Cervical erosion is a frequent and common disease in women The literature reports that its incidence is as high as 40% to 60% in married and fertile women. The female cervix is divided into an inner and an outer opening. The epithelium of the inner opening is a slender, mucus-secreting red columnar cell, while the outer opening is covered by a grayish-yellow squamous epithelium. Under the influence of certain factors such as estrogen, the squamous epithelium of the external opening of the cervix becomes covered by columnar epithelium and cervical erosion is formed. When the surface of the celiac is observed under colposcopy, it is actually intact columnar epithelium, which is observed as red celiac-like to the naked eye because the columnar epithelium is a single layer with a red interstitium underneath. So celiac disease is not a disease, and it can even be said that the more celiac the healthier it is. Cervical erosion is not really erosion. Compared to a normal smooth cervix, it only feels visually like erosion. This change is related to the displacement of the junction between the squamous and columnar epithelium of the cervix. Colposcopic observation of cervical “erosion” is a squamous-columnar junction transformation zone. Many women are so afraid of this disease, in large part because they are frightened by the word “celiac”. Celiac disease is mostly asymptomatic, and many women are accidentally found to have celiac disease during a normal physical examination when they had no previous symptoms. Why is this? This is because cervical erosion itself is not an inflammatory condition, i.e. it is not an epithelial loss and inflammatory reaction in the pathological sense, but an ectopic cervical columnar epithelium, which is one of the physiological changes of the cervix and not a pathological change. When there is no pathogenic microbial infection, that is, when there is no combined inflammation, patients with cervical erosion may have no clinical symptoms or may only show increased discharge. Some patients may present with bloody leucorrhea or bleeding after sexual intercourse. Of course, there are some patients with more severe symptoms, and in addition to abnormal leucorrhea, they may also have symptoms such as backache, vulvar and vaginal itching. However, this is not due to celiac disease itself, but mostly due to a combined inflammatory infection. Some people believe that cervical erosion is caused by sexual life, so once they are diagnosed with cervical erosion, they are quite reluctant to have a sexual life. In fact, this view is wrong. At present, the real etiology of celiac disease is still unclear. It is generally believed that mechanical stimulation or injury after marriage, such as childbirth, abortion or too frequent sexual intercourse, can cause varying degrees of cervical squamous epithelial destruction and a decrease in local resistance of the cervix, which can easily cause cervical inflammation. However, it is clinically found that women who do not have sex still have cervical erosion, sometimes even severe erosion. This shows that sexual life is not the culprit of cervical erosion. At the same time, experts remind unmarried, or non-sexual women, if they have persistent leucorrhea, or with changes in color and texture, they should also visit a gynecological clinic in time to identify the cause and treat it in time. Cervical erosion does not necessarily lead to infertility In the past, it was believed that cervical erosion is often accompanied by inflammation, and inflammatory cells can engulf sperm, as well as cause changes in the nature of cervical mucus, thus preventing sperm from penetrating the cervical mucus to reach the uterine cavity. As the sperm cannot reach the uterine cavity, they naturally cannot meet the egg and conception cannot take place. However, it is now found that more young women have cervical erosion that is only an alteration of the cervical epithelial cell type and is not associated with an inflammatory infection and therefore does not lead to infertility. For women who are ready to get pregnant, if celiac disease is not accompanied by any symptoms, fertility specialists recommend that they should actively try to get pregnant without rushing to do much treatment for celiac disease. If it is accompanied by excessive leucorrhea or yellowish leucorrhea that has caused discomfort, it can be treated with appropriate medication and pregnancy can be attempted after the symptoms have improved. Celiac disease has nothing to do with cancer. Many women with celiac disease are worried about cervical cancer, believing that the heavier and longer the celiac disease is, the more likely cervical cancer will occur. Theoretically, cervical erosion is a physiological change caused by the replacement of the squamous epithelium of the cervix by the columnar epithelium, rather than true erosion. Cervical cancer, on the other hand, is an abnormal change in the squamous epithelium of the cervix, mainly due to human papillomavirus (HPV) infection. The causes and pathogenesis of the two are different, as are the pathological changes. Therefore, simple cervical erosion, if not combined with HPV infection, does not lead to the development of cervical cancer. However, women with cervical erosion should be reminded that during gynecological examination, cervical exfoliation cytology should be performed to initially exclude the possibility of cervical cancer. It is difficult to distinguish early cervical cancer from cervical erosion by gynecological examination alone. If possible, HPV testing should be performed along with cervical exfoliation cytology to exclude the possibility of cervical cancer and precancerous lesions. Is vaginal douching helpful in treating celiac disease? The surface of the female vaginal mucosa is squamous epithelium, which is affected by female sex hormones and undergoes a cycle of shedding, which has a protective effect. At the same time, the squamous epithelium secretes glycogen, which is broken down into lactic acid by Lactobacillus parasiticus in the