to menopause.
What is an endometrial polyp?
Polyps are composed of endometrial glands, stroma, and blood vessels. So what nourishes and grows these annoying little "fleshy things"?
Endometrial polyps are caused by excessive growth of the uterine lining in a localized area, and are related to hormonal imbalances, particularly estrogen and progesterone. The more inflammatory stimulation and the more severe the endocrine imbalance, the faster the polyps grow.
Take a look at these symptoms. Which one resonates with you: Excessive menstrual bleeding? Prolonged periods? Irregular bleeding? Infertility?
If you have even one, be careful as it could be an endometrial polyp!
If so, go see a doctor and get an ultrasound. It's possible that an endometrial polyp is hiding inside and causing the problem!
The "little fleshy thing" can occupy space in the uterine cavity, blocking the fertilization process and affecting embryo implantation. Even if pregnancy occurs, it can easily lead to miscarriage or abnormal embryonic development.
Based on your symptoms, gynecological examination, and ultrasound examination, the doctor can make a preliminary diagnosis.
But is there no hope if you have "chubby cheeks"?
If there are no symptoms and the polyp is only discovered by ultrasound, the spontaneous disappearance rate within one year is about 27%, and the malignancy rate is low. Observation and follow-up are recommended. The chance of spontaneous disappearance of the polyp also increases after treatment with progestin-based drugs.
If there are symptoms, such as abnormal bleeding or infertility, what methods can be used to eliminate it?
Polyps can be removed or curettage performed hysteroscopically, with a pregnancy rate of 43%-80% after the procedure. However, blind curettage can easily miss polyps, and the risk of recurrence after the procedure is 3.7%-10%.
Some patients worry that the surgery might cause a recurrence. Is it because the doctor's skills are inadequate?
That's getting off-topic.
To stop your succulents from growing too much, first, stop watering them. You must also regulate their hormone levels and eliminate any inflammation.
However, life is full of pressures, and you can't guarantee that your ovarian function will remain youthful forever. As you age, obesity, high blood pressure, and other factors are all high-risk factors for gaining weight.
Is it possible to avoid surgery? Aren't you worried about it becoming cancerous if you don't have surgery? The cancer rate is 0.2%-0.4%.
A white-collar woman has a "little bit of fat" and goes to the toilet 7 or 8 times a day for more than ten days every month to change her panty liner.
People initially thought she had a urinary tract infection and was promiscuous. She only recovered after undergoing surgery following ineffective medication.
For women who have already given birth or do not plan to have children in the near future, short-acting oral contraceptives or levonorgestrel-releasing intrauterine systems (such as Menloyue) can be considered to reduce the risk of recurrence after the procedure. A foreign study showed a recurrence rate of 3.7% nine years after the procedure.
If you're still worried about a recurrence, then you should have it completely removed by surgically removing your uterus.
For patients who do not wish to have children and have experienced multiple relapses, endometrial resection is recommended; for patients over 40 years of age with a high risk of malignancy, hysterectomy may be considered.
How to prevent endometrial polyps?
1. Avoid endocrine disorders: Exercise regularly, avoid long-term use of hormone-based health supplements, try to avoid negative emotions, learn to talk about your feelings, and maintain a positive attitude. Does this guarantee a "meat-free world"? There are still two steps to go.
2. Avoid ascending infection of vaginal inflammation, avoid multiple abortions, pay attention to hygiene during menstruation and postpartum period, avoid sexual intercourse and tub baths during menstruation, and change panty liners promptly.
3. If you have gynecological inflammation, seek timely treatment. If you have symptomatic endometrial polyps that are ≥1cm, it is recommended to remove them surgically as soon as possible. Postoperative medication is necessary to prevent recurrence and to prevent cancer.
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