Author: Yang Junyue (from Chuanzhi Xiaohonglou)
Source｜Medical World Obstetrics and Gynecology Channel
According to a World Health Organization survey, many gynecological diseases can be detected and treated early through gynecological examinations. For women, gynecological examinations are an indispensable "protective shield".
Most adult women have regular gynecological checkups every year. However, the report often makes women feel intimidated, especially when they see words like "fluid accumulation," "endometrial thickening," "tumor," "swelling," "erosion," and "decreased hormones."
Today, I'm here to personally dispel some long-held misconceptions about gynecological examinations among our female readers! Don't panic if you encounter the following abnormalities during a gynecological examination!
1
Pelvic effusion: Most cases are physiological pelvic effusions and require no treatment.
It's quite common to find a small amount of pelvic fluid during abdominal ultrasound examinations, and there's no need to be overly concerned if this happens. Pelvic fluid accumulation is a symptom, not a disease; more accurately, it's an imaging description of fluid within the pelvic cavity. Pelvic fluid can be physiological or pathological. Women may experience a small amount of pelvic fluid during ovulation, menstruation, or when constipated; these are all physiological fluid accumulations and do not require treatment.
However, if a patient has pelvic inflammatory disease, adnexitis, or endometriosis, they are more likely to develop pathological pelvic effusion. Patients with the following symptoms need to undergo early and effective diagnosis and treatment.
1. A feeling of heaviness or pressure in the lower abdomen and lumbosacral region.
2. Decreased immunity
3. Menstrual irregularities
4. Infertility
2
Thickened endometrium: This may be a normal physiological phenomenon and has no impact on the risk of endometrial cancer.
Many women become anxious when they see thickened endometrium during gynecological ultrasound examinations. In fact, thickened endometrium is often a normal physiological phenomenon and does not affect the risk of endometrial cancer in the following situations.
For premenopausal women, if a gynecological examination shows endometrial thickening, it's important to check for menstrual changes and assess the condition in conjunction with the menstrual cycle. The endometrium of women of reproductive age undergoes a cyclical process of "growth-thickening-shedding-thinning," a physiological process regulated by ovarian hormones. During this period, endometrial thickening to 14-16 mm is normal. However, a thickness exceeding 10 mm outside of menstruation is considered pathological.
For postmenopausal women with asymptomatic endometrial thickening, studies have shown that asymptomatic endometrial thickening of 1-3 mm has no impact on the risk of endometrial cancer, requiring only close follow-up observation. However, if vaginal bleeding occurs or the endometrial thickness is significantly increased (4-5 mm), histological diagnosis and treatment are necessary.
3
Uterine fibroids : The vast majority do not affect health and do not require surgery.
If the words "uterine fibroids" appear on your report, don't panic. Uterine fibroids (leiomyomas) are the most common benign tumors in gynecology. The vast majority of them do not affect health and do not require surgery.
However, the possibility of malignant transformation should be considered, although this risk is not necessarily related to the size of the fibroid. If the fibroid is small, a follow-up ultrasound every 6-12 months is recommended. If there are no significant changes, there's usually no major concern. However, if the fibroid grows significantly in a short period, caution is advised. There's no specific size limit: a growth of 1-2 cm in 3-5 months is generally not a problem, but an increase of 2-3 cm or more in 2-3 months requires attention. Furthermore, if a postmenopausal fibroid grows larger than its original size, surgery is recommended.
4
Cervical cysts: Can be treated if they affect sexual life or childbirth.
Many people are terrified of the word "swelling," but cervical cysts are only scary because of their name. The discovery of cervical cysts during a gynecological exam is often a sign of chronic cervicitis. It occurs during the healing process of cervicitis, where secretions from the cervical glands are blocked by excessive proliferation of new squamous epithelium, forming a cystic mass. In most cases, treatment is unnecessary.
Small cervical cysts usually don't cause any discomfort and don't require special treatment; regular annual checkups are sufficient. However, if the cyst is too large (greater than 10mm) and affects sexual life or childbirth, medical attention is necessary.
5
Ovarian cysts : Physiological cysts can disappear with the menstrual cycle.
Patients often come to the clinic with their medical reports showing ovarian cysts, looking worried and asking, "Doctor, can ovarian cysts turn into cancer?" In fact, ovarian cysts are divided into physiological and pathological types.
Physiological ovarian cysts are self-limiting. The vast majority of ovarian cysts in women of reproductive age are functional, namely follicular cysts or corpus luteum cysts. They are usually discovered during ovulation induction or ultrasound monitoring of follicular growth. In women with normal ovulation cycles, physiological cysts may disappear spontaneously within 2 months, generally without the need for surgical intervention.
If a cyst persists for more than 2 months, causes acute abdominal pain, and is difficult to distinguish from diseases such as ovarian tumors, ectopic pregnancy, or endometriosis, and the cyst does not shrink after drug-induced suppression, or if it occurs in postmenopausal women and the cyst grows larger during follow-up, laparoscopy and timely surgical treatment should be performed.
6
Cervical erosion: This term has long been abandoned internationally; the "erosion" here is not the same as the cervical erosion we're referring to.
The term "cervical erosion" is no longer used; it has been replaced by the new term "cervical columnar epithelial ectopia." When the cervix becomes infected, it will show signs such as cervical congestion and eversion of the mucosa. Cervical erosion is now considered to be just one manifestation of the cervix, and it has been renamed cervical erosion-like changes.
Cervical erosion-like changes may be physiological columnar epithelial ectopia of the cervix. After ruling out cervical cancer and cervical inflammation, it is generally considered physiological columnar epithelial ectopia and usually does not require treatment. There is no need to panic if a physical examination report shows "cervical erosion" unless the doctor recommends cervical cancer screening or precancerous lesions are found, in which case special treatment is necessary.
7
Decreased estrogen levels: a physiological phenomenon of declining ovarian function
When women experience amenorrhea or irregular menstruation, doctors will recommend testing their estrogen levels. In women over 40, a decline in estrogen levels is usually due to declining ovarian function, which is physiological and generally irreversible. Additionally, certain medications may cause a temporary decrease in estrogen levels. For these reasons, women undergoing gynecological examinations should not be overly concerned.
However, if a gradual decrease in estrogen is accompanied by symptoms such as hot flashes, night sweats, palpitations, and insomnia, or if menstruation is prolonged, an examination is necessary to determine if there is endometrial thickening. If needed, further diagnosis can be made to determine if there are endometrial lesions, premature ovarian failure, or breast diseases.
8
Breast hyperplasia: a benign lesion, with a very small chance of becoming cancerous.
Breast hyperplasia is a common phenomenon among young women. Some women worry excessively about it, even developing a fear that it's a precursor to cancer. In fact, there are many types of breast hyperplasia. Most, such as simple lobular hyperplasia, have no specific treatment and can resolve on its own. A very small number (ductal and mammary epithelial hyperplasia and atypical hyperplasia) can develop into breast cancer; regular checkups are sufficient. Women should learn how to perform breast self-exams and make it a habit to do so monthly. For premenopausal women, the best time for self-exams is between menstrual periods. If any abnormalities are found, they should consult a doctor immediately.
Regular gynecological checkups are essential for the health of women. While gynecological exam reports are important, they are not as alarming as they may appear. It's crucial to dispel any misconceptions and accept any abnormalities in the report. It's important to note that many unregulated medical institutions exaggerate the severity of illnesses, causing panic and leading to overtreatment. If treatment is necessary, please choose a reputable hospital for proper medical care.
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