Menopause health science

Menopause is a normal physiological transition stage for women. It is neither a "sign of aging" nor a "pretentious excuse." There is no need to bear it hard or excessive anxiety. With scientific evaluation and individualized intervention, more than 90% of people can go through it smoothly, and it will basically not affect normal life.

I have been working in gynecology clinics for almost 9 years, and I have met too many people who have misunderstandings about menopause. Last week, I met a 47-year-old middle school teacher who had been suffering from insomnia for 3 months. She couldn’t concentrate in class during the day. She also had inexplicable hot flashes. Her face turned red and she was sweating. Students privately asked her if she was sick. Not only did she want to save face, she secretly bought several estrogen health products that claimed to "slow down aging". After taking them for half a month, her breast pain became excruciating and she came to see a doctor. After a check, the breast nodules had increased from grade 3 to grade 4a. Fortunately, the pathological results were benign, and they gradually disappeared after stopping the health products.

In fact, what we often call menopause is called perimenopause in medical standards, which refers to the period from when ovarian function begins to decline to 1 year after menopause. The average age of menopause for Chinese women is 49.5 years old. The entire period can be as short as 1-2 years or as long as 10 years. The essence is that the ovaries, the "warehouse" where eggs are stored, are almost empty, and estrogen secretion has changed from regular fluctuations to "jumping up and down." Just like the voltage in an old neighborhood fluctuates, light bulbs flash all the time, and electrical appliances are prone to tripping. Problems such as hot flashes and night sweats, insomnia and irritability, irregular menstruation, joint pain, and vaginal dryness are all chain reactions caused by "unstable voltage." 70% of women will encounter it. It is not that your personality has become worse, nor that you "can't handle things."

The most controversial question now is "whether hormone supplements can be used." The experts I contacted are indeed divided into two groups: experts in the field of gynecological endocrinology mostly believe that as long as you have no family history of breast cancer, no unexplained vaginal bleeding, no active blood clots, and serious liver and kidney function problems, using low-dose hormone supplements within 10 years of menopause or during the "window period" before 60 years old, the benefits far outweigh the risks. It can not only quickly relieve symptoms, but also prevent osteoporosis, cardiovascular disease and other chronic diseases of the elderly.； However, there are also many conservative experts, including many colleagues in traditional Chinese medicine, who prefer to "prioritize natural adjustment." After all, medicine is a three-part poison. People with mild symptoms can survive smoothly by adjusting their lifestyle, and there is no need to be exposed to exogenous hormones.

My own experience is that there is no conflict between these two views at all. It all depends on the individual situation: If you have been unable to sleep all night for a month or two, are sweating every time you move, and are in such a bad mood that you always feel that life is boring, then don’t take it hard and go to a regular hospital for menopause specialist or gynecological endocrinology for evaluation. Take the medicine when you need it. It is better than suffering from depression or severe osteoporosis before intervention.； If you only occasionally get a sudden heat in your chest and sweat a little, but it doesn't affect your eating and sleeping, then there is really no need to take medicine, just adjust the rhythm of your life.

Oh, by the way, many people also ask whether "natural estrogen supplements" such as soy isoflavones and royal jelly can be eaten? I generally advise everyone that it is okay to drink sugar-free soy milk and eat some tofu and tofu. The activity of phytoestrogens is only one-thousandth of human estrogen. The amount you eat daily will not cure the disease at all, so just supplement it with protein. But don’t buy those highly purified soy isoflavones and royal jelly products that cost hundreds of dollars a bottle. The dosage is uncertain and you don’t know if artificial estrogen is secretly added to it. Many people develop breast nodules and endometrial thickening due to random supplements.

There is also a very interesting observation. I found that most of the aunts who have gone through menopause smoothly have one thing in common: they do not regard themselves as "patients", nor do they insist on being "strong women". Aunt Chen, who came for a review last month, had quarreled with her husband last year and wanted to divorce because of hot flashes. Later, she listened to my suggestion and delegated the job of picking up and dropping off her grandson to her son and daughter-in-law. She went square dancing with her sisters three times a week and soaked her feet for 20 minutes before going to bed every night.

Oh, yes, and the role of family members is really important. I have met several patients before, and the symptoms are actually not serious, but their family members always say "you are just hypocritical for menopause." Originally, hormone fluctuations make people emotionally sensitive, but if they are told too much, they will really suppress depression. I often tell the family members who come to accompany the doctor, if she loses her temper or sheds tears for no reason, don’t argue with her, just pass her a glass of water or a piece of paper. This is more reasonable than anything else. This is not her problem, it is the hormones causing her temper. After this period, she will be fine.

To put it bluntly, menopause is a signal sent by your body, telling you that you have been busy for work and family for too long in the first half of your life, and it is time to slow down and hurt yourself more. If you really feel uncomfortable, go to the doctor and do whatever makes you feel better. It is really not that scary.