Menopausal health and ovarian anti-failure multiple choice questions

There is no absolutely correct option. The core bottom line of all choices is "evidence-based medical basis", and the ultimate standard is "your own comfort and health needs." There is no need to bear it or pay the IQ tax.

Last week, we encountered two extreme cases in the clinic. A 49-year-old lady had stocked up on ovary maintenance kits worth more than RMB 30,000. She went to a beauty salon twice a week to undergo "essential oil massage" on her ovaries. After two months of regular menstrual massage, her menstruation became irregular twice a month. A B-ultrasound also revealed a corpus luteum cyst. After asking, she learned that the essential oil the masseur used for her had estrogen secretly added to it. Not only did she spend a lot of money, but she also suffered. Another 46-year-old college teacher had such severe hot flashes and night sweats that he had to change his shirt three times in one class. He had such insomnia that he could only sleep for more than one hour a day. He refused to take hormone supplements because he was afraid of getting cancer. In the end, he became anxious, but his daughter forced him to do it.

In fact, the points that many people struggle with are essentially just a few unclear multiple-choice questions. There is never a unified answer, and practitioners in different fields do have different judgment standards.

Let’s first talk about the hormone supplementation issue that everyone is most concerned about. The mainstream view of Western gynecology is very clear: as long as you are within 10 years of menopause, younger than 60 years old, and have no contraindications such as breast cancer, endometrial cancer, or active thrombosis, the benefits of HRT (hormone supplementation therapy) for moderate to severe menopausal symptoms are far greater than It can not only quickly relieve discomforts such as hot flashes, insomnia, and vaginal dryness, but also reduce the long-term probability of osteoporosis and cardiovascular disease in the elderly. my country's 2023 version of menopausal management guidelines also lists it as a first-line intervention plan for moderate to severe symptoms. However, many practitioners of natural medicine prefer to use lifestyle modification + plant extract intervention first for mild to moderate symptoms, such as black cohosh and standard extracted soy isoflavones. After all, about 1% of people who use HRT will experience breast tenderness and irregular bleeding as adverse reactions. People with high risk factors for breast nodules must weigh the pros and cons more carefully.

No one is right or wrong. The core thing is whether you have symptoms that affect your normal life and whether you have clear contraindications. There is no need to talk about hormone discoloration, and there is no need to force supplements without symptoms.

Let’s talk about whether the “ovarian anti-failure projects” flying all over the market are IQ taxes. Can you believe that I just admitted a patient with a ruptured corpus luteum last month and got ovarian massage in a beauty salon? The ovaries are deep in the pelvic cavity, with the bladder in front and the rectum behind them. Ordinary people cannot touch them when lying down. Those so-called "rubbing can activate the ovaries" and "red light irradiation promotes follicle development" are purely deceptive. There is also the one that claims that an injection of stem cells worth hundreds of thousands of dollars can make the ovaries return to 20 years old. At present, domestic stem cell anti-ovarian anti-aging is still in the clinical trial stage, and there are no approved civilian projects at all. What is injected is either saline or nutrient solution. It is a trivial matter that the money is wasted. If something goes wrong with a preparation of unknown origin, it will be a big trouble.

But that doesn’t mean that all non-medical interventions are useless. I know a 52-year-old sister who has been dancing square dance for 5 years. She sleeps 7 hours a day and rarely stays up late to smoke or drink. She has almost no menopausal symptoms. Her menstruation is still regular and her condition is much better than that of many people who take supplements randomly. Regular exercise, adequate sleep, and stable mood. These free things are the core of really delaying the decline of ovarian function.

Some people also ask whether drinking soy milk, eating snow clams, and bird's nests every day can nourish the ovaries? The consensus in the nutrition community is that drinking 300-500ml of pure soy milk every day, the soy isoflavones in it are weak estrogen, which is indeed helpful for relieving mild hot flashes and is very safe. However, animal-derived supplements such as snow clams and purple river chestnuts have relatively high estrogenic activity. People with uterine fibroids, breast hyperplasia, and endometrial polyps may take them, but they can easily stimulate the growth of the lesions. I once had a patient who ate a snow clam every day for three months in order to resist aging. The uterine fibroids that turned out to be 1.2cm directly increased to 3.5cm. She was so frightened that she quickly stopped. The view of traditional Chinese medicine is more moderate. It is believed that menopause is characterized by "deficiency of the Ren pulse and weakening of the Taichong pulse". Regularly eating some liver and kidney nourishing foods such as wolfberries, mulberries, and yams are much more effective and less likely to cause problems than sky-high price supplements that often cost thousands of dollars.

I have been a gynecologist for 12 years, and I have seen too many people regard menopause as the "switch of aging". They are either so anxious that they spend money on various anti-aging products, or they think "I can handle it as well as everyone else". In fact, it is completely unnecessary. Menopause is a normal physiological stage. Just like you have your period in your teens, or you may have a baby in your twenties, they are all necessary stages in life. Is there any standard answer? If your symptoms are mild and you can live comfortably with exercise and diet adjustments, that’s absolutely fine. If your symptoms are severe enough to affect your work and life, just take the medicines you need without any psychological burden.

After all, your body and your comfort are the most important, right?