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Zhang Xiu Rong
Obstetrics and Gynecology
About me
I graduated from Changchun University of Traditional Chinese Medicine and have been working in the field of obstetrics and gynecology for over 20 years. I have attended advanced training programs at higher level hospitals and have published multiple national-level papers.
Proficient in diseases
Specializes in the treatment of common gynecological diseases, infertility, pelvic inflammatory disease, vaginitis, as well as the diagnosis and treatment of cervical cancer and precancerous lesions.
Voices
What tests are done for endometriosis?
Endometriosis is generally diagnosed through color ultrasound and CA-125 blood tests. If the endometrial tissue is located within the uterine muscle, it forms adenomyosis, at which point the ultrasound will show an enlarged uterus and uneven muscle wall echogenicity. Blood tests for the tumor marker CA-125, if elevated above the normal level of 35, generally indicate adenomyosis. If the endometrial tissue is located in the ovaries, it can form ovarian chocolate cysts, which are visible on the ultrasound as ovarian sections and echoes, with typical ultrasound reports indicating ovarian chocolate cysts. Therefore, routine examinations for endometriosis typically include color ultrasound and blood tests, which can confirm the diagnosis.
Do uterine polyps cause lower abdominal pain?
Endometrial polyps generally manifest clinically with a shorter menstrual cycle, usually occurring every 20 days or so, and a longer period, typically lasting 8 to 10 days or more before it ends. This is a typical clinical presentation of endometrial polyps, and there is usually no pain in the lower abdomen. However, if there is frequent bleeding and the bleeding lasts for a long time, causing endometrial inflammation, pain in the lower abdomen may occur. If the endometrial polyps are not inflamed, there will be no pain in the lower abdomen. If endometrial polyps are detected, the treatment generally involves performing a polypectomy under hysteroscopy within three to seven days after the end of the menstrual period, followed by anti-inflammatory treatment as appropriate. With simple endometrial polyps, there is no pain in the lower abdomen.
Is it normal to have painful periods?
Dysmenorrhea is generally abnormal. Under normal circumstances, if menstruation involves ovulation, there may be slight discomfort in the lower abdomen during menstruation, which is considered normal. If dysmenorrhea is present and tends to worsen over time, this condition usually indicates the possibility of endometriosis. In such cases, it is essential to visit a hospital for a color ultrasound and a CA125 blood test to confirm if the pain is caused by endometriosis, and treatment should be based on the diagnostic results. Furthermore, if dysmenorrhea is caused by a cold uterus, symptoms might include pain accompanied by a cold sensation in the lower abdomen and cold extremities. In this case, it is typically necessary to take medicine that warms the meridians, dispels cold, and alleviates pain in the uterus. If dysmenorrhea is due to qi stagnation and blood stasis, one can take medicine that promotes blood circulation, removes blood stasis, and relieves pain in the meridians. Therefore, dysmenorrhea is not normal.
How to treat ovarian teratoma
The treatment for ovarian teratoma can only be addressed through surgical methods; this type of teratoma cannot be treated effectively with medication or conservative approaches. Therefore, once an ultrasound report indicates the presence of a teratoma, it is often advised to undergo surgery as soon as possible. After the surgery, the removed tissue should be examined pathologically again to check for any malignant tendencies. The majority of teratomas are benign, with only a very small number of undifferentiated ones showing malignant potential. Hence, most teratomas require surgical treatment at a hospital. There are different surgical options for treating teratomas, including open abdominal surgery and minimally invasive surgery. If conditions allow, most people will opt for laparoscopic surgery to treat ovarian teratomas.
What should I do about endometrial polyps?
Endometrial polyps, if diagnosed, are generally treated within 3 to 7 days after the end of menstruation. You can go to the hospital to have the polyps removed under hysteroscopy. Postoperative anti-inflammatory and symptomatic treatment is then sufficient. The removed polyps should be sent for pathology analysis, and based on the pathology results, an appropriate treatment method can be selected. Generally, most endometrial polyps are benign, with a very small percentage having a tendency to become malignant. Endometrial polyps are prone to recurrence, so it is essential to undergo proper anti-inflammatory and symptomatic treatment after the removal of endometrial polyps. The diagnosis of endometrial polyps generally requires a hospital visit for a color Doppler ultrasound. After menstruation, if the ultrasound shows thickened endometrial echoes or uneven echoes, most can be diagnosed through this ultrasound. Treatment can only be performed surgically.
