Menopause health education

Menopause is a normal physiological transition stage in which women’s ovarian function changes from strong to declining. It is not a disease in itself. However, about 75% of perimenopausal women in my country will experience uncomfortable symptoms such as hot flashes and night sweats, mood swings, sleep disorders, and vaginal dryness. Among them, 10% to 20% of them will have symptoms that seriously affect their quality of life. It has been confirmed that through scientific lifestyle adjustments + standardized medical intervention when necessary, more than 90% of discomforts can be effectively relieved, and there is no need to endure it at all.

I just met a 48-year-old sales director, Sister Zhang, in the outpatient clinic last week. She used to be able to stay up for three days and nights with her team, but she suddenly seemed like a different person in the past six months: she would get angry at her subordinates over the smallest things, and shed tears for no apparent reason when she returned to the office. She had hot flashes more than a dozen times a day, and her collar would get wet at every turn. She thought she was suffering from depression. She went to a psychiatrist and was prescribed anti-anxiety medication for two months, but she didn't feel any better. After checking her sex hormones, she found out that she was in perimenopause.

Many people may have heard the saying that "menopause will pass if you tolerate it". This view is actually not wrong. Twenty years ago, there were not many domestic intervention studies on menopause. Everyone was generally wary of the side effects of hormones. Indeed, many people survived it. This is also the core basis of the "let nature take its course" nowadays. However, with the continuous updating of domestic peripheral menopause management guidelines in recent years, the academic community has actually reached a clearer consensus: whether to intervene depends entirely on the degree of your symptoms and personal wishes, and there is no unified standard answer.

If you only have hot flashes once in a while, your mood is a little sensitive but completely under control, your menstruation is irregular but not heavy, and you are not anemic, then you really don’t need to take any medicine, drink less coffee and less alcohol, take half an hour to go out for a walk every day, and have a regular schedule, most people can make a smooth transition. But if you are like Sister Zhang, you have hot flashes more than a dozen times a day, you toss and turn at night and you can't fall asleep at 2 or 3 o'clock, you feel like crying and getting angry at every turn, you even have pain during intercourse, and you have repeated urethritis, which has obviously affected your normal life, so there is really no need to carry on. Low-dose hormone supplementation therapy commonly used in clinical practice now, as long as it is within 10 years of menopause and before the age of 60, and does not have contraindications such as breast cancer, unexplained vaginal bleeding, or active liver disease. If used according to the doctor's advice, the benefits far outweigh the so-called risks. It can not only quickly relieve symptoms, but also help you preserve bone mass and reduce the probability of osteoporosis and cardiovascular disease in later life. This is also the core view of the "window period intervention school" recommended by current mainstream guidelines.

Many people are afraid of the word "hormone" when they hear it. They are afraid of getting fat and getting cancer. I have met several patients who would rather secretly buy "menopausal maintenance pills" and "ovarian maintenance essential oil" online than go to the hospital to prescribe regular medicine. In the end, they spent tens of thousands of dollars, and their symptoms were not cured, and they even developed abnormal liver function. There are also people who drink soy milk from a thermos every day, claiming that it can supplement estrogen. To be honest, the activity of soy isoflavones in soy milk is only one thousandth of human estrogen. You have to drink ten pounds of soy milk a day to relieve symptoms. Drinking it until your stomach is bloated is useless. If you really want to supplement phytoestrogens, it is better to follow the doctor's advice and eat purified soy isoflavone preparations, and the dosage is accurate. As for Internet-famous supplements such as snow clam and royal jelly, the doses of animal estrogen contained in them are unstable. Eating too much may stimulate the endometrium and breast glands. It is really not recommended to eat them blindly.

After working in outpatient clinics for so many years, I have accumulated several tips that have been reported to be effective by patients. They are much more reliable than the stereotyped "exercise more and drink more hot water" on the Internet: I usually carry a small ice patch in my bag and stick it on the back of my neck when hot flashes come up. I can stand in a ventilated place for half a minute and it can basically suppress it. It is much more effective than drinking ice water and eating cold things, and it is less likely to hurt the stomach. Don't hold it in when your emotions come up. You don't have to force yourself to "be an emotionally stable adult." Find a place where no one is around to yell, or go for a walk downstairs, or even buy a stress-relieving toy and squeeze it twice. It's better to let your emotions out than to keep them in your heart. There are also problems that many people are embarrassed to talk about, such as vaginal dryness, pain during intercourse, and repeated urinary tract infections. It’s really not something you should endure as you get older. You can either use medical water-soluble lubricants or apply low-dose estrogen ointments locally. You can see significant improvement in a week or two. There is no need to wrong yourself.

Last month, a 52-year-old aunt came for a follow-up consultation. She was diagnosed with bone loss after 3 years of menopause. She always felt that the pain in her waist and legs was caused by raising her grandson, and she couldn’t relieve it no matter how much she rested. After the evaluation, there were no contraindications, and she started taking low-dose hormone supplements. I drink a cup of whole milk every day, bask in the sun for 15 minutes, and dance Baduanjin for 20 minutes. After three months, my bone mass has stabilized during a review, and my waist and leg pain has mostly improved. Now I go hiking in the suburbs with my little sister every week, and the photos I take on my friends circle are more energetic than before.

In fact, I have been practicing gynecological endocrinology for more than ten years. What I want to tell you most is that menopause is never a "scourge", nor is it a sign of "getting older". It is just a signal sent by your body to tell you to pay more attention to your own feelings next. Don't always think that it will be over if you endure it, and don't blindly believe in various maintenance remedies on the Internet. If you really feel uncomfortable, go to the menopausal clinic or gynecological endocrinology department of a regular hospital for an evaluation. The adjustment method that suits you is the best. After all, being comfortable is the most important thing in the rest of your life.