Menopause Health Science Popularization Competition

When participating in menopausal health science popularization competitions, the core logic of getting high scores has never been to pile up medical terminology and publish a thick reference list, but to break away from the stereotyped narrative of "menopause means bad temper and need to supplement estrogen", and to do "useful and non-offensive" science based on the real pain points of 45-55-year-old women. Professionalism is reserved as the bottom support, and empathy is the key to qualifying for the finals.

Last year I was invited to be a judge for a menopause science popularization contest hosted by a certain city’s health and family planning commission. Before the contest, I thought I would see all white coats reading PPT, but I was completely confused by the first deputy director of the gynecology department of a tertiary hospital. She spent 10 minutes presenting. She talked about the hormone fluctuation curve of the hypothalamus-pituitary-ovary axis for 7 minutes, and recited the thresholds of FSH and LH three times. Most of the people sitting there were middle-aged and elderly female audience members from the community. By the time she finished speaking, there were already two aunties in the back row with their heads down and taking a nap.

After she left the stage, a young nurse from the street health service center came on stage. She was still wearing her daily work clothes and didn't have a manuscript. The first sentence she said when she came up was: "Last week, my mother was squatting on the sofa to unpack the new scarf I bought for her. Halfway through unpacking, she suddenly started to sweat. She took off her coat. When I shouted hot, my dad rolled his eyes and said, "Are you menopausal again?" My mom burst into tears on the spot, saying that she hadn't had a full night's sleep in half a month. She was covered in sweat when she turned over. She didn't dare to turn on the air conditioner for fear of knee pain, and blowing the fan gave her a migraine. She told us that no one understood her. 」

I was sitting at the judges' table with a bit of a sore nose. When I looked up at the aunties below, many of them were nodding, and some even wiped their eyes quietly. In the end, the nurse's score was 0.8 points higher than that of the deputy director just now, and she won the first prize.

When it comes to popular science about menopause, the unavoidable controversy is whether hormone supplements can be used. The guidelines for Western medicine are here. The "Guidelines for Menopause Management and Menopausal Hormone Treatment" updated in 2023 by the Obstetrics and Gynecology Branch of the Chinese Medical Association is very clear: Women younger than 60 years old, within 10 years of menopause, and without contraindications can use menopausal hormone therapy (MHT) in a standardized way. The effective rate of relieving hot flashes, night sweats, and sleep disorders is more than 90%. It can also prevent osteoporosis and cardiovascular disease. The benefits far outweigh the risks.

But I also know many seniors in the field of traditional Chinese medicine. They prefer to regard menopause as a normal life stage for women. They do not advocate forcibly interfering with hormone levels. They recommend methods of soothing the liver, regulating qi, strengthening the spleen and kidneys, such as moxibustion on Sanyinjiao, drinking rose flower Ophiopogon japonicus tea, and light exercise such as Baduanjin and square dancing, which can also help to pass this stage smoothly.

No one is right or wrong. I have met two patients with completely opposite situations: one went through menopause at the age of 48. His hot flashes were so severe that he had to go to the toilet every 20 minutes to blow on his face at work. He tried various conditioning methods to no avail. After taking MHT for half a year according to regulations, the symptