Patient's question:
My partner had one childbirth (Cesarean section) in 2000 and an induced abortion once in 2004. Now she wants to have another baby. After checking at the hospital, they said she has mild endometritis. The next day, blood test results showed: Luteinizing hormone 6.82, Follicle-stimulating hormone 5.77, Prolactin 71.93, Estrogen 80, Testosterone 0.26. The doctor said the prolactin level is too high and may require surgery. My partner has been under a lot of work pressure recently, often catching colds, experiencing dizziness, and feeling weak all over. She also suffers from sleepiness but cannot sleep soundly. This is the general situation. I hope to get a response from an expert. My partner and I really want to have another baby.Doctor's answer:
Hello: The cervix is the channel connecting the vagina to the uterus and also serves as an important defense line against pathogens invading the uterine cavity from the vagina. Under normal circumstances, the cervix secretes viscous mucus to form a mucus plug, resisting the invasion of pathogens into the uterine cavity. However, when the body's resistance declines or the cervix is affected by various factors leading to increased secretion, the external part of the cervix remains long immersed in the secretion, making it more susceptible to pathogenic infections, which can result in cervicitis. Cervicitis is one of the most common gynecological diseases among women, affecting more than half of them. It is classified into acute and chronic forms. Acute cervicitis often occurs postpartum or concurrently with acute pelvic inflammatory disease and is often overlooked. Clinically, chronic cervicitis is the most common form. Chronic cervicitis not only increases patients' suffering and affects women's health but is also associated with the occurrence of cervical cancer and should be treated actively. Chronic cervicitis is often caused by local damage to the cervix due to childbirth, miscarriage, or surgical procedures, followed by bacterial infection. Poor hygiene during the postpartum period, menstrual cycles, or unclean sexual practices can also introduce pathogens into the reproductive tract, leading to cervicitis. Erosion of the cervix is the most common local feature during the progression of chronic cervicitis. Due to the infiltration of inflammatory secretions, the squamous epithelium of the cervix degrades, replaced by the columnar epithelium of the cervical canal, which manifests as cervical erosion. Clinically, cervical erosion is classified into three degrees based on its area: Grade I erosion (mild): The area of cervical erosion does not exceed one-third of the cervix's surface area; Grade II erosion (moderate): The area of cervical erosion exceeds one-third but is less than two-thirds of the cervix's surface area; Grade III erosion (severe): The area of cervical erosion exceeds two-thirds of the cervix's surface area. Due to long-term stimulation by chronic inflammation, the cervix tissue undergoes repeated congestion, edema, and hyperplasia of glands and stroma, which can lead to "cervical hypertrophy." Prolonged chronic inflammatory stimulation of the cervix can cause hyperplasia of the mucous membrane in the cervical canal, forming one or more fresh red, fragile, and bleeding papillary structures, known as "cervical polyps." Some women, upon discovering they have cervicitis, become extremely anxious as if they have a "life-threatening illness," while others, conversely, neglect mild cases and allow them to progress to severe stages. Both attitudes are unacceptable. For patients with cervicitis, the first step is to alleviate their concerns. Mild cervicitis without discomfort symptoms may not require treatment, but regular annual gynecological examinations are recommended, or local medication on the cervix can be used. Severe cervicitis that does not improve with treatment, exhibits obvious symptoms, or shows signs of malignancy may require surgical removal of the cervix.What is cervicitis? The cervix is the channel connecting the vagina to the uterus and also serves as an important defense line against pathogens invading the uterine cavity from the vagina. Under normal circumstances, the cervix secretes viscous mucus to form a mucus plug, resisting the invasion of pathogens into the uterine cavity. However, when the body's resistance declines or the cervix is affected by various factors leading to increased secretion, the external part of the cervix remains long immersed in the secretion, making it more susceptible to pathogenic infections, which can result in cervicitis. Cervicitis is one of the most common gynecological diseases among women, affecting more than half of them. It is classified into acute and chronic forms. Acute cervicitis often occurs postpartum or concurrently with acute pelvic inflammatory disease and is often overlooked, while clinically, chronic cervicitis is the most common form. Chronic cervicitis not only increases patients' suffering and affects