Diagnostic scraping is the diagnostic scraping of the endometrium for pathological examination to clarify the diagnosis, with the aim of understanding the endometrial lesions and ovarian function. If cervical lesions have to be excluded, the mucosa of the cervical canal and the endometrium are scraped separately, called segmental scraping. So when do we need this painful-sounding procedure to help our women? Firstly, when there are patients with abnormal uterine bleeding who are in the reproductive stage or menopausal transition, or who have failed medication or have risk factors for endometrial cancer, they should be excluded from malignant lesions through diagnostic scraping; for unmarried patients, if medication fails or if organic lesions are suspected, diagnostic scraping should also be performed with the consent of the patient through explanation. Secondly, for patients with infertility, scraping should be performed 1-2 days before menstruation or within 24 hours of menstrual flow in order to determine ovulatory function; those with irregular bleeding or heavy bleeding can be scraped at any time. In the case of dysfunctional uterine bleeding and incomplete abortion, scraping can both clarify the diagnosis and play a role in hemostatic treatment. Why does pathological examination of the endometrium reflect ovarian ovulatory function? Does endometrial lesion necessarily mean endometrial cancer? Let’s briefly understand some general knowledge of endometrium. Endometrial changes are affected by estrogen and progesterone. After ovulation, endometrium is affected by estrogen and progesterone and shows secretory phase changes; endometrium is affected by estrogen without progesterone for a long time, endometrial hyperplasia or even cancer may occur, which is common in patients with anovulation during menopause transition and polycystic ovary syndrome. For endometrial hyperplasia, progestin can be used to convert the persistently hyperplastic endometrium into a secretory phase so that the endometrium no longer thickens. When the doctor recommends a diagnostic scraping, it must be a way for the doctor to further understand the patient’s disease and its cause and to take corresponding treatment measures. If the patient does not do it when it should be done, it will only delay the diagnosis and treatment, and will be regretted like Auntie Zhu. In the clinic, there are still a number of patients who choose to escape when the doctor gives the advice to scrape, the first reason should be the fear of the procedure and fear of pain. Most women are nervous about gynecological exams, and it’s understandable that they feel intimidated in the face of a hard surgical bed and cold surgical instruments. And the need for scraping due to dysfunctional uterine bleeding, middle-aged women still account for a large proportion of patients, this part of the patient has old and young, in the work is unable to get away, they are worried about the need to rest after surgery, afraid that this will affect family life and work. Other young women who have not yet had children are more worried about complications. Infertility patients feel that scraping the uterus must cause damage to the uterus, especially when they see the informed consent form for scraping, which states that there is a risk of uterine perforation and postoperative infection, they insist on refusing the operation. In the face of the half-understood views of friends and relatives on scraping, the doctor’s advice and explanations are left behind, preferring to believe only in Chinese medicine or health products. Nowadays, with the increase of people’s demand for medical environment and humanization, more than 80% of surgeries are performed under painless and analgesic conditions in our outpatient clinics, and patients under 55 years old with no medical or surgical comorbidities can undergo surgeries under anesthesia and say goodbye to fear and pain completely. Since the incidence of uterine perforation is low, about 1/350-2500, there is generally no need to worry too much. When it comes to patients who are menopausal or have a history of cesarean delivery, the surgeon will be doubly careful to avoid damage and a few days of postoperative prophylactic antibiotics can prevent infection. The endometrium changes with estrogen and progesterone, and after scraping, the endometrium will continue to repair, proliferate and peel off. The endoscopy can help to understand the ovarian ovulation and endometrial condition, so that endometrial hyperplasia, endometrial polyps and even endometrial cancer can be detected at an early stage, so that infertility patients can have a cause to follow and doctors can provide more targeted treatment, so that the ovaries can ovulate more regularly and the endometrium can peel off in a more orderly manner. Diagnostic scraping is a common gynecological procedure that is significant in diagnosing uterine diseases and ovarian function and is guaranteed by modern medical science and technology. For your health, please feel free to accept the relevant advice and treatment from your doctor.