I often see patients coming from out of town to see celiac disease, and many rural women are even being lured into LEEP surgery, which is really sad, why a “minor” disease that is not a serious problem at all can become the heartbreak of so many people. Here’s a little bit of science to help. The majority of the cervical erosion is essentially the outward migration of the squamous junction caused by high estrogen levels, high estrogen levels during the reproductive years, the squamous junction outward migration is obvious, looks uneven, not smooth, red, manifested as “cervical erosion”, after menopause estrogen levels decline, the squamous junction shrinks back into the cervical canal, looks like the cervical also smooth. It is a physiological change, a sign of a young and fertile woman, and in most cases does not require treatment. For women who have had sex, only cytology screening (TCT) and HPV testing (if available) are done and if the cytology is abnormal, the results are treated accordingly. Colposcopy and pathology are done if necessary, and if CIN lesions are present they are treated as CIN, if not the next follow-up is decided based on the results of HPV and TCT. The main reason why cervical erosion is so important is that many people think that cervical erosion is related to cervical cancer, plus a few doctors are driven by profit to brag about misinformation, making women’s psychological pressure too much, turning it into a “heart disease”, and even severe erosion is not the same room for several years, seeking medical help every day. Personally, I think that cervical cancer has little to do with cervical erosion, and most cervicals that seem to be very eroded do not have cervical cancer, while many smooth cervicals or those with a few small red dots on the surface are cervical cancer or precancerous lesions. Early cervical cancer or precancerous lesions cannot be identified by the naked eye, and rely mainly on cervical smear (TCT) screening and HPV testing, followed by colposcopy and biopsy for confirmation. For women who are married or have had sexual intercourse with or without cervical erosion, it is recommended that TCT be done once a year for early screening of cervical cancer or precancerous lesions; if the HPV test is negative at the same time, TCT once every 3 years is sufficient. In reality, it is still seen that there are still cases of missed diagnosis. It is still recommended to do TCT every year, and increase the number of examinations if there is bleeding after sex or contact bleeding in between. At present there is over-treatment of celiac disease, which has a confusion of concepts and other such as economic interests driving it. Nowadays, it is outrageous that many unscrupulous hospitals use celiac disease as a signboard to attract patients to their gynecological clinics, allowing healthy people to check a celiac disease, followed by medication, infusion, and even LEEP, laser, and even thousands of thousands of dollars for treatment, becoming a typical means of over-treatment. We hope that more people will become aware of this problem and avoid being over-treated. Treatment of cervical erosion in women who have not had children is generally not recommended because physical therapy such as damage too deep can affect the elasticity and hardness of the cervix and may be prone to cervical laceration during childbirth, so it is generally not advocated. So which conditions require treatment? When cervical erosion is accompanied by infection, or when there is a combination of vaginitis or Chlamydia trachomatis (CT) infection, it can lead to abnormal leucorrhea, with high volume, odor, yellow color, and can present with vague discomfort in the lower abdomen and bleeding after sexual intercourse, which is acute cervicitis and requires intravenous or oral treatment with sensitive antibiotics. Polymethylsulfonyl vaginal medication is effective. The efficacy of the various other drugs is really not complimentary. Instead, physical therapy is the most commonly used and effective treatment, and most of them can be cured in just one session. The principle of physiotherapy is to destroy the single layer of columnar epithelium on the surface of the cervical erosion, causing it to necrotize and fall off to be covered by a new layer of squamous epithelium for the purpose of healing. For women who have completed childbirth and have severe cervical erosion with excessive leucorrhea, yellow leucorrhea (excluding vaginitis) or frequent bleeding after sexual intercourse, excluding acute cervicitis, laser, microwave or cryotherapy can be done. Cryotherapy or microwave treatment does not form scars, so cervical stenosis usually does not occur. The occurrence of cervical stenosis with laser treatment is also rare, and most of them do not affect the elasticity of the cervix if they are more superficial. Postoperative healing of the cervical wound takes 3 to 4 weeks, or about 6 to 8 weeks for deeper lesions. It is especially important to exclude cervical cancer before treatment so that early cancer is not misdiagnosed as inflammation and treatment is delayed. I have seen several cases of cervical cancer treated by laser as cervical erosion, so that the cancer cells spread, I feel really sad! ① Before treatment, cervical scraping should be done routinely for cytological examination; ② Acute genital inflammation is contraindicated; ③ The treatment time should be chosen within 3-7 days after menstruation to prohibit sexual intercourse; ④ After physiotherapy, there is an increase in vaginal discharge, even a large amount of watery discharge, and there may be a little bleeding when the scab is removed 1 to 2 weeks after surgery, so care should be taken to keep the vulva clean and dry to prevent infection; ⑤ Before the trauma is completely healed, the cervical cancer can be treated with laser. ⑤ During the period when the wound is not completely healed (4-8 weeks), it is forbidden to take a tub bath, have sexual intercourse and vaginal douching; ⑥ Physical therapy may cause postoperative bleeding, cervical canal stenosis and infection. After treatment, regular review is needed to observe the healing of the wound until it is healed, and attention should be paid to the presence of cervical canal stenosis. LEEP or cervical conization should not be done for cervical erosion. For old cervical laceration and mucosal ectasia caused by childbirth, cervical repair is feasible.