What should I do if my period has been absent for three months?
If a woman does not menstruate for three months, medically this is called amenorrhea. If she is relatively young, it is essential to visit a hospital for relevant examinations. Generally, an ultrasound is conducted first to check the thickness of the endometrial lining and to assess if there are any organic diseases affecting the uterus or ovaries. If the endometrium appears thin and there are no organic diseases, further examinations should include tests for six sex hormones, which are indicators of ovarian function. If the results suggest premature ovarian failure or some endocrine disorders, treatment can be tailored according to these findings. Moreover, if the woman has reached menopausal age and indeed has not menstruated for three months, this condition is considered amenorrhea, which might be physiological. Hence, if an older woman experiences amenorrhea, it is likely true menopausal amenorrhea. Additionally, if a woman who normally has regular menstrual cycles does not menstruate for three months, pregnancy cannot be ruled out, and it is crucial to conduct relevant tests for early pregnancy.
Best time for cervical polyp surgery
The best time for cervical polyp surgery is within three to seven days after the end of menstruation, when the cervical canal polyp removal surgery should be performed. After the surgery, the removed tissue must be re-examined pathologically, as most polyps are benign, but a very small number may have malignant tendencies. Therefore, it is essential to perform another pathological examination after the cervical polyp removal surgery. After surgery, oral anti-inflammatory medication should be taken for symptomatic treatment, and sexual intercourse should be avoided for a month. Topical medications can also be used for symptomatic treatment. Since most cervical polyps are caused by chronic inflammation, postoperative anti-inflammatory or topical medications can be used for symptomatic treatment to prevent the recurrence of polyps. After the removal of a cervical canal polyp, it is crucial to have a follow-up check every six months to a year, as polyps are prone to recurrence.
Is third-degree cervical erosion severe?
Grade III cervical erosion, if cervical cancer and precancerous lesion screening show no issues, simple Grade III cervical erosion is not severe and not frightening. Normally, cervical erosion is classified by the size of the area into Grade I, Grade II, and Grade III erosion. Grade III erosion is the most severe type among cervical erosions. Patients with cervical erosion typically start by undergoing routine cervical cancer screening at hospitals. This usually involves a TCT (ThinPrep Cytologic Test) and HPV virus testing. Through these two tests, it is possible to preliminarily screen for cervical cancer and precancerous lesions. If these tests show no issues, simple Grade III cervical erosion is not frightening. At this point, treatment can include physical methods such as laser, electrocoagulation, or cryocondensation for symptomatic treatment, or some people may use medication for symptomatic treatment, which is also an option. If the cancer screening shows no problems, Grade III cervical erosion is not severe.
Causes of Dysmenorrhea
The general causes of dysmenorrhea include endometriosis or cold in the uterus, or stagnation of qi and blood stasis, all of which can lead to painful menstruation. Clinically, if dysmenorrhea is generally mild abdominal discomfort without affecting study or work, this mild dysmenorrhea is generally not a big problem. If dysmenorrhea shows a gradually worsening trend, it generally requires a visit to the hospital for a color ultrasound to check for endometriosis. If dysmenorrhea caused by endometriosis is present, it will show a worsening trend and in severe cases, may include symptoms of nausea and vomiting, so this situation is generally caused by a displacement of the endometrial lining. Additionally, some patients may experience cold hands and feet, and cold abdominal pain during the painful menstruation, which is mostly considered to be caused by cold in the uterus. Furthermore, stagnation of qi and blood stasis can also lead to dysmenorrhea, typically presenting with blood clots during menstruation, where pain relief follows the discharge of blood clots, suggesting a high possibility of being caused by stagnation of qi and blood stasis.
How long does it take for a miscarriage to expel the gestational sac?
Under normal circumstances, in the case of a natural miscarriage, the gestational sac is usually expelled within one week, and the decidua tissue is also expelled within one week. If there is still bleeding more than one week after a natural miscarriage, it is imperative to visit a hospital for related examinations, typically requiring an ultrasound to observe the miscarriage situation. If the miscarriage is complete, then there are generally no major issues. However, if the miscarriage is incomplete, a dilation and curettage procedure may be necessary. It is possible for an incomplete miscarriage to occur naturally. Therefore, if there is still bleeding after one week, further examinations are necessary. In cases of natural miscarriage, it is usually advised to wait at least six months before trying to conceive again, and relevant examinations must be conducted before attempting again to determine the causes of the natural miscarriage and to treat accordingly.