women's health but is also associated with the occurrence of cervical cancer and should be treated actively. Chronic cervicitis is often caused by local damage to the cervix due to childbirth, miscarriage, or surgical procedures, followed by bacterial infection. Poor hygiene during the postpartum period, menstrual cycles, or unclean sexual practices can also introduce pathogens into the reproductive tract, leading to cervicitis. Erosion of the cervix is the most common local feature during the progression of chronic cervicitis. Due to the infiltration of inflammatory secretions, the squamous epithelium of the cervix degrades, replaced by the columnar epithelium of the cervical canal, which manifests as cervical erosion. Clinically, cervical erosion is classified into three degrees based on its area: Grade I erosion (mild): The area of cervical erosion does not exceed one-third of the cervix's surface area; Grade II erosion (moderate): The area of cervical erosion exceeds one-third but is less than two-thirds of the cervix's surface area; Grade III erosion (severe): The area of cervical erosion exceeds two-thirds of the cervix's surface area. Due to long-term stimulation by chronic inflammation, the cervix tissue undergoes repeated congestion, edema, and hyperplasia of glands and stroma, which can lead to "cervical hypertrophy." Prolonged chronic inflammatory stimulation of the cervix can cause hyperplasia of the mucous membrane in the cervical canal, forming one or more fresh red, fragile, and bleeding papillary structures, known as "cervical polyps." Some women, upon discovering they have cervicitis, become extremely anxious as if they have a "life-threatening illness," while others, conversely, neglect mild cases and allow them to progress to severe stages. Both attitudes are unacceptable. For patients with cervicitis, the first step is to alleviate their concerns. Mild cervicitis without discomfort symptoms may not require treatment, but regular annual gynecological examinations are recommended, or local medication on the cervix can be used. Severe cervicitis that does not improve with treatment, exhibits obvious symptoms, or shows signs of malignancy may require surgical removal of the cervix.
What are the causes of cervicitis? The peak incidence of cervical cancer is between the ages of 45 and 49, but it has shown a trend toward younger ages, with urban women having a higher incidence rate than those in rural areas. It is reported that more than half of women suffer from cervical diseases, yet among 517 gynecological patients with an average age of less than 30, 87 exhibited cervical lesions, with a detection rate significantly higher than in the past. Experts analyze that the younger incidence of cervical diseases is related to early sexual activity. Women who marry and give birth early, have a history of miscarriage, sexually transmitted diseases, or multiple sexual partners are at high risk for cervical cancer. Cervicitis is a common disease among women, with three main causes: mechanical irritation or injury: Cervicitis is related to sexual activity, and natural or induced miscarriages, diagnostic curettage, and childbirth can all cause cervical injury and lead to inflammation. Adult women should pay attention to contraception, avoid or reduce induced abortions, and maintain postpartum hygiene to prevent postpartum infections; pathogenic infection: The most common cause is purulent inflammation caused by pathogens such as staphylococcus, escherichia coli, streptococcus, and pseudomonas aeruginosa. Viruses and trichomonads can also cause cervicitis; chemical irritation: Using acidic or alkaline solutions to rinse the vagina or inserting suppositories can also lead to cervicitis.
Prevent cervicitis through sexual activity: Preventing cervicitis involves many aspects. First, it is essential to delay the start of sexual activity, advocate late marriage and protected sex (condoms), and adopt good contraceptive measures to avoid repeated induced abortions. Specific attention should be paid to the following aspects: 1. Not starting sexual activity too early is the key to preventing cervicitis. The squamous epithelium of the cervix during puberty has not yet matured, and sexual activity can easily cause squamous cell shedding, leading to cervicitis. 2. Avoid early, frequent, or excessive childbirth and miscarriages. Childbirth and miscarriage can cause cervical injury, providing opportunities for bacterial invasion. 3. Avoid unclean sexual practices. Unclean sexual practices can easily introduce various pathogens, triggering cervicitis or even cervical cancer. 4. Actively treat acute cervicitis; undergo regular gynecological examinations (once a year); avoid childbirth or injury to the cervix; promptly suture cervical lacerations postpartum. 5. Maintain cleanliness of the external genitalia and vagina. Prevent infections during childbirth, miscarriage, or post-cervical physical therapy, and avoid sexual activity for a short period.