vagina, thus maintaining an acidic environment in the vagina and inhibiting the growth and reproduction of bacteria. Under normal circumstances, women are not advised to do excessive vaginal douching, which is not beneficial in maintaining the acidic environment of the vagina, but can lead to dysbiosis, which can lead to vaginal inflammation. Celiac disease is not caused by bacterial infection. If you apply antiseptic, antiseptic, anti-itch and anti-inflammatory lotions to douche the vagina, it may destroy the protective barrier of the vagina itself, which is not beneficial to celiac disease and may cause secondary vaginal infections. Therefore, if celiac disease is not accompanied by vaginal inflammation, the application of local vaginal douches is not advocated. Can celiac disease be cured? Currently, the most widely used methods for the treatment of celiac disease in China are medication and physiotherapy. Physiotherapy is usually considered to be a one-time cure for cervical erosion. In fact, in the absence of a clear cause, no conservative treatment is likely to cure cervical erosion completely. Clinically, it is often encountered that after physiotherapy treatment of cervical erosion, the erosion area becomes smooth (columnar epithelium is replaced by squamous epithelium), but after a period of time, cervical erosion reappears. The reason for this is that the principle of microwave, ironing, laser or freezing methods is to destroy the columnar epithelium on the erosion surface, causing it to necrotize, crust off and new squamous epithelium to grow in to “cure” it. If the real cause of the disease is not removed, celiac disease may occur again. Should celiac disease be treated or not? In recent years, there have been some new ideas in the academic community about the management of cervical erosion. When there is no pathogenic microbial infection, cervical erosion may have no clinical symptoms or may only manifest as increased discharge and does not require treatment. Does physiotherapy have any effect on subsequent pregnancy and delivery? Treatment by physical methods such as laser may cause slight damage to the cervix and may affect the dilatability of the cervix during later delivery. It is best to go to the hospital for a check-up before planning to get pregnant. If the cervical erosion does not affect pregnancy or is not combined with an acute infection, you can get pregnant first and wait for the delivery before undergoing laser treatment. However, if your condition requires it, you should still follow your doctor’s advice and actively cooperate with the treatment. In principle, physiotherapy only destroys a layer of cells on the surface of the cervix, and by repairing the damage, the columnar epithelial cells are transformed into squamous epithelial cells, thus treating cervical erosion, and therefore physiotherapy does not cause narrowing of the cervical opening, let alone infertility. The treatment of “cervical erosion” is contrary to medical ethics For decades, physical therapy such as electric ironing, laser and freezing has been advocated in China for moderate and severe cervical erosion. In recent years, LEEP (i.e. electrosurgical loop excision of the cervix), which is specifically used for the treatment of precancerous cervical lesions in western developed countries, has also been used for the treatment of cervical erosion. It is worth mentioning that there is a worrying trend of further expansion of this treatment driven by economic interests! What are the dangers of treating “cervical erosion”? First of all, the treatment of the so-called “cervical erosion” is against medical ethics, as it is unethical to treat women who may not have cervical disease, adding to their physical and mental burden and financial loss! Some unethical hospitals and doctors seize on patients’ fear of cervical erosion and violate the “three-step principle” by readily performing colposcopy without cervical TCT and then holding magnified pictures of the so-called “cervical erosion” in a graphic manner. The second is that treatment without cervical screening may miss cervical invasive cancer or high-grade pre-cancerous lesions, which is dangerous for the woman being treated. In addition, treatment may bring other harm, such as adhesion or atresia of the ectocervix leading to obstruction of menstrual bleeding, trauma leading to long-term inflammatory response of the cervix or endometriosis of the cervix, causing post-coital bleeding or bloody leucorrhea, and impaired cervical function leading to miscarriage or premature delivery during pregnancy. People have known about cervical cancer for more than 200 years and it is the most common malignant tumor in underdeveloped countries and regions. In most areas of China, due to limited medical conditions, clinicians used to judge the presence of cervical disease by visual observation only, but only a few cervical invasive cancers can be recognized by visual observation. However, only a few cases of cervical invasive carcinoma can be recognized by visual inspection. Some smooth-looking cervixes may have hidden lesions in the cervical canal, and it is usually difficult to determine the presence of cervical disease by visual inspection alone. Invasive carcinoma of the uterine cervix originates from the squamous or glandular epithelium of the uterine cervix. The early stage of its natural history is a persistent infection with high-grade HPV, which leads to a slow disruption of the mature differentiation process of the epithelium in the migratory zone of the cervix; this early stage is known as cervical precancerous lesions (≥CIN II/AIS). The primary method for screening the cervix is cervical cytology, and the secondary method is high-risk HPV DNA testing. The conventional method to confirm the diagnosis of cervical invasive carcinoma and its high-grade precancerous lesions is the “three-step technique”, i.e. cervical cytology, colposcopy and histopathology. There is only one strategy for treating high-grade precancerous lesions: removal of the entire lesion.