Women are known as "half the sky", and they play an important role in their lives and careers. But because in life, women have to raise babies, but also have to be financially independent, but also to do housework... All kinds of pressure and burden superimposed, female friends often appear depressed heart knots and can not be discharged, over time, due to poor mood caused by various diseases followed, such as menstrual irregularities, premature ovarian failure, breast hyperplasia, thyroid nodules... There are often female friends who joke that they are 30 years old, but the ovaries and body have lived to be 50 years old.
Only with a healthy body can we have a wonderful life. Most female friends are very willing to invest in their children and families, but they are reluctant to invest in themselves. In fact, only by loving yourself can you better love others.
On the occasion of "March 8th Women's Day", the reporter interviewed Liu Huiling, director of the Second Ward of gynecology of Gansu Provincial People's Hospital, and Zhang Jianwei, deputy director of the Second Department of Head and Neck of Gansu Provincial Cancer Hospital, and the two experts answered questions from ovarian maintenance, precautions for perimenopause (menopause) and thyroid nodule prevention and treatment, etc., to prescribe a healthy "prescription" for female friends and rebuild a different self.
Expert Profile: Liu Huiling
Doctor of Medicine, Chief Physician, Director of the Department of Gynecology And Gynecology Of Gansu Provincial People's Hospital. He is the chairman of the Gynecologic Oncology Committee of the Gansu Geriatrics Association, the vice president of the Obstetrics and Gynecology Branch of the Gansu Medical Doctor Association, and the standing committee member of the Gynecologic Oncology Committee of the Gansu Medical Association. He is good at minimally invasive treatment of gynecological diseases and has rich experience in the diagnosis and treatment of gynecological tumors.
Topic 1: Women should protect their ovaries
The ovaries are an important organ for women. However, more and more young women are showing behaviors such as bad lifestyle habits and excessive weight loss, and ovarian recession is getting younger and younger. The time limit for the normal work of the ovaries is about 50 years old, and after 50 years of age (average age), women enter the menopause period, and women lose the nourishment of estrogen and gradually enter the aging stage. Therefore, when premature ovarian failure occurs, it must be paid enough attention.
Q: What is premature ovarian failure?
Liu Huiling: In medicine, premature ovarian failure refers to the situation that a woman less than 40 years old has menopause and enters the postmenopausal stage early.
The main manifestations of premature ovarian failure are menstrual disorders, rare menstruation, and amenorrhea (menstruation stopped for more than half a year is called amenorrhea, and stopping for more than 1 year and the female hormone level drops to perimenopausal levels is called menopause), accompanied by perimenopausal symptoms such as hot flashes, sweating, poor sleep, and emotional instability.
Q: What are the causes of premature ovarian failure?
Liu Huiling: There are many reasons for premature ovarian failure, some of which are not artificially controllable, such as genetics, immunity, etc.; the other part is avoidable, such as paying attention to plasticizers in food packaging, medical devices and women's cosmetics; long-term negative emotions, long-term smoking and excessive alcohol consumption.
Q: What are the signs of premature ovarian failure?
Liu Huiling: Ovarian failure can lead to the inability of eggs to grow and be excreted, followed by a decrease in estrogen, resulting in a series of perimenopausal symptoms:
1. Rough skin, yellowing, acne, acne, enlarged pores;
2. Menstrual abnormalities, menstrual irregularities, abnormal menstrual flow until amenorrhea;
3. Abnormal mood, hot flashes, night sweats, baking heat, irritability, insomnia, etc.;
4. Abnormal reproductive function, leading to female infertility;
5. Autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus and other diseases.
Q: How do I care for and maintain my ovaries?
Liu Huiling: Develop good living habits, rest on time, avoid staying up late, holding urine, sitting for a long time, etc.; avoid ingesting harmful substances, not smoking, and avoid second-hand smoke. Maintaining a good mood and reducing negative emotions is conducive to protecting brain and ovarian function. Diet should be regular and quantitative, balanced, avoid intemperation, diversified structure, thick and thin collocation, increase the intake of a variety of fruits and vegetables, choose whole grains or high-fiber foods and other carbohydrates.
