Menopause health management methods

Based on individually adapted lifestyle adjustments, priority is given to medical intervention in accordance with doctor's advice for moderate to severe symptoms. At the same time, emotional support and social environment adaptation are taken into consideration. There is no need to bear the burden and there is no need to be overly anxious.

I have been working as a female menopausal health clinic in a maternal and child health hospital for 11 years, and I have seen too many patients who have gone astray. The 48-year-old sister Zhang who I just received last week is a typical example. After listening to the little sisters who danced square dances, estrogen supplements can rejuvenate youth. I bought imported estrogen cream from overseas and took it for two months. Instead, the hot flashes did not go away. Instead, my breasts were so swollen and painful that I couldn't even wear underwear. I had insomnia all night. When I went for a check-up, I found that the breast nodules had increased from level 1 to level 3.

When it comes to hormone supplementation (MHT), there are actually different voices in the academic community. The mainstream view of Western medicine is that it is a first-line solution for relieving moderate to severe vasomotor symptoms (that is, people often say sweating all over the body, waking up several times at night with night sweats) and genitourinary tract atrophy. As long as it meets the indications of "within 10 years of menopause, age less than 60 years old, no family history of breast cancer, and no high-risk factors for thrombosis," if used according to the doctor's instructions and followed up regularly, the benefits far outweigh the risks. However, there are also many conservative experts who prefer non-drug solutions for mild to moderate symptoms. After all, there are indeed a small number of people who will experience breast tenderness and irregular bleeding after use, even if they meet the indications. In the traditional Chinese medicine system, menopause is not regarded as a "disease that requires treatment" at all. This is a normal life cycle transition for women with "deficiency of the Qiqi Ren pulse, weak Taichong pulse, and exhaustion of the Tiangui". Most of them start with nourishing the kidneys, soothing the liver, and regulating qi and blood. I have seen many hot flashes with no symptoms. For patients with severe symptoms, moxibustion on Guanyuan and Sanyinjiao twice a week, or Xiaoyao Pills and Zhibai Dihuang Pills, combined with Baduanjin for 20 minutes a day, will reduce the frequency of hot flashes by more than half in three or four weeks, and the effect is no worse than taking low-dose hormones.

When many people think of health management, they think of taking medicine. In fact, most people’s menopausal discomfort can be relieved by adjusting their living habits alone. There used to be a 46-year-old middle school teacher. During the first six months of menopause, he would suddenly blush and sweat in the middle of class. He was so embarrassed that he couldn't help but get angry with his students. He bought a bunch of bird's nest and donkey-hide gelatin supplements. He gained 7 pounds in three months, his blood sugar was at the critical level, and his symptoms were not cured at all. Later, I asked her to stop all supplements, drink enough 1800ml of warm boiled water every day, eat less spicy coffee, replace one-third of the white rice and flour with whole grains such as oats and quinoa, walk around the playground for 40 minutes after class every day, and go hiking with colleagues on weekends. Less than a month later, she came to the clinic specifically to see me and said that she had not had hot flashes in the past week and could stabilize her mood in class.

Oh, by the way, many people ignore the role of emotional and social support. Not long ago, a family member of a patient came to me and said that his mother was always finding faults at home after menopause. Both father and son avoided her, but the old lady was even more aggrieved and cried at home every day. Regarding the issue of emotional regulation, there are now two different clinical approaches: one is that as long as the diagnostic criteria for anxiety and depression are not met, medication is not recommended, and patients are encouraged to go out to socialize, dance square dances, travel with their sisters, or even find hobbies that interest them. ； Another point of view is that if you have suffered from insomnia, low mood, and always feel that life is boring for more than two weeks, early intervention with some oryzanol or even a small dose of anti-anxiety drugs can prevent the development of more serious psychological problems and is safer. Personally, I prefer a combination of the two. I try to adjust my living conditions first, and then take medication if it doesn't work. There is no need to force it, and there is no need to think that taking mood-regulating drugs is "mental illness."

Another point that people rarely pay attention to is bone health. Many people only know to take calcium tablets when they suffer from leg and back pain during menopause. In fact, calcium supplements alone are useless. They must be combined with vitamin D and stay in the sun for 15 minutes a day to promote calcium absorption. It is best to do a bone density screening once a year. If there is already bone loss, you must follow the doctor's advice and use some anti-bone resorption drugs, otherwise it will be too late to supplement after a fall and fracture.

I have been doing outpatient clinics for so many years, and my biggest feeling is that there is really no unified "correct management method" for menopause. Some people don't take any medicine, but take their grandson to square dance every day, and the transition is over comfortably.； Some people have been taking hormone supplements for 5 years according to the doctor's advice. All the indicators in the physical examination are normal, and they are in better condition than their peers. ； There are also people who have taken the traditional Chinese medicine treatment seriously, drank traditional Chinese medicine and used Baduanjin, and lived very comfortably. To put it bluntly, health management is never about conforming to any standard answer. Your own comfort is the most important thing.