Do you agree that "menstruation" is a veteran actor?

Author: Jiang Zhuangliang, Jiangxi Provincial Maternal and Child Health Hospital

Source｜Medical World Obstetrics and Gynecology Channel

Several little boys pooled together more than ten yuan to buy toys. "What can you buy with more than ten yuan?" one of them asked.

“I think we can go buy sanitary napkins,” was another answer.

"What's so good about sanitary napkins?" everyone asked him.

"I'm not too sure, but the TV said that with it you can go hiking, water skiing, play ball, ice skating, and be happy without any worries."

Okay, let's get back to the main topic. As the saying goes, when soldiers come, generals will block them; when water comes, earth will dam it. Next, we're going to talk about her nemesis—menstruation (it's commonly believed that vaginal bleeding is menstruation, but that's not the case; menstruation is the regular vaginal bleeding caused by the periodic shedding of the uterine lining). Well then, let's just go with the flow for now.

Some say that Yuejing is like a veteran actress; her performances are never monotonous, and I simply don't know what to say. She can play a ghost or deity convincingly, a demon convincingly, a pitiful beggar, or an arrogant tycoon. All I can say is that her acting is so good and natural that it doesn't even feel like she's acting. But she really is acting! Is acting too well a sin?

He can handle any genre of film, including comedies, tragedies, suspense films, action films, nature exploration films, and disaster films. He can effortlessly take on any role and any film type.

Model operas with an eight-legged essay style

Everyone should know the story of Fan Jin passing the imperial examination. He devoted his entire life to the exams, focusing almost entirely on the eight-legged essay (a literary style exclusive to the imperial examinations in the Ming and Qing dynasties). So, the question arises: what exactly is the eight-legged essay?

The so-called "eight-legged essay" refers to an essay with eight parts, following a fixed format: it consists of eight sections—introduction, development, opening, entry, first argument, middle argument, second argument, and conclusion. The topics are always taken from the Four Books and Five Classics. The last four sections each contain two parallel and antithetical paragraphs, totaling eight paragraphs. The content is conservative, and the form is rigid. Model operas, like the eight-legged essay, are conservative and lack innovation.

Menstruation also follows a fixed pattern: the proliferative phase (early, mid, and late), the secretory phase (early, mid, and late), the transitional period between each phase, and the menstrual period. Changes in estrogen and progesterone are the cause and driving force behind menstruation. The cycle is generally around 28-30 days, or may have its own cyclical regularity. At this point, she's like a professionally trained actress, every move and gesture stereotyped, dogmatic, and rigidly following the rules.

We women look forward to menstruation like this, enjoying its natural, formulaic performance, much like a model opera. But if it's like a neurotic performance artist, unpredictable and improvising, coming and going as it pleases, then it's abnormal uterine bleeding.

wuxia film

In the Romance of the Three Kingdoms, there is a famous "bowing". This bow is a sign of good fortune and finding a kindred spirit, with peach blossoms smiling on the altar; this bow is a sign of a generous will to protect the country and establish a great career; this bow is a sign of loyalty and courage to stay together through thick and thin.

This is the oath of brotherhood of the three men in the Peach Garden, which means they do not seek to be born on the same day, month, and year, but they seek to die on the same day, month, and year.

I overheard a conversation between a few close female friends. The gist was that their periods used to be irregular, but since they became roommates and became very close, they've decided that they don't care if they were born or die on the same day, but only if they get their periods on the same day. Women are just as capable as men! They can be sworn sisters, sharing life and death, and even have synchronized periods! Can you men do that? She's like the heroine of a martial arts movie.

As for why I should ask you, you need to first explain why white hens can lay white eggs while black hens cannot lay black eggs. Then I will tell you why.

Comedy/Tragedy

Menstruation can sometimes be a sign of early pregnancy. When contraception fails or menstruation is late, it becomes a tragicomedy!

For newlyweds who plan to have a child, marriage and a baby are a double blessing. But for those who don't, it's a tragedy. Worry, anxiety, and the ordeal of abortion can sow the seeds for future complications like uterine adhesions and infertility. It's a rollercoaster of emotions, a constant cycle of joy and sorrow. Don't you think it's the culprit—menstruation—that's to blame?

disaster movies

Speaking of disaster movies, in the clinic, we often encounter cases of persistent vaginal bleeding (after sexual intercourse or gynecological examination). These patients may present with irregular bleeding, prolonged menstrual periods, increased menstrual flow, or postmenopausal irregular vaginal bleeding. In the case of cervical cancer, the amount of bleeding varies depending on the size of the lesion and the extent of vascular invasion within the stroma. Endogenous cervical cancer tends to cause bleeding later, while exogenous cervical cancer tends to cause bleeding earlier. Endometrial cancer, on the other hand, often presents as postmenopausal irregular vaginal bleeding.