Timely replenishment of calcium preparations and vitamin D. Perimenopausal women are prone to osteoporosis and should consume adequate calcium and vitamin D. Nutritional surveys have shown that perimenopausal women also need calcium supplementation of 400 to 600 mg/day. It is recommended to first supplement through dietary supplementation, so that the daily intake of calcium can be achieved by sufficient milk (more than 300ml), dark green vegetable intake (more than 500g), and then with soy products.
Proper weight control. Perimenopausal women should maintain a suitable weight, too high weight can increase the risk of cardiovascular and cerebrovascular disease, too low can increase the risk of osteoporosis. Adhere to outdoor exercise and sunbathing, at least 150 minutes of moderate-intensity aerobic exercise per week, such as walking, jogging, cycling, swimming, dancing, etc.; Do muscle tone exercises at least 2-3 times a week to increase muscle mass and strength.
Menopause and menstruation? It's either joy or sorrow
Gynecological clinics often receive some elderly patients, and in the years after menopause, they have menstruation again, and some people initially think that it is the "second spring", but after doing the examination, it is found that it is a cervical lesion.
After ovarian failure in women, menstruation is permanently shut down, called menopause. Once vaginal bleeding occurs after menopause, it should be taken seriously.
Q: What is the rate of bleeding after menopause?
Liu Huiling: The average age of menopause in Chinese women is 50 years old. Vaginal bleeding after 1 year of natural menopause is called postmenopausal bleeding, and the amount of vaginal bleeding is generally not much, including brown and coffee-colored vaginal discharge. The incidence of postmenopausal bleeding is about 10%.
Q: What are the causes of bleeding?
Liu Huiling: A non-organic lesion: the decline of the female ovaries is a gradual process, the effects of residual follicles may lead to 1-2 menstrual cramps after menopause, and there are still a small amount of estrogen in the body of women after menopause, which promotes endometrial hyperplasia and shedding, causing menstrual cramps, but generally less. In other women, the original IUD is ectopic, incarcerated, deformed and even perforated, causing damage to the endometrium or causing non-specific endometritis, resulting in bleeding. Both vaginitis and endometritis, endometrial or cervical polyps, can cause bleeding of varying degrees.
Endometrial and cervical cancers need to be vigilant. Endometrial cancer is clinically manifested as vaginal bleeding after menopause, and vaginal bleeding is generally not much. Cervical cancer in the later stage of irregular vaginal bleeding, the amount of bleeding can be more or less, can show bloody watery secretions, accompanied by fishy odor.
Q: What is the proportion of malignant tumors with postmenopausal bleeding?
Liu Huiling: From a clinical point of view, malignant tumors account for 7%-18% of postmenopausal bleeding, once there is bleeding, there is no need to panic excessively, but still be vigilant, once symptoms appear, timely medical treatment, improve relevant examinations, clarify the cause, timely treatment.
Expert Profile: Zhang Jianwei
Chief Physician of Head and Neck Surgery, Deputy Director of the Second Department of Head and Neck of Gansu Cancer Hospital, Youth Member of the Head and Neck Tumor Professional Committee of the Chinese Anti-Cancer Association, and Member of the First Standing Committee of thyroid Cancer of the Gansu Anti-Cancer Association. He specializes in the treatment of thyroid and parathyroid gland, laryngeal and hypopharynx and oral and maxillofacial tumors, surgery and comprehensive treatment of benign and malignant tumors of soft tissues of the head, face and neck, and repair and reconstruction of tissue loss after head and neck surgery. He has extensive experience in the surgical treatment of advanced thyroid cancer and the surgical treatment of laryngeal cancer.
Topic 2: Why is thyroid disease "female preference"?
With the popularity of physical examinations, thyroid nodules have become more and more common.
