Menopause Health Guidance

Menopause is a normal physiological transitional stage caused by the decline of ovarian function in women. It is neither a "sign of old age" nor a "pretentious excuse." The principle of intervention is always individualized adaptation and physical and mental coordination. Lifestyle should be adjusted if the symptoms are mild, and if the symptoms are serious, the benefits of intervention are far greater than the risks of hard work.

I just met 52-year-old Aunt Zhang in the clinic last week. She was sitting opposite the consultation table with half a tube of estrogen ointment she bought online. She was sweating on her forehead because she was struggling: she woke up three or four times a night, and her chest and neck were sweating all over her body. The sheets were soaked. Her family also said that she was "too old to talk about it every day."

Regarding whether to use hormones during menopause, there are actually two voices in the industry: those who support it are based on the latest International Menopause Society guidelines. As long as you are within 10 years of menopause, under the age of 60, in the "window period", with no family history of breast cancer or endometrial cancer, and no risk of active thrombosis, low-dose menopausal hormone therapy (MHT) can not only quickly relieve short-term symptoms such as hot flashes, insomnia, and vaginal dryness, but also prevent long-term osteoporosis and cardiovascular problems. The benefits far outweigh the minimal risk of adverse reactions.； Cautious doctors, on the other hand, prefer to give priority to intervention with plant extracts and lifestyle adjustments as long as the symptoms do not seriously affect normal life, and try to avoid the intake of exogenous hormones. After all, there are indeed risks of individual differences. For example, Aunt Zhang herself had grade 3 breast nodules and was not very receptive to hormones. Later, she went to a traditional Chinese medicine doctor, who used prescriptions to soothe the liver and regulate qi. She also drank a cup of sugar-free soy milk every day and soaked her feet for 10 minutes before going to bed. After a follow-up visit in less than a month, she said she only had one or two hot flashes a week at most, and she could sleep well.

Oh, by the way, when it comes to drinking soy milk, many people’s first reaction is to supplement soy isoflavones. This is actually quite controversial. Research in the field of nutrition has calculated that in order to achieve an effective dose that can improve menopausal symptoms, you need to drink at least 8 to 10 pounds of thick soy milk every day, which is impossible for normal people to drink. So there is absolutely no need to force yourself to drink soy milk every day. Drink it when you feel comfortable, and stop when you feel uncomfortable with bloating. It is really unrealistic to expect severe menopausal symptoms to be cured by dietary therapy.

I met 48-year-old Sister Li before. I heard people said that exercise can relieve menopausal symptoms. She danced for an hour every morning and evening. After dancing, she became very flustered and had more frequent hot flashes. Later, she was persuaded to walk slowly for 40 minutes every evening and go to the community to take Ba Duan Jin classes two days a week. After only half a month, she said she felt much better. In fact, the reason is very simple. The autonomic nerves of menopausal people are easily excited. Strenuous exercise, staying up late, and drinking strong tea and coffee will stimulate the activity of the sympathetic nerves and aggravate the symptoms. Just choose exercises that you find relaxing and gentle. There is no need to follow the trend of high-intensity exercise.

What many people tend to overlook are emotional issues. Not long ago, a 49-year-old college teacher came to see a doctor. He said that he used to have a very good temper and was always kind to his students. But in the past six months, he didn’t know what happened. He wanted to get angry at every turn. After he did, he would hide in the office and cry. He even suspected that he was suffering from depression. After checking his sex hormones, he found out that he was in perimenopause. She didn't want to take medicine, so she signed up for a pottery class and kneaded clay twice a week. She also did abdominal breathing for 10 minutes before going to bed every day. She came back for a follow-up visit two months later and said her mood was much more stable. Don’t really think that poor mood during menopause is caused by “thinking too much” or “worsening of personality”. Hormone fluctuations will directly affect the brain’s emotional regulation center. Sensitivity, irritability, and unreasonable depression are all normal physiological reactions. Don’t hold it in, find a hobby that allows you to focus, whether it’s growing flowers, dancing ballroom, or even going home and pinching bubble wrap. Relieving emotions is better than anything else, and your family should be more tolerant. Saying “You’re just looking for trouble” really hurts more than anything else.

There is another common misunderstanding that needs to be mentioned: many people think that menopause is the two or three years before and after menopause. It is over and done with, and there is no need to pay special attention to it. Don’t underestimate the impact of the past few years. A while ago, a 62-year-old aunt fell down and fractured her femoral neck. The bone density test showed that she had severe osteoporosis. When asked, she always felt back pain during the menopausal years. She thought it was from raising her grandson, so she didn’t take it seriously. If she had started taking calcium and vitamin D just after menopause and had her bone density checked regularly, it would not have been so serious at all. Some people have no obvious symptoms of hot flashes and sweating. Instead, they always experience recurring urinary tract infections, vaginal dryness, or inexplicable palpitations and chest tightness. They have been to cardiologists and urologists many times but cannot find the problem. Finally, they go to a menopausal clinic to find the root cause. These are all symptoms of menopause that are easily ignored.

Of course, don’t mess around. Previously, an aunt followed the trend and bought the Internet celebrity “ovary maintenance supplement”. After taking it for half a year, her skin became brighter and her sleep improved. However, the physical examination revealed endometrial hyperplasia. The health products sent for examination were indeed found to have excessive amounts of exogenous estrogen. Those essential oils and health products that claim to be able to "reverse menopause" and "delay ovarian aging" are basically IQ taxes. If you really need them, you must go to a regular hospital's gynecology or menopausal clinic for evaluation. Don't use your own body as a testing ground.

In fact, menopause is like puberty in reverse - puberty is when hormones suddenly rise, and we get acne, rebellion, and short temper. Menopause is when hormones slowly decrease, causing hot flashes, insomnia, and emotional sensitivity. In essence, it is the process of the body adapting to hormonal changes. There is no unified "standard answer." Some people don't feel anything at all and it goes away smoothly, while some people still feel uncomfortable after five or six years. There is no need to compare with others, and there is no need to feel embarrassed. When you feel uncomfortable, just go to a doctor. You can feel comfortable in whatever way you want. Being able to spend this period of time in a down-to-earth manner is more important than anything else.