A. What is celiac disease Celiac disease used to be a disease that plagued many women, and when they went for a physical exam, almost nine times out of ten they would be diagnosed with celiac disease. To talk about celiac disease, you may still need to start with the education of your doctor. In the unified textbook for Chinese medical students, in Obstetrics and Gynecology until 2008, celiac disease was always present as a standard disease, and even talked about its clinical presentation, diagnosis and treatment. But in reality, that was a misconception. Obstetrics and gynecology in China has been out of step with international practice for many years. Previously, obstetricians and gynecologists treated cervical epithelial ectropion during the physiological phase of the cervix as a pathological phenomenon and diagnosed it. In 2008, the 7th edition of the textbook of Obstetrics and Gynecology for undergraduate students clearly stated in its preface that it should be in line with international standards and pay attention to the updating of knowledge …… to constantly update clinical diagnostic and therapeutic standards. For example, the name “cervical erosion” was abolished and replaced by the physiological phenomenon of “cervical columnar epithelial ectasia”. So from that time on, the diagnosis of “cervical erosion” should have been eliminated in China, but due to the slow updating of knowledge of many physicians, even 5 years after the revision of this diagnosis in undergraduate textbooks, there are still many physicians who are diagnosing “cervical erosion”. Celiac disease, in the end, is actually a misconception of a normal manifestation of the cervix in the past. There are two different types of cells in the cervical area, squamous epithelial cells near the vagina and columnar epithelial cells near the uterus. The two types of epithelium are different in appearance. The part of the cervix that looks a bit like “erosion” is covered by columnar epithelium, while the outer part of the cervix, which is relatively smooth, is covered by squamous epithelium. Columnar epithelial cells and squamous epithelial cells are in a dynamic balance, somewhat similar to the stalemate zone in a war, which is medically named as “squamocolumnar junction zone”, and this zone is also a good area for cervical cancer. The squamocolumnar junction zone is easily affected by estrogen. Before puberty, when ovarian function is not perfect and estrogen is low, the columnar epithelium is more on the inner side; after menstruation, the columnar epithelium is more on the outer side under the influence of estrogen, so there are more columnar epithelium like “erosion” found at the cervical opening during examination. After menopause, the estrogen level of women decreases and the columnar epithelium starts to retreat inward again, so the “vesicles” will not be visible at the time of examination. The actual cervical cavity is not a cervical cavity, but a different degree of cervical epithelial ectropion. Some people may have contact bleeding, but it is only an individual difference of the cervix, just like some people chew something hard, some blood comes out of the teeth or mouth, which is understandable. It is important to mention here that cervicitis, if there is an increase in leucorrhea, yellowing and odor, these are signs of inflammation of the cervix, which is a symptom that occurs after an infection on the cervix. The cervical cyst and hypertrophy are also the result of chronic inflammation of the cervix. If you understand what has been proposed, it is easy to understand that the so-called “cervical erosion” is actually a normal physiological phenomenon that does not require any treatment, and now if you check the Internet to find many ways to treat cervical erosion, it is wrong. Also by the way, for symptomatic cervicitis, treatment is needed. The specific treatment method needs to be determined by different hospitals, but usually, acute inflammation can be treated with suppository medication, while chronic inflammation can be treated with physical treatment methods such as laser or freezing. V. Do you need regular checkups? Regular checkups of the cervix are necessary, this is not to prevent cervical erosion, but to prevent cervical cancer. Will it develop into cancer without treatment The occurrence of cervical cancer is related to the infection of human papillomavirus (HPV). Some so-called high-risk HPV types of HPV are prone to precancerous lesions and cervical cancer when they are persistently infected in the squamocolumnar junction area of the cervix. Cervical cancer has seen a substantial decrease in mortality since the availability of cervical smears, and the key is early prevention and treatment. Currently, it is recommended that women after the age of 21 should undergo cervical smear once a year, and after the age of 30, they can be examined in combination with HPV. If three consecutive HPV and cervical smear examinations are negative, the interval can be extended to once every three years, and screening can be stopped after the age of 65. 7. Does it have an effect on fertility Understanding that celiac disease is a physiological phenomenon means that it will not have an effect on fertility.