What are the causes and clinical manifestations of cervicitis? Cervicitis is classified into acute and chronic forms. Acute cervicitis is most common after postpartum infection, characterized by increased vaginal discharge, lower abdominal and lumbosacral pain, and elevated white blood cell counts with fever in some patients. During this stage, sexual activity and vaginal surgery should be avoided, and oral and local anti-inflammatory medications should be used for treatment. Currently, chronic cervicitis is the most common form in China, accounting for more than half of married women, and it is associated with the occurrence of cervical cancer, so women should pay attention to it. Chronic cervicitis is often caused by the invasion of pathogens into the cervix due to childbirth, miscarriage, or vaginal surgery. It can be divided into four types: cervical erosion, cervical polyps, cervical hypertrophy, and cervical nabothian cysts. Among these, cervical erosion is the most common, and during gynecological examinations, the cervix appears to lose its pink, smooth mucosa, with an uneven surface and a red granular appearance, as a result of the replacement of squamous epithelium by columnar epithelium. The size of the erosion varies, and it can be classified into three types based on its area: Mild erosion (Grade I): The area of erosion does not exceed one-third of the cervix's surface area; Moderate erosion (Grade II): The area of erosion exceeds one-third but is less than two-thirds of the cervix's surface area; Severe erosion (Grade III): The area of erosion exceeds two-thirds of the cervix's surface area. Chronic cervicitis often manifests as increased vaginal discharge, which is purulent or may contain blood streaks. Contact bleeding (bleeding after intercourse) may occur, especially with severe cervical erosion or polyps. Patients with widespread inflammation may experience lower back pain.
Clinical manifestations and treatment of cervicitis: Cervicitis is a common disease among women of childbearing age, classified into acute and chronic forms. It is often caused by cervical injury due to childbirth, miscarriage, or surgery, followed by pathogenic infection. Additionally, it is related to frequent sexual activity, physical or chemical irritation, endometritis, and vaginitis. Clinically, chronic cervicitis is more common and often lacks symptoms of acute inflammation. Chronic cervicitis is associated with the occurrence of cervical cancer, as research shows that the incidence of cervical cancer among patients with cervical erosion is 0.75%, significantly higher than those without cervical erosion. Therefore, actively treating cervicitis is of great significance for preventing cervical cancer. [Clinical manifestations> The main symptom is increased vaginal discharge. Acute cervicitis presents with purulent vaginal discharge, lower abdominal and lumbosacral pain, or urinary symptoms such as frequent urination, urgency, and dysuria. Chronic cervicitis presents with milky or pale yellow mucous discharge; with severe cervical erosion or polyps, the discharge may be bloody or bleeding after intercourse. Mild cases may have no systemic symptoms, but when inflammation spreads along the uterosacral ligaments to the pelvic cavity, symptoms such as lower back pain, lower abdominal pressure, and dysmenorrhea may occur, worsening during bowel movements or sexual activity. Additionally, viscous purulent discharge is unfavorable for sperm passage and can also cause infertility. [Diagnosis> 1. Typical clinical manifestations. 2. Gynecological examination: Acute inflammation shows congestion and edema of the cervix, erosion, or purulent discharge from the cervical canal, with pain upon touching the cervix. Chronic cervicitis shows varying degrees of erosion, hypertrophy, polyps, glandular cysts, or everted mucosa, or purulent discharge from the cervical os, with a harder cervix upon palpation. If erosion or polyps are present, contact bleeding may occur. 3. Pap smear showing Class II atypical squamous cells. 4. For more severe cases, cervical biopsy may be performed to confirm the diagnosis. 5. Cervical erosion or polyps are difficult to differentiate from early cervical cancer, as the latter has harder, fragile, and bleeding tissue. Cervical smear and, if necessary, colposcopy and cervical tissue biopsy are required for differentiation. [Treatment> 1. Western medicine treatment (1) Physical therapy: Includes electrocautery, cryotherapy, laser, and infrared therapy, suitable for large erosion areas with deep inflammation, generally curing after one treatment. (2) Medication: Acute cervicitis can be treated with broad-spectrum antibiotics, such as cephalosporins combined with metronidazole. (3) Surgery: Cervical polyps can be removed surgically, cervical glandular cysts can be drained by puncture, and old cervical lacerations or everted mucosa can be repaired. 