Celiac disease, the most common gynecological disease among women, is a term that almost every woman hears from her first gynecological checkup and then begins the long journey of fighting “celiac disease”. So, what is celiac disease? Does it need to be treated or not? How can we treat it once and for all? Next, I will take you into the labyrinth of “celiac disease” to get a glimpse of its true nature. First, we have to start with the normal structure of the cervix. The normal cervix is a tube-like structure, which is, frankly, a cylinder with a hole in the middle, which we used to call the cervical canal. It is about 3-4cm long and 2.5cm in diameter. The upper part of the tube is connected to the uterine body and is called the endocervix; the lower part of the tube is called the ectocervix, which can be seen by the doctor during vaginal examination. The inner part of the cervical canal is lined with a layer of cells called columnar epithelium, which is thin and transparent, and the color of the blood vessels underneath the cells can be seen, so it looks red. On the outside, it is lined with about a dozen to dozens of layers of cells called squamous epithelium. Because the squamous epithelium is overlapped by many layers, the nutrient blood vessels underneath it are not clearly visible, so it shows a light pink color. The columnar epithelium is connected to the squamous epithelium right at the mouth of the cervix, which we call the squamocolumnar junction. In young girls or after menopause, due to the lack of estrogen, the epithelium proliferates slowly or even atrophies, and the squamous junction shrinks back to the inside of the endometrium, so that only the light pink squamous epithelium can be seen from the outside, and the columnar epithelium cannot be seen, which is called columnar epithelial migration. After puberty and before menopause, the ovaries of women are mature and function well, producing enough estrogen to make the columnar epithelium proliferate and move to the outside of the ectocervix, and then a large red area will be seen during gynecological examination, which is called columnar epithelial migration. Most of the time, what we call celiac disease is columnar epithelial migration. The International Medical Organization has now recognized that cervical epithelial migration is a physiological change and does not require treatment. However, one may ask, if it is a physiological condition, why do I feel uncomfortable? For example, increased leucorrhea with bad odor? Or bleeding after intercourse? What should I do about this? It has to do with the characteristics of the columnar epithelium. Columnar epithelium is a single layer of epithelium, for example, columnar epithelium is a beautiful woman wearing only a layer of muslin, while squamous epithelium is a beautiful woman with a thick winter coat, but also wrapped tightly. Therefore, the columnar epithelium is more delicate and easily injured; the squamous epithelium is thicker and can protect itself. When having sex, or during gynecological examinations, accidental overexertion can damage these columnar epithelium and destroy the blood vessels underneath it causing bleeding. At the same time, the columnar epithelium also has a secretory function, just like the salivary glands can secrete saliva, the columnar epithelium can also secrete mucus. Under normal circumstances, the mucus secreted by the columnar epithelium serves as a lubricant for the vagina. However, when the columnar epithelium moves out and is exposed to the vagina, the acidic environment and some bacteria in the vagina will increase the amount of mucus secretion, which is reflected in the amount of leucorrhea; in case of bacterial infection, the leucorrhea may become yellow or purulent. In case of bacterial infection, the leucorrhea may become yellow or purulent. Because the increased leucorrhea, odor and bleeding during intercourse are similar to other diseases such as vaginal inflammation, cervical cancer, endometritis, endometrial cancer, etc., you should go to the hospital for further examination as soon as possible to detect other diseases and treat them in time. There is another type of “cervical erosion”, which doctors call “true erosion”. This type of celiac disease is difficult to distinguish from columnar epithelial ectoplasia with the naked eye. It is due to the surface of the cervix where the columnar epithelium or squamous epithelium has peeled off for various reasons. For example, chemical erosion, various germ infections such as trichomonas or mycobacterial infections, and herpes virus or syphilis infections can cause damage to the cervical epithelium, which peels off and forms true erosion. This kind of erosion, however, needs to be diagnosed by further examination by a doctor and needs to be treated as soon as possible. Therefore, we conclude that “simple cervical erosion”, i.e., the ectopic columnar epithelium, is a physiological phenomenon that accompanies women throughout their lives and does not require special treatment.