The most pressing women’s questions are answered by an obstetrician-gynecologist and the author of the book “An Honest Conversation with a Russian Gynecologist” Dmitry Lubnin.
4 May 2020
How to cure the human papillomavirus, can it really cause cancer?
– There is no drug that kills the virus, so do not swallow expensive pills in vain, do not give injections and droppers. There is a vaccine that creates immunity, which is already included in the vaccination calendar in Europe and the United States. Basically, it is designed only for girls who have not yet begun sex. There is no other protection against the virus. And a condom won’t always save you from it. However, not everything is so scary. Have you found a virus? This is not an indicator, let alone a harbinger of cancer. The doctor should pay attention not to the tests, but to the state of the cells of the cervix. How do you know if everything is okay with them? With the help of cytology or more modern analysis – liquid cytology, which allows you to determine not only the presence of the virus, but also its concentration. What is the likelihood that a woman infected with HPV will develop cancer? It is not as great as some doctors imagine to patients. Cervical cancer is a disease of those who do not go to a gynecologist for years. It doesn’t develop in a year or two. This is a long, staged process. Cancer can be unexpected only if the woman has not been to a doctor for, say, 5-7 years. If you visit your gynecologist all the time, there will be no “surprises”. Even the precancerous stage can be stopped.
Everywhere they talk about the epidemic of genital herpes. How to protect yourself?
– There are no epidemics now. If patients with chlamydia come to the doctor for five days in a row, he may have a false feeling that this infection has become more active recently. But this is an accident. And if you count all the patients of the doctor, divide by years of practice, it may turn out that the diagnosis of “chlamydia” was the least common to him. It’s just that all five women with this infection came in one week, so an “epidemic” arose. So it is with herpes. There is as much of it as always. You cannot protect yourself from herpes. Almost all people have antibodies to this virus, that is, most have encountered it. But the virus breaks out only in those who have impaired immunity due to stress or some other factor. Herpes can be called a disease of poor immunity. Although it can be sexually transmitted through genital and oral contact, not everyone is infected with it, and the main protector against this virus is human cellular immunity.
How to choose the right hormonal contraception? Do I need to take any tests?
– Today, some tablets differ from others only in a different combination of components. The woman’s body will perceive either one combination or another. It’s like with shoes. There is your size, but not your last, but there are shoes that fit like a glove. You can only check whether shoes or tablets are right for you by experience. Therefore, you do not need to do any tests, they will not tell you or the doctor which particular drug to choose. Each new contraceptive that appears on the market is not a completely new phone that radically changes the idea of these devices, but just another new combination, like another shade of lipstick. The doctor can help you choose hormonal pills in only one way – to find out if the patient has any contraindications to them. And that’s all. Then it remains to decide what to use – pills, a patch or a vaginal ring. How to understand that contraception has come up? You shouldn’t feel bad, you shouldn’t notice. If during the first months of using the drug there are side effects, it must be replaced.
Is it necessary to cauterize cervical erosion?
– In general, erosion, or ectopia (as the name of the disease sounds right), needs treatment only in two cases. The first – if the ectopia is quite large, the woman begins to have too abundant discharge that interferes with her. And the second – when the superficial vessels of ectopia are injured during intercourse, which leads to bloody discharge. If you have this disease, but it is asymptomatic, there are no atypical cells, you do not need to do anything, just watch.
You go to the doctor with complaints of pain during menstruation, and he says – you will give birth, and everything will pass. Is it so?
– Painful periods are called dysmenorrhea. It is primary and secondary. The primary one has no reason and is associated with the fact that the uterus incorrectly accumulates prostaglandins in its layers – substances that, on the one hand, lead to a contraction of muscle fibers, and on the other, cause pain. In other words, this form of the disease is a kind of immaturity of the uterus, and it really will go away after childbirth.
Secondary dysmenorrhea is associated with the presence of other gynecological diseases – endometriosis, fibroids, inflammation of the uterus or appendages. With this form, the rule “give birth – it will pass” does not work, because the cause of the pain is an undiagnosed disease. Primary dysmenorrhea is treated with non-steroidal anti-inflammatory drugs. They will block the accumulation of prostaglandins. You need to take them not when you are already climbing the wall from pain, but two days before the onset of menstruation. Secondary dysmenorrhea can be cured only if the root cause is eliminated.
Many female diseases arise from a weakened immune system. Strengthen it and many problems can be avoided.