2. Traditional Chinese medicine treatment (1) Damp-heat in the lower burner: Excessive leukorrhea with yellow color or blood streaks, viscous like pus, offensive odor, burning and swelling in the vagina, short and yellow urine, red tongue with greasy yellow coating, and a slippery and rapid pulse. Treatment method: Clear heat, resolve dampness, and stop leukorrhea. Medicines: Poria, Poria cocos, Radix paeoniae rubra, Radix moutan, Herba scutellariae lateriflorae each 15g, Fructus gardeniae, Alisma orientale, Coix lacryma-jobi (), Radix asari cum rhizoma each 10g, and Radix glycyrrhizae 6g. Over-the-counter medicine: Anti-inflammatory tablets. (2) Spleen and kidney deficiency: Excessive leukorrhea with white color and thin consistency, fishy odor, soreness and weakness in the lower back and knees, poor appetite, abdominal distension, frequent urination, pale tongue with slippery white coating, and a deep and slow pulse. Treatment method: Strengthen the spleen, warm the kidney, resolve dampness, and stop leukorrhea. Medicines: Codonopsis pilosula, Atractylodes macrocephala, Poria cocos, Coix lacryma-jobi, Eucommia ulmoides, Osseum cuttlefish each 15g, Tribulus terrestris and Euryale discoides each 10g, and Radix glycyrrhizae 6g. Over-the-counter medicine: Warming the channel and stopping leukorrhea pills. 3. External treatment methods (1) Cervical medication method ① Taraxacum mongolicum, Erigeron canadensis, Polygonum aviculare, and Cortex phellodendri each 15g, and Cortex cinnamomi and Radix scutellariae each 10g, and Balsamum officinale 0.4g, and Acacia catechu 1g. Grind into a fine powder and apply to the affected area of the cervix, once every other day. Suitable for acute cervicitis. ② Dual material throat wind powder: First, wipe away the secretions on the cervix surface, then spray the powder on the affected area, twice a week, with 10 treatments constituting one course. Suitable for acute cervicitis and cervical erosion. ③ Yangyin shengji powder: Clean the cervix and spray the powder on the affected area, twice a week, with 10 treatments constituting one course. Suitable for cervical erosion. (2) Vaginal irrigation method: Chrysanthemum indicum, Atractylodes macrocephala, Polygonum multiflorum, Folium artemisiae, and Fructus cinnamomi each 15g, and Radix stemona and Cortex phellodendri each 10g. Boil into a concentrated solution of 20ml and perform vaginal irrigation once a day, with 10 treatments constituting one course. Suitable for acute cervicitis. [Prevention and care> 1. Maintain cleanliness of the external genitalia. 2. Minimize damage to the cervix caused by induced abortions and other gynecological surgeries. 3. Pause cervical medication during the menstrual period and avoid sexual activity during treatment.
Cervicitis: The hidden bomb in women's bodies: Cervicitis is a common gynecological disease but is often overlooked by women. ▲ Cervicitis leads to infertility: Chronic cervicitis is the most common gynecological disease, often occurring after childbirth, miscarriage, or surgical damage to the cervix, followed by pathogenic infection. It is usually a result of untreated acute cervicitis, with pathogens hiding in the cervical mucosa, forming chronic inflammation. Many women with acute cervicitis have mild symptoms, which are often ignored, leading directly to chronic cervicitis. About 20% to 25% of patients with excessive vaginal discharge have cervicitis. If the inflammation causes viscous purulent discharge, it can hinder sperm passage through the cervical canal, leading to infertility. ▲ What are the symptoms of cervicitis? Increased vaginal discharge is the most common symptom of acute cervicitis, sometimes even the only symptom, appearing purulent or mixed with blood, often accompanied by lower back pain and lower abdominal pressure. Sometimes, the external genitalia may experience itching, burning, and urinary symptoms such as frequent urination and urgency. A few patients may have dyspareunia or fever. Some women with acute cervicitis may have mild symptoms, making it easy to overlook and develop into chronic cervicitis. The main symptom of chronic cervicitis is increased vaginal discharge. When inflammation spreads along the uterosacral ligaments to the pelvic cavity, symptoms such as lower back pain and lower abdominal pressure may occur. Its clinical manifestations mainly include cervical erosion, cervical hypertrophy, cervical polyps, cervical canal cysts, and cervical mucosal inflammation. ▲ Correctly understand cervicitis: Generally, simple cervicitis does not pose a significant threat to health, but the symptoms such as increased vaginal discharge, lower back pain, and lower abdominal pressure can affect mood. From a cancer prevention perspective, cervicitis is closely related to cervical cancer. Cancer prevention surveys show that among women without cervical erosion, 0.39% suffer from cervical cancer, while among those with cervical erosion, 2.05% do. This indicates that actively treating chronic cervicitis and taking proactive preventive measures are of great significance for women's health and preventing cervical cancer. ▲ Misunderstandings about cervicitis: Although cervicitis is a common gynecological disease, many women today lack awareness of it, holding some misconceptions. Some believe that all married women will develop cervicitis, considering it unimportant and irrelevant to work or life, with treatment or no treatment making no difference. Others, conversely, view cervicitis as a precancerous condition, becoming frightened of cancer ("cancer phobia") and affecting their mood and daily life. Both attitudes are incorrect. Chronic cervicitis and cervical cancer share some symptoms, such as spotting after intercourse or blood streaks in vaginal discharge. If such symptoms occur, it is essential to undergo cervical smear, colposcopy, and cervical biopsy to rule out cancer before treating cervicitis for reference.