Behind a banner

This is the 4235th article of Da Yi Xiao Hu

A moment in the clinic

The door of the clinic was pushed open, and a fashionably dressed patient, holding a banner in his hand, shouted excitedly: "Director Wang, thank you for saving my life!!" Director Wang Guanghua, who was seeing the patient, was stunned.

Let me tell you

World Health

The story begins two months ago...

Director Wang Guanghua of the Department of Obstetrics and Gynecology at Shanghai Tongren Hospital received Ms. Sun, who had been postmenopausal for 10 years. She came to the hospital with "lower body pain and discomfort, accompanied by increased secretions for several years" and was finally diagnosed with "senile vaginitis."

What exactly caused Ms. Sun to suffer from discomfort for several years?

The average menopause age of Chinese women is about 48 to 50 years old. When entering menopause, the secretion of estrogen and progesterone by the ovaries will also decrease, and estrogen is particularly important for women's reproductive organs. The lack of estrogen in the body will cause the vaginal wall to atrophy, the normal acidic environment of the vagina will be destroyed, the local resistance will be weak, and it will be easily invaded by bacteria and cause inflammation. After suffering from senile vaginitis, the lower body will repeatedly experience burning, itching, pain, etc., which is difficult to talk about and greatly affects the quality of life.

Treatment of senile vaginitis:

First, supplement estrogen to increase vaginal resistance;

The second is to use antibiotics to inhibit bacterial growth.

Adequate estrogen therapy can restore normal vaginal acid pH and microbial flora. However, estrogen is a double-edged sword. As women's life expectancy increases, the quality of life after menopause has attracted much attention. Menopausal hormone therapy is an effective treatment for urogenital syndrome of menopause.

For symptomatic women within 10 years of menopause or younger than 60 years, hormone replacement therapy is safe only if contraindications are eliminated:

1. Confirmed or suspected breast cancer;

2. Confirmed or suspected estrogen-dependent malignant tumors;

3. Unexplained vaginal bleeding;

4. Untreated endometrial hyperplasia;

5. Previous or current venous thrombosis;

6. Known thrombophilia;

7. Active or recent arterial thrombotic disease;

8. Acute liver disease or history of liver disease.

Before prescribing medicine for Ms. Sun, Director Wang asked about her medical history in detail and recommended a complete gynecological and breast examination, which Ms. Sun found puzzling.

Questions again and again? ?

Is it necessary to make such a big fuss about senile vaginitis?

In the past, medicines were usually dispensed directly. Is it necessary to do breast ultrasound?

Director Wang explained in detail the indications and contraindications of menopausal hormone therapy, and told her that menopausal hormone therapy needs to be carefully evaluated and can only be used with confidence if the benefits outweigh the risks. Finally, at Director Wang's insistence, Ms. Sun agreed to the ultrasound examination.

If you don't check, you won't know. Ms. Sun's test results showed that she had solid nodular breast lesions of US-BI-RADS 4b (indicating a high possibility of malignancy in breast nodules). She had never taken the breast seriously, but it turned out to be such a big health hazard! Soon, Ms. Kong underwent breast surgery and was eventually diagnosed with invasive ductal carcinoma .

So the scene at the beginning happened. Ms. Sun thanked Director Wang for his "dedication to duty, benevolence and medical skills", which enabled her to discover the disease in time and gain a new life.

A tiger in my heart sniffing the roses

World Health

As a doctor, every consultation, physical examination, diagnosis, treatment, prescription, etc. must be careful, attentive, and responsible. Although Ms. Kong was diagnosed with breast cancer, she was lucky because she met Director Wang, who provided standardized diagnosis and patient explanations. It was the doctor's persistence that allowed her to discover the breast problem, otherwise she would have regretted it.

In daily diagnosis and treatment, many patients do not understand the examinations and tests prescribed by doctors, thinking that it is only a slight discomfort. Is it necessary to do so many examinations? "There is no trivial matter in medical treatment, and it is not too cautious." Doctors face many patients every day and have experienced "big storms". Their diagnosis and treatment work also follows the diagnosis and treatment guidelines and evidence-based medicine. In the face of confusion, effective doctor-patient communication is particularly important, which can increase the trust between doctors and patients. Patients follow the doctor's instructions to complete the examination and treatment, which can effectively reduce risks, avoid missed diagnosis and misdiagnosis, protect the interests of patients, and comprehensively improve the quality of medical care.

May every menopausal woman be treated gently! ♥♥♥

Department of Obstetrics and Gynecology, Shanghai Tongren Hospital

Written by: Yan Yan Reviewed by: Wang Guanghua