Menopause Health Lecture

Menopause is not a hurdle that you have to "suffer through". There is no standard answer that suits everyone. Your feelings come first, and you can do whatever makes you feel comfortable.

Some people may be confused after hearing this. My relatives and friends either say that it is okay to endure it, or that taking hormone supplements will cause cancer. Some people say that taking various skin care products can solve the problem. How come you don’t have a standard answer? Don’t worry, I’ve been doing menopausal health management for almost 10 years, and I’ve seen between 1,000 and 800 cases. Today I’m going to talk to you about something that is real and not frivolous.

Last week, I met a 48-year-old Sister Zhang in the clinic. She burst into tears when she sat down in the clinic. She said that after her menstruation stopped half a year ago, something was wrong with her. She was sweating all the time during the day, and carried a small fan in her bag in the winter. She tossed and turned until two or three o'clock at night and couldn't fall asleep. She didn't like anything her husband did, and he would quarrel even if he said a few words. Her daughter, who is in high school, avoided her and said, "Mom, are you going through menopause recently? You are too irritable." She herself felt aggrieved. She said that the old sisters around her said that menopause was just like that and that she could just tolerate it for a few years. Someone also recommended a menopausal care kit worth more than 3,000 yuan to her, saying that after taking it, she could return to her 30s. She couldn't make up her mind, so she came to the hospital to ask.

In fact, what everyone refers to as "menopause", medically called perimenopause, is essentially the process of ovarian function going from peak to decline. Estrogen levels fluctuate and decline, usually between the ages of 45 and 55. The performance of each person is very different: about 30% of people feel almost nothing, and menstruation slowly stops and it is over. The remaining 70% of people will have varying degrees of hot flashes, night sweats, emotional sensitivity, insomnia, joint pain, vaginal dryness and other problems. In serious cases, it will indeed affect normal life.

The most quarrel among everyone right now is nothing more than the question of "whether to take hormone supplements." I am not biased and will explain the views of both parties clearly to everyone. Many elders and even those who have clinical opinions in the early years believe that "medicines are three parts poisonous". Too much hormone supplementation will increase the risk of breast cancer and blood clots. There is no need to suffer this crime. It will pass after a few years. If you really feel uncomfortable, just eat some soy isoflavones and drink some soy milk. It is naturally safer. But on the other hand, both the International Menopause Society and the latest domestic gynecological guidelines clearly state that if symptoms have seriously affected life, and contraindications such as breast cancer, blood clots, and endometrial lesions have been excluded, the most effective way to relieve symptoms is to use the lowest effective dose of hormone replacement therapy (MHT) during the "window period", that is, before the age of 60 and within 10 years of menopause. Moreover, if used at this stage, the risk is very low, and the benefits far outweigh the possible risks.

I met a 52-year-old Aunt Wang who had such hot flashes that she didn’t dare to go out in the summer. She changed four or five tops a day and refused to take medicine for two years for fear of getting cancer. After a comprehensive evaluation, she found no breast nodules and no history of blood clots. She took the lowest dose of estrogen and progesterone compound tablets and her hot flashes disappeared in less than two weeks. Now she dances square dances with the community team every night. The last time she came for a review, she told me that she had recently signed up for a Chinese painting class at a senior college and her life was more comfortable than before menopause. I have also met a 49-year-old sister Li. Her symptoms are very mild, but she occasionally feels a little irritable. She is particularly resistant to taking medicine, so she plays Baduanjin with her friends for half an hour every morning, soaks her feet for 10 minutes before going to bed, drinks some soy milk and eats soy products, and lives a good life. I will not insist on persuading her to take medicine.

But there is a pitfall that I have to remind everyone not to step into: don’t believe in those so-called “pure natural menopausal skin care products” and “special medicines for reversing menopause.” Last year, I treated an aunt and spent more than 20,000 yuan to buy an Internet celebrity’s menopausal conditioning pills. After taking it for three months, the hot flashes disappeared and the skin improved. The results were found during the physical examination. The endometrium is thickened to 14mm, and it is diagnosed as atypical hyperplasia. If it is a step later, it may develop into endometrial cancer. Many of those products that say they are "all natural and hormone-free" secretly add large doses of estrogen. You have no idea how outrageous the dose is, and the risk is more than 10 times higher than the hormone drugs prescribed by regular hospitals.

Many people think that menopause is just about bad moods and hot flashes. In fact, bone problems are the most easily ignored. Estrogen itself protects bones. After menopause, estrogen is lost, and bone loss is extremely rapid. Many aunts break bones after a fall five or six years after menopause. In fact, they did not pay attention to calcium supplements in the early years. I generally recommend that everyone check their bone density once a year after menopause, drink 300ml of pure milk every day, bask in the sun for 15 minutes, and take some time to walk every day. It will be absorbed much better than if you take hundreds of yuan of calcium tablets.

By the way, don’t always think that having a bad temper during menopause is due to “poor self-cultivation.” It’s really not the case. It’s just caused by hormone fluctuations. There’s no need to blame yourself. I often tell my sisters who come to see me that if they really can’t help but want to lose their temper, they should directly tell their family members, “I’m not in a good mood during menopause, please bear with me.” If you really want to scold me, don’t hold it in, just blame it on menopause. Holding it in your heart will lead to problems.

After talking so much today, there are actually no rules that you must abide by. To put it bluntly, menopause is just a stage in your life. It is not a disease. You do not need to be the "perfect mother" or "perfect wife", and there is no need to be overly anxious and look for remedies. If you feel uncomfortable, go to the menopausal clinic or gynecology department of a regular hospital. If you can accept the medicine, evaluate the risks. If you can't accept it, adjust your lifestyle. Whatever makes you feel comfortable is more important than anything else.