Menopause health guidance content

The core of menopausal health management has never been "to endure until menopause and everything will be fine", but to focus on the physical changes caused by estrogen fluctuations, and to make personalized adjustments from three directions: symptom intervention, emotion regulation, and chronic disease prevention based on individual tolerance and underlying disease conditions. There is no "standard answer" that applies to everyone, and the most effective plan is to meet your own needs.

I just met 48-year-old Sister Wang in the clinic last week. As soon as she entered the door, her eyes were red and she said that she seemed to be a "different person" recently: last week, her son forgot to take out the trash, so she scolded the child for half an hour, then turned around and hid in the toilet and cried for two hours.； I was lying in bed tossing and turning at night with my eyes open until after two o'clock. I suddenly felt a hot flash in my chest and neck, and even the collar of my pajamas was wet. I originally thought I was depressed, so I went to a psychiatrist and prescribed a lot of medicine. After checking my sex hormones, I found out that I was entering perimenopause - what we often call menopause, the transition period from the beginning of menstrual disorders to one year after menopause.

The first thing many people are concerned about is "What to do if you have hot flashes, sweating, or can't sleep well." This is also the most controversial area at present: Should I take hormone supplements? At present, the International Menopause Society and domestic gynecological endocrinology guidelines have made it clear that for moderate to severe menopausal symptoms, low-dose supplementation of estrogen and progesterone (MHT) is the most effective way to relieve symptoms within 10 years of menopause, under the age of 60, and without contraindications such as breast cancer, endometrial cancer, active thrombosis, or severe liver and kidney dysfunction. I have a sister who is a nurse in the same department. She is 47 years old and has gone through menopause. She has hot flashes and cannot wear long sleeves in summer. She has taken low-dose hormones for 4 years and has regular breast ultrasound, gynecological B-ultrasound, and coagulation function checks every year. Now she is 52 years old and is in very good condition. She has not even suffered from atrophic vaginitis that she always suffered from before. Of course, there are also many patients who are naturally resistant to "taking hormones" and always feel that "the medicine is only three parts poisonous". They can also choose a milder method: for example, black cohosh extract, which is currently clinically proven to be effective, can relieve mild hot flashes by about 60%. There are also many patients who can relieve symptoms through acupuncture and moxibustion. There is no distinction between these two options. As long as you feel comfortable and have regular physical examinations, it is fine.

Don’t think that losing your temper during menopause is a sign of “worsening of personality.” Many family members will also complain, “Why are you so unreasonable now?” It’s really not that people are being pretentious. It’s that the decline in estrogen will directly affect the secretion of serotonin and dopamine related to mood regulation. Just like when your mobile phone battery only has 10% left, small advertising pop-ups that you usually don’t care about can make you anxious. It’s not that you have a bad temper, but that the battery can’t hold it. A special teacher from a key middle school came to see a doctor before. She said that she could usually be calm when teaching high school seniors. During that time, she couldn't help but get angry when students whispered something in class. Afterwards, she hid in the office and slapped herself, feeling sorry for the students. In fact, it was caused by hormone fluctuations. When encountering this kind of situation, don't force yourself to "be an emotionally stable adult". If you are really annoyed, just talk to your sisters of the same age. Take 15 minutes a day to walk in the park twice, or even throw useless plastic bottles at home twice. It is not shameful to talk to a psychiatrist if you are really depressed. It is much better than suppressing breast nodules and thyroid nodules on your own.

Many people think that as long as menopause is symptom-free, everything will be fine. In fact, this is the easiest pitfall. Estrogen protects women in all aspects: it can not only protect vascular endothelium, reduce blood lipid deposition, but also reduce bone loss. In the first 10 years after menopause, women's bone loss rate can reach 2%-3% per year, and in 10 years it can lose about 30%. The incidence of cardiovascular disease has also increased 2-3 times compared with before menopause. Last year, a 53-year-old aunt came for a physical examination. She had no symptoms at all after 5 years of menopause. When she found out that her bone density had reached severe osteoporosis and her blood lipids were so high that she needed to take medicine, she was shocked and said that she had never cared about this before. So even if you have no symptoms of hot flashes or insomnia during menopause, you must remember to check your bone density, blood lipids, and sex hormones every year. Drink two more sips of milk, eat some dark green vegetables, soak in the sun for 10 minutes a day to replenish vitamin D, and do half-an-hour strength training two or three times a week, such as lifting mineral water bottles and practicing squats against the wall. It is much more effective than eating celebrity health products that cost hundreds of dollars.

Speaking of which, when my mother was going through menopause, she had grade three breast nodules and was a person who should be cautious about taking hormone supplements. I didn’t let her take any medicine, so I signed her up for a Tai Chi class in the community. Every night I went to do 40 minutes of soy milk with my old sisters. She always had soy milk at home and soaked her feet for 10 minutes before going to bed. Except for occasional hot flashes and sweating, she didn’t have much emotion. Now she is 58 years old and her bone density is better than many people in their 40s.

In fact, to put it bluntly, menopause is a very natural transitional stage in a woman’s life, just like menstruation in adolescence and gray hair in old age. Don’t treat it as a scourge, and don’t ignore it. You can refer to other people's experiences, but you really don't need to follow rigid formulas. Listening to your own body's feelings is better than anything else.