"As an important endocrine organ of the human body, the thyroid gland is greatly affected by eating habits, daily routines, emotions and mentality, so the incidence of thyroid disease has almost become a thermometer for the current situation of young people's lives." Zhang Jianwei, deputy director of the Second Department of Head and Neck of Gansu Provincial Cancer Hospital, said that among women under 30 years old in mainland China, the incidence of thyroid cancer ranks first among malignant tumors. In the 2018 Shanghai Tumor Incidence Report, the incidence of thyroid cancer in women has surpassed breast cancer, becoming the first high incidence of malignant tumors. Among them, young female patients (20-40 years old) account for 35% of female patients.
Q: What is a thyroid nodule?
Zhang Jianwei: Thyroid nodules are "clumps with one or more abnormal values in the thyroid gland due to various causes", which must be confirmed by imaging (usually ultrasound).
The incidence of thyroid nodules is relatively high, and thyroid nodules can be detected by specialists on palpation in 3% to 7% of the general population. With ultrasound, thyroid nodules can be detected in 20%-70% of the general population.
Q: Why are women more susceptible to thyroid disease?
Zhang Jianwei: The incidence of thyroid disease in women is almost 3-4 times that of men, which is related to the innate traits of many women.
Most women are more likely than men to experience mood swings when faced with stress from life, work, or severe mental stimulation, resulting in abnormal immune regulation. As a result, the thyroid gland secretes too much thyroid hormone, causing thyroid nodules or thyroid diseases.
There are also many women who are picky about eating, losing weight, eating irregularly, and their body nutrition cannot keep up with them, which also has an impact on the thyroid gland.
Most thyroid nodules are benign Don't worry
Q: What are the causes of thyroid nodules?
Zhang Jianwei: The occurrence of thyroid nodules, first of all, is genetic factors, regardless of whether good or malicious, the occurrence of thyroid nodules has a cluster phenomenon. The second is radiation exposure to the neck, especially under 14 years of age, which is usually due to radiation therapy for other tumors in the head and neck.
It should be noted that the so-called radiation and other radiation of mobile phones are different, and there is currently no evidence to prove that the use of mobile phones and communication base stations and wifi hotspots around the house will increase tumorigenesis. The latest information shows that the long use of mobile phones at night and the long time of exposure under light may increase the risk of thyroid cancer. Other factors include high mental stress and emotional disorders that can also lead to an increased risk of thyroid nodules.
Q: How far are thyroid nodules from thyroid cancer?
Zhang Jianwei: According to epidemiological surveys, the incidence of thyroid nodules in adults in mainland China is about 20.43%, which means that almost 1 in 5 people have thyroid nodules.
Thyroid nodules are a benign lesion of the thyroid gland, just like the scars or moles on our skin, most thyroid nodules have no obvious harm, nor do they affect the health of the human body, just go to the hospital regularly to check the color ultrasound.
It is generally believed that the malignancy rate of thyroid nodules is about 5%, of which more than 90% are papillary cancers, which is the most gentle and lazy cancer in the human body, if found at the time, the tumor is less than 1cm, through standardized treatment, there are long-term data showing that the risk of dying from thyroid cancer is close to 0.
Q: Do I have to have surgery for thyroid nodules?
Zhang Jianwei: After the discovery of thyroid nodules, the most important problem is to distinguish between benign and malignant. For nodules with a diameter greater than 1 cm, experienced specialists can make a preliminary diagnosis through physical examination, and for thyroid nodules with a diameter of less than 1 cm or a thick neck, deep position, or cannot be combined with physical examination, it is currently recognized that the best examination method is ultrasound combined with fine needle puncture.
For benign thyroid nodules, if there is no breathing difficulty, swallowing obstruction (especially dry and hard food swallowing), hoarseness, or retrosternal growth, or nodules larger than 4 cm in diameter. There is no need for immediate surgery, you can choose to actively observe, regular review is enough. Ablation treatment can also be performed after thyroid cancer is ruled out.
Wen Tu 丨 Benliu news reporter Ouyang Haijie