Menopause health science content

Let me make it clear to everyone about the core conclusion about menopause: Menopause is not a "normal phenomenon when you get older, and it will pass if you tolerate it." It is caused by hypogonadism and hormone fluctuations in women around 45-55 years old (men 50-65 years old). During the physiological transition stage, more than 90% of hot flashes, insomnia, irritability, joint pain and other discomforts can be alleviated through scientific intervention. Early intervention can also reduce the risk of osteoporosis, cardiovascular disease, and cognitive degeneration in the next 30 years. There is no need to endure it.

I just met a 48-year-old Aunt Zhang in the clinic last week. She suffers from hot flashes more than a dozen times a day. No matter how low the air conditioner is turned on in summer, she will be sweating as soon as she gets hot. She tosses and turns at night and cannot fall asleep until two or three o'clock. She quarrels with her husband over trivial matters until she blushes and feels thick. Something was wrong, but I always heard people say, "Menopause is like this, just wait for five or six years and you'll be fine." I endured it for two years. This time I went to take a X-ray because my waist was sprained, and I had my bone density checked. It was already low enough to approach the critical value of osteoporosis. If it were two years later, it would be easy to break a bone if I fell.

When it comes to intervention, everyone’s current understanding is actually divided into two distinct groups, and no one can convince anyone.

One group is a staunch "natural conditioning group" who believes that "medicines are three parts poison" and they will never use drugs and just rely on diet and exercise to make adjustments. In fact, this idea is really suitable for people with mild symptoms. I once had a patient who occasionally had hot flashes in the afternoon and was a little more anxious than before. It did not affect her sleep and normal life. She increased the square dance she danced every day from 20 minutes to 40 minutes. She changed the soy milk she drank to mixed soy milk made of soybeans + black beans + chickpeas. She also ate 10 grams of ground flaxseed mixed in porridge every day. When she came back for a follow-up visit in 3 months, most of the symptoms had disappeared and she did not take any medicine. By the way, many people say that drinking soy milk to supplement estrogen is indeed useful, but you need to pay attention to the amount. Drinking 300-500 ml of light soy milk every day is enough. If you drink a few large cups of particularly thick soy milk, it may increase the burden on the breast and kidneys. Especially those with breast nodules and gout, they must control the amount.

The other school is the "hormone supplement school", which believes that as long as there are symptoms, hormone supplements should be taken, and quick relief of discomfort is the last word. This view is also supported by sufficient clinical data: If you have moderate to severe symptoms, such as hot flashes more than five times a day, insomnia for more than a month, or even vaginal dryness, recurrent urinary tract infections, and rapid bone mass loss, as long as there are no contraindications such as a history of breast cancer, active liver disease, or high risk factors for blood clots, the benefits of menopausal hormone therapy (MHT) under the guidance of a doctor far outweigh the risks. Many people are afraid of gaining weight by taking hormones. In fact, the hormones used now are natural low-dose hormones, which simulate the normal hormone levels when you are young. They will not cause puffiness at all. On the contrary, many people gain weight during menopause because their metabolism declines and they cannot control their mouths and move their legs. Don’t blame hormones. At present, there are indeed different opinions on the use of MHT in the academic community. Some studies believe that using MHT after the age of 60 may increase the risk of thrombosis, while other studies believe that as long as it is monitored regularly, the benefits will still be higher. Therefore, the current clinical consensus is "window period use", that is, use within 10 years of menopause and under 60 years old, which has the lowest risk and the highest benefit.

Let me tell you a piece of trivia that many people don’t know: men also have menopause. I met a 52-year-old man before. He always felt weak, couldn't sleep well, and his temper was getting worse. He thought it was due to high work pressure. After more than half a year of treatment, it didn't work. Finally, the androgen level was found to be ridiculously low. After supplementing with a small dose of androgen, the condition returned not long after. Many people assume that menopause is a female issue when they mention it. In fact, men’s testosterone levels slowly decline after the age of 50, and they will also experience similar symptoms. However, most people’s reactions are relatively mild, and they are easily dismissed as “older and less energetic.”

There is another common pitfall that I would like to remind everyone: don’t assume that you are menopausal whenever you have hot flashes, palpitation, or irritability. Last month, I met a 47-year-old woman who had endured menopause for 3 months. She also drank a lot of skin care products and lost 10 pounds. In the end, she was found to have hyperthyroidism, and her symptoms were almost exactly the same as those of menopause. So no matter how you plan to treat it, the first step is to go to a gynecologist or menopausal specialist to draw blood to test hormones and do a basic physical examination to rule out the possibility of other diseases first, and don’t make up for it on your own.

Let me talk about my own clinical experience for so many years: hormone fluctuations during menopause are like the hot and cold water heater in your home. It’s not that your posture when taking a bath is wrong, but that there is something wrong with the temperature control of the machine itself. Just adjust it and it will be fine. There is no need to hold it hot or cold. Many aunts are embarrassed to talk about their discomfort, either because they think they have a bad temper, or they are afraid that their family will think that they are looking for trouble. There was an aunt who had a tendency to be depressed before, and her husband said that she "just has free time." Later, the family came to listen to a popular science, and my husband found out that it was physiological reasons. After returning home, he took the initiative to accompany the aunt downstairs for half an hour every day, and the aunt recovered very quickly.

If you are bothered by hot flashes, you can keep a small ice pack at hand. When you feel hot, apply it to your forehead for half a minute and you will be able to press it down quickly. If you can't sleep, don't lie down and check your phone. Get up and sit for a while, drink half a cup of warm milk, and then lie down when you feel sleepy. The more anxious you are to sleep, the more you will be unable to fall asleep.

In fact, menopause is like another period of adolescence in life. It is all caused by hormones. Some people have mild reactions and others have severe reactions. There is no need to hold on or feel ashamed. You can easily overcome this hurdle by finding the right method that suits you.