Menopause health management

There has never been a unified "standard answer" to menopausal health management. The core is to combine the individual's physical foundation, symptom severity, and acceptance willingness to alleviate current discomfort and reduce the long-term probability of osteoporosis, cardiovascular disease, etc. without increasing additional health risks. The so-called "best plan" is always the one you are willing to stick to for a long time and the body gives positive feedback.

The sister Zhang I met in the clinic last week is a typical example. She is 48 years old. She started having hot flashes six months ago. She woke up in the middle of the night and her chest and back were covered in sweat, and the sheets were wet. I read Xiaohongshu and said that estrogen supplements are effective, but my best friend stopped me and said: "Taking hormones can cause cancer, so don't touch it blindly." I bought two boxes of soy isoflavones and took them for three months, but the symptoms were not relieved. Last week, because my son forgot to bring his keys, I almost dropped the new iPhone. When I checked, my bone density has reached the critical value of low bone mass, and if it goes further, it will lead to osteoporosis.

In fact, I meet about a dozen people like Sister Zhang who are struggling every week in my clinic. To put it bluntly, there are only two contradictions: one is the fear of side effects of intervention, and the other is the fear of problems if not intervened. These two concerns are very normal. After all, there is no one-size-fits-all view in the industry regarding menopausal intervention. I have been doing gynecological endocrinology for more than ten years, and I have seen people with mild symptoms. They are just a little irritable occasionally. They don’t need to take any medicine. They can go on a square dance or go on a trip with friends and they will be over. ； I have also seen severe cases, such as hot flashes to the point where I dare not wear long sleeves in summer, and depression to the point where I can’t even leave the house. Finally, I took menopausal hormone therapy (MHT) as a standard and slowly recovered. It is true that thousands of people are different.

Doctors who support starting MHT as early as possible rely on clear evidence-based evidence: as long as it is started within 10 years of menopause and during the "window period" of under 60 years old, and there are no contraindications such as family history of breast cancer, active thrombosis, and unexplained vaginal bleeding, supplementation with natural low-dose hormones will not only It can quickly relieve discomforts such as hot flashes, insomnia, and vaginal dryness. It can also help you retain bone mass and reduce the risk of cardiovascular disease in the elderly. The so-called "hormones cause cancer" has long been overturned by new research. The risk of long-term use is even lower than the probability of developing diabetes if you drink milk tea every day. However, there are also many conservative doctors and patients who do have concerns: they have underlying diseases such as breast nodules and uterine fibroids, or they are really unable to overcome the psychological barrier of "taking hormones". If they insist on taking supplements, they will increase the psychological burden, and the gain will not be worth the loss.

There are also many people who believe more in the conditioning ideas of traditional Chinese medicine. I have a colleague in the traditional Chinese medicine department who is 49 years old. He is menopausal and has not taken hormones. He drinks Erxian Tang twice a week and does Baduanjin for 20 minutes every day. His hot flashes disappeared in more than a year. Last year, his bone density was stronger than that of many 30-year-old girls. But I have also met patients who blindly took supplements. I heard that deer fetus ointment and royal jelly can "nurture the ovaries". After taking them for half a year, it was just ordinary breast hyperplasia, but Type 3 nodules grew directly. I was so scared that I stopped quickly. To put it bluntly, Chinese medicine conditioning also requires syndrome differentiation. Not everyone is suitable for warm tonic. I have seen many problems caused by taking supplements blindly.

In fact, you really don’t have to worry about whether to take medicine or not. You can adjust the little things in your life first, and many people’s symptoms will be relieved by half. I once had a patient who worked as an Internet operator. She used to have three cups of American refreshment every day and had hot flashes more than ten times a day. I asked her to change her coffee to warm light chrysanthemum tea, and the number dropped to two or three times a week. There are also people who are still deficient in calcium after taking calcium tablets every day. In fact, they are just too lazy to go out and bask in the sun. If they are exposed to the sun for 20 minutes a day, enough vitamin D can be synthesized to supplement the calcium. Also, don’t watch short videos until one or two o’clock every day. During menopause, hormone fluctuations will affect your sleep. If you stay up late, it’s strange that your mood will be stable.

Many people tend to ignore emotional issues and always think that they are "hypocritical" when they have a bad temper during menopause. In fact, this is not the case. It's just that hormone fluctuations send wrong signals to the brain. Don't blame yourself, and you must explain the special nature of this stage to your family members. There was a patient who came here with her husband before. I joked with her husband, saying that she is like a child in adolescence at this stage, and she can't control her emotions when she gets emotional. Don't argue with her. Give her a glass of warm milk, go out for a few rounds, and wait until she is relieved. Later, she came back for a follow-up visit and said that her husband would hand over the peeled apple whenever he saw something wrong with her face. The two of them had not even had a fight in the past six months.

I once met a 52-year-old aunt who had suffered from hot flashes for 6 years, saying, "This is how the older generation got here." However, last year she fell downstairs and fractured her femoral neck. After the surgery, she lay down for three months and now has to use crutches. She later told me that if she had known better, she would not have suffered this fate. Of course, there is no need to be overly anxious and use the symptoms on the Internet to apply to yourself, let alone believe in the IQ tax of "reversing menopause" or "returning to youth". Menopause is a normal physiological process, no different from adolescence and pregnancy and childbirth. What we have to do is never to fight aging, but to make ourselves more comfortable and healthier as we age.

A few days ago, a 50-year-old patient came for a follow-up consultation. He said that now he and his sister do Tai Chi every morning and take a half-hour walk after dinner in the evening. The symptoms of hot flashes are basically gone. The bone density during the last physical examination was normal. Even the migraines that he often suffered before are much better. She told me that she used to think that menopause was a "hurdle", but now she realizes that by making good adjustments, this stage can make up for all the health lessons she missed in the previous half of her life. You see, there is no unified standard answer. Your own comfort is more important than anything else.