Women's health hurdles

More than 90% of women's lifetime health risks cannot avoid two hurdles - reproductive endocrine fluctuations around the age of 30, and perimenopausal functional decline around the age of 50.

Last week, I was helping to sort out cases at the gynecology clinic. I happened to meet a 32-year-old Internet operator girl with bags under her eyes that almost reached her cheekbones. As soon as she sat down, she said that she hadn't had a period in half a year. She picked out handfuls of her hair and thought she had stayed up late. After six hormone tests, she found polycystic syndrome and insufficient luteal function. She also said that among the five girls in her department who were around 30 years old, three had irregular menstruation, and one had just been diagnosed with grade three breast nodules. Don't tell me, this is a typical sign that you have crossed the first hurdle.

The hypothalamus-pituitary-ovarian axis in Western medicine is what we often call the "command axis" that regulates hormones and menstruation. Women around the age of 30 are stuck in the most complex stage of life: they have just given birth, got up in the middle of the night to feed three times, and have to rush to PPT during the day, or they are anxiously pushed away by various indicators during the pregnancy preparation period. Those who are not married cannot escape invisible discrimination and pressure in the workplace. This axis is most likely to "go on strike" in a continuous state. Traditional Chinese medicine is more direct. The "Huangdi Neijing" states that "the five or seven Yangming pulses weaken, the face begins to burn, and the hair begins to fall." Around the age of thirty-five, the spleen and stomach qi and blood are the first to go downhill, which is reflected on the face with wrinkles and spots, and on the body with irregular menstruation, hair loss, and easy fatigue. The two sets of logical explanations are different, but they point to completely overlapping problems.

Several female obstetrics and gynecology doctors around me also encountered pitfalls when they were over 30 years old. There was a deputy director who stayed up late for three months in a row to be evaluated for professional titles, and had heavy menstruation for two consecutive months. Nowadays, there are many quarrels in the industry over the solution to this hurdle: one group says that early intervention is needed. If hormone abnormalities occur, medication should be taken to adjust them. Don’t wait for problems to occur before replenishing them. ； The other group says that as long as it is not at the pathological level, priority should be given to adjusting your work schedule and reducing stress. Taking estrogen supplements and anti-sugar pills will easily disrupt your balance. In the end, there is no unified conclusion. Anyway, everyone's tacit consensus is: Don't believe in "stay up the latest night and use the most expensive skin care products." Endocrine disorders, no matter how expensive skin care products are, can't save your face.

If the hurdles at age 30 are mostly caused by stress and stages of life, then the hurdles at perimenopause at around age 50 are when the body's functions naturally decline, and it is easy to fall over if you fail to catch it.

Not long ago, my best friend took her mother for a physical examination. The 48-year-old woman rarely even caught colds before. This time, the bone density T-score has reached -2.6, which belongs to the category of osteoporosis. She has been suffering from back pain for more than half a year. Her mother thought it was due to being tired from doing housework. She also thought that she was suffering from insomnia and losing her temper because she was "looking for trouble during menopause." After almost two years, if my best friend hadn't forced her to go for a physical examination, she might have broken a bone one day if she fell.

This hurdle is even more controversial: Western medicine now promotes hormone replacement therapy (MHT). Supporters say that as long as the risks of breast and endometrium are screened in advance and small doses of estrogen are supplemented, it can not only alleviate the problems of hot flashes and insomnia, but also reduce the probability of cardiovascular disease and osteoporosis in later life. The benefits far outweigh the disadvantages.； The opposition insists that they should not take the medicine if they can, especially for people with breast nodules and a family history of gynecological tumors. The potential risks cannot be ignored. The methods of traditional Chinese medicine are different. Many people can relieve insomnia and irritability problems by drinking Ganmai Jujube Decoction and moxibustion on Sanyinjiao. Among the doctors I have contacted, the more radical ones suggest that you should have a perimenopausal evaluation every year at the age of 45. The more conservative ones recommend exercise and dietary adjustments first unless the symptoms have seriously affected your life. There is no standard answer. It all depends on the individual's physical foundation.

To be honest, I have seen too many people misunderstanding this hurdle, thinking that "menopause is just a matter of bad temper and it will pass if you tolerate it." Many aunts have been accustomed to it all their lives. They wear plasters for bone pain, take melatonin for insomnia, and endure it until they finally go to the hospital for heart problems or broken bones. Instead, they suffer even greater consequences.

In fact, these two hurdles are not scary at all. Many times our anxiety about women's health either magnifies small problems into "incurable diseases" or interprets the signals sent by the body as "hypocrisy." When I was 30 years old, my period was delayed for three consecutive months. I was scared to death. After the test, I found that my prolactin was high. Later, I started two major projects that required me to stay up late. I went to the park to dance for half an hour three days a week. I didn't take any medicine and it was normal the next month.

There is no perfect health guide. To put it bluntly, don’t compete with yourself, take off the stress that you should, have a gynecological ultrasound every year, check six hormones, and check your bone density after the age of 45, which is much more useful than stocking a cupboard of supplements.