At this time, she often plays the role of a postmenopausal old woman. Hearing a doctor diagnose her with endometrial cancer or cervical cancer feels like being struck by lightning, like the sky is falling and the world is ending—a catastrophe that makes her scream and cry out in despair. At this moment, it's hard to say much; all that can be said is: utterly miserable.

Korean dramas

Nowadays, most people download or cache TV shows and movies online, so shows with many episodes directly influence their choices. People no longer have the patience for Korean dramas with hundreds of episodes. A uterine incision diverticulum is a condition that can form on the cesarean section scar, essentially a small hole in the lower segment of the uterus. Menstrual blood may be trapped inside this hole, causing it to drizzle intermittently, like a light spring rain.

You say it doesn't resemble an ugly, long, bound foot cloth? Doesn't it look like something out of a Korean drama? I can't find a more suitable alternative. It not only affects a woman's normal quality of life, but can also lead to anemia, infections, and even infertility. At this moment, she plays the role of a resentful woman tormented by prolonged and persistent menstrual bleeding.

Action movies

The wedding night is supposed to be one of the four great joys of life, but joy can easily turn to sorrow. If a newlywed couple both end up in the gynecology emergency room on their wedding night, it's obvious it's due to a ruptured hymen or bleeding, or perhaps a ruptured posterior fornix (which is even more extreme). Of course, I've also encountered patients who went into shock due to uncontrollable bleeding from a ruptured hymen and required blood transfusions. Therefore, comrades, treat your wives gently; be their protectors. Being too rough will have consequences.

Thriller

I've treated patients like this before. Their periods were always regular with normal flow. They were admitted because they suddenly experienced heavy vaginal bleeding while walking or sitting comfortably. The patients were terrified and sought medical attention. Doctors routinely consider performing a diagnostic curettage, but blindly performing the curettage only made the bleeding more uncontrollable. The doctors were also quite alarmed.

At this point, it's necessary to consider whether it's a uterine arteriovenous fistula. This condition has a low incidence but is highly dangerous, primarily affecting women of reproductive age (mostly 20-40 years old) with sudden, massive bleeding. In such cases, curettage is contraindicated. Currently, color Doppler ultrasound can provide a definitive diagnosis, and angiography can pinpoint the location, but pregnancy and trophoblastic diseases must be ruled out. With the development of interventional techniques, this condition has shifted from a routine hysterectomy to a more common approach that preserves the uterus. At this point, she's like the lead actress in a thriller.

Suspense films

Abnormal vaginal bleeding that can be mistaken for menstruation could also be caused by ectopic pregnancy, submucosal fibroids, or blood disorders. Ectopic pregnancy can be differentiated through ultrasound and HCG testing. Submucosal fibroids can be accurately diagnosed with ultrasound or hysteroscopy. However, blood disorders are sometimes difficult to diagnose promptly, as changes in body temperature or blood cell counts are often overlooked. Like a suspense drama, the true culprit remains a mystery until the very end. In this suspenseful situation, the protagonist is often like Yue Buqun, deeply, deeply hidden.

Yuanqu

When talking about Yuan Dynasty opera, the most famous work that comes to mind is undoubtedly "The Injustice to Dou E." Why would I force myself to write something melancholic, or make a far-fetched connection between menstruation and Yuan Dynasty opera, using the analogy of the matchmaker god to randomly pair up lovers? It's because the author of this representative work, "The Injustice to Dou E," was Guan Hanqing. Guan Hanqing himself described himself as "an indestructible, unyielding, and unbreakable copper pea." I have always admired Guan Hanqing.

But what I want to say is that menstruation isn't like a tough pea; it can't withstand evaporation, boiling, stir-frying, or even being beaten. Perhaps because of a change in weather, anger, a change of location, or a miscarriage, menstruation becomes lighter, irregular, or even stops.

Remember, menstruation isn't an elevator; you can't just tell it which floor to stop at. Menstruation isn't a package; you can't just tell it to arrive on a specific date.

"Let him be strong, the breeze still caresses the mountain; let him be arrogant, the bright moon still shines on the great river." We should approach illness with this calm and composed mindset. We should see through the clouds to the sun, looking beyond the surface to the essence. We should grasp the fundamental nature of menstruation—the periodic shedding of the uterine lining that causes regular vaginal bleeding—and remain steadfast amidst change. If it becomes abnormal, simply make an appointment and seek medical attention.

Finally, Dr. Jiang would like to say: "Life is like a play, it all depends on acting skills, but the most superb acting skills are sincerity." Sincerely read this popular science article; in this fragmented era, learning from these snippets of information may be helpful to you and your family.