Menopause Health Lecture

Menopause is not a physiological transition period that can be “passed through with patience”. More than 90% of uncomfortable symptoms such as hot flashes, insomnia, and emotional loss can be alleviated through individualized intervention. There is no “magic prescription” that applies to everyone. All interventions must be professionally evaluated first and avoid contraindications before choosing a plan.

I met 52-year-old Aunt Zhang at a community free clinic last week. She has been suffering from night sweats for almost half a year. She woke up at night and was so wet that her pajamas could see through two layers of pajamas. She didn’t dare to go to the hospital. She secretly bought royal jelly and Xiaoyao Pills and took them for three months. As a result, last week’s physical examination showed that the breast nodules had increased from category 2 to category 4a. She was so scared that she hurriedly registered. I have encountered too many patients like her who are stubborn and blindly taking supplements. Many people’s understanding of menopause is that “it’s just a bad temper, and it will be fine until menopause.” But in fact, hormone fluctuations during this period not only affect the quality of life, but may also lead to hidden dangers of osteoporosis and cardiovascular disease.

The industry’s current thinking on menopausal intervention is not unified. In the Western medicine system, one group advocates seizing the "intervention window period" within 10 years of menopause and before the age of 60. As long as there are no contraindications such as a history of breast malignant tumors, active blood clots, or severe liver and kidney dysfunction, supplementing with the lowest effective dose of estrogen and progesterone can not only quickly relieve symptoms, but also reduce the risk of chronic diseases in old age. The benefits far outweigh the risks. ； However, there are also many conservative clinicians who, considering that many people have low acceptance of hormones, will also recommend making lifestyle adjustments for three months first. If no effect is achieved, then consider medication. There is no absolute right or wrong. It all depends on the individual's physical condition and acceptance.

The thinking of traditional Chinese medicine is different, classifying menopausal discomfort as "pre- and postmenopausal syndromes", the core of which is kidney qi deficiency and yin and yang imbalance. Some people suffer from kidney yin deficiency due to heat, sweating, dry mouth and tongue, so they need to use Zhibai Dihuang Pills to nourish yin. ； Some people are afraid of the cold, have cold hands and feet, and have loose stools due to kidney yang deficiency. Instead, they need to warm the kidneys. If they do the opposite, the more they eat, the worse the symptoms will be. There was an aunt who had kidney yang deficiency before. She read on the Internet that Zhibai Dihuang Pills could be used to treat hot flashes. She took it for half a month and had diarrhea for a week.

Many people's first question as soon as they sit down is: Doctor, is it okay for me to drink soy milk every day? Will it supplement estrogen? Seriously I get asked this question dozens of times a week. Soy isoflavones are indeed phytoestrogens, but their activity is less than one-thousandth of the body's own estrogen. If you drink three to five cups of soy milk a day, that amount of soy milk is not enough to relieve mild hot flashes. It is at most an auxiliary. Don't expect it to cure diseases. Of course, don't worry about swelling of nodules after drinking it. Drinking it normally is completely fine.

Another point that is easily overlooked is that emotional problems during menopause are really not "caused". Last month, there was a 47-year-old female patient who was the head teacher of a key middle school. She used to have a very gentle personality. Half a year ago, she started getting angry with students and quarreling with her husband when she went home. She also felt that something was wrong, but she couldn't control it, and she always felt that life was boring. After checking her hormones, she found out that estrogen fluctuations affected the secretion of 5-hydroxytryptamine in the brain. Either her personality had changed, or it was caused by physiological factors. Later, she was prescribed some medicine to regulate neurotransmitters, along with mindful breathing. When she came for a follow-up visit last month, she said she hadn’t blushed with her family for a long time.

Oh, by the way, there are also those "ovarian care packages" and "menopausal anti-aging miracle pills" sold online, so don't buy them randomly. There was a patient who spent more than 20,000 yuan to buy a set of ovary maintenance essential oil. He went to a beauty salon every day to rub his belly, saying it could delay menopause. However, after three months of rubbing, his menstruation stopped. Also, because an unknown dose of estrogen was added to the essential oil, it was found that the endometrium had almost doubled in thickness. The ovaries grow deep in the pelvic cavity, separated from the belly, fat, and muscles. What essential oils can penetrate into them? To put it bluntly, they all charge an IQ tax.

I have talked so much with you today. I am not asking you to buy medicine and take it by yourself after listening to it. Instead, I want to remind you that everyone’s physical condition is different. Some people are suitable for taking hormones, some are suitable for taking Chinese medicine, and some people can feel much better just by adjusting their work and rest and dancing for half an hour every day. Don’t blindly follow other people’s experiences. If you really feel uncomfortable, going to a gynecological endocrinology or menopausal clinic in a regular hospital for an evaluation is better than anything else. There is really no need to bear the hurdle of menopause.