Author: Xu Chao, Reproductive Hospital Affiliated to Shandong University
Source｜Medical World Obstetrics and Gynecology Channel
1
Why does bleeding occur after intercourse?
First, regarding the often-discussed "first time," there will be bleeding after the hymen ruptures (of course, some people may not bleed, so don't use this to judge whether your partner is a "first time"). Rough movements, improper positions, etc., during sexual intercourse can all lead to vaginal tearing and bleeding. Therefore, during sexual intercourse, don't just focus on thrusting; be gentle and ensure sufficient lubrication.
Secondly, having intercourse after menstruation has ended can cause uterine contractions due to strong sexual stimulation, potentially resulting in residual menstrual blood being released and causing bleeding after intercourse. Another possibility is ovulation bleeding, during which estrogen levels temporarily drop, causing the uterine lining to lose hormonal support and partially shed, resulting in bleeding.
In addition, it is very important to be aware that cervical lesions can also cause bleeding during intercourse. For example, cervicitis and cervical polyps have more fragile tissue at the site of the lesion, and cervical cancer lesions have many small blood vessels. During sexual intercourse, the friction of the glans penis against the cervix can cause damage to the lesion, leading to rupture and bleeding.
2
Does having a lot of body hair only affect appearance?
Some women are overweight and have excessive body hair, even a bit of facial hair. Some may only feel it affects their appearance, but they should also pay attention to their menstrual cycle. If their periods are irregular, it's best to get checked for polycystic ovary syndrome (PCOS). Excessive body hair is also a typical symptom of PCOS.
Women with polycystic ovary syndrome (PCOS) typically experience oligomenorrhea or amenorrhea, hyperandrogenemia, infertility, obesity, recurrent miscarriages, gestational diabetes, impaired glucose tolerance, non-insulin-dependent diabetes mellitus, hypertension, metabolic syndrome, and an increased risk of cardiovascular and cerebrovascular diseases. Therefore, women with excessive body hair should pay close attention to their health.
3
How to calculate ovulation period?
You can estimate ovulation based on your menstrual cycle: For women with regular menstrual cycles, ovulation occurs 14 days before your next period. The time from ovulation to the start of menstruation is relatively fixed at 14 days, so this method can be used to roughly estimate the ovulation date. Having intercourse two days before or after this date increases the chances of conception.
You can measure your basal body temperature: Take your temperature immediately after waking up each morning without any activity. Basal body temperature is typically below 36.5℃ about two weeks before ovulation and above 36.5℃ about two weeks after ovulation. Normally, the temperature rises by 0.3-0.5℃ after ovulation.
You can also use ovulation test strips to detect ovulation. 24-48 hours before ovulation, luteinizing hormone (LH) levels in urine will peak, and detecting this peak will indicate ovulation within the next day or two. Of course, having an ultrasound scan at a hospital to monitor ovulation is still the most accurate method.
In addition, during ovulation, a woman's cervical mucus becomes clear, slippery, and elastic, with high stretchability and is not easily broken. Therefore, if women feel vaginal wetness, it may indicate that ovulation has occurred. Some women may also experience abdominal pain or light vaginal bleeding during ovulation, which can also be used as supplementary indicators.
4
Why do girls experience menstrual cramps?
Dysmenorrhea is divided into primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhea is mainly related to increased prostaglandin levels in the endometrium during menstruation. Prostaglandins can cause excessive contraction of uterine smooth muscle, leading to vasospasm and resulting in uterine ischemia and hypoxia, thus causing dysmenorrhea. In addition, increases in substances such as vasopressin, endogenous oxytocin, and β-endorphin can also cause dysmenorrhea. Many people experience worsened dysmenorrhea due to exposure to cold, consuming cold foods such as ice cream, or experiencing stress and anxiety. This is because physical coldness and mental tension cause stronger muscle and blood vessel contractions, resulting in more intense pain.
Secondary dysmenorrhea occurs when the endometrium grows in other locations (endometriosis, adenomyosis), causing menstrual cramps whenever bleeding occurs. For primary dysmenorrhea, keeping warm, relaxing, and even drinking hot water may alleviate the pain. However, for severe cramps, ibuprofen or other pain medications can be taken. Secondary dysmenorrhea requires treatment targeting the specific underlying cause.
5
Why is an episiotomy performed during vaginal delivery?
Because some mothers have tight perineums and large fetuses, the resistance to delivery is greater. If forced delivery is attempted, perineal tears may occur, resulting in irregular wound edges. This not only prolongs the healing time of the perineal wound but also makes it very easy for scars to form after the wound heals, causing the mother to experience a foreign body sensation when having sex after childbirth.
In addition, if abnormalities occur during labor, requiring a swift end to the process, an episiotomy may be performed. When necessary, an episiotomy facilitates fetal delivery and prevents postpartum urinary incontinence and pelvic floor relaxation caused by perineal trauma. The incision has clean edges, is easier to close than a tear, and is beneficial for both the mother and fetus.
In recent years, clinical attitudes toward episiotomy have also been changing. It is now believed that during childbirth, unless absolutely necessary, medical staff will try to avoid episiotomy and instead take other measures to protect the perineum.
6
Does having large breasts mean producing more breast milk?
The breast is primarily composed of 15-20 lobules of glandular tissue (mammary glands) and adipose tissue. The ratio of fat to glandular tissue varies considerably among women. Milk secretion is performed by the mammary glands; fat cannot produce milk.
During pregnancy, under the influence of estrogen and progesterone, the small ducts and alveoli of the mammary glands proliferate rapidly, and the alveoli enlarge. In late pregnancy, under the influence of prolactin, the alveoli begin to secrete milk. During lactation, the mammary glands develop even better, the alveolar cavities enlarge, and some cavities fill with milk. Although breasts do enlarge during late pregnancy and lactation, breast size alone cannot predict milk production; some women have large breasts simply because they have more fat. Therefore, large breasts ≠ abundant breast milk.
References:
[1] Xie Xing, Gou Wenli. Obstetrics and Gynecology. 8th ed. [M]. People's Medical Publishing House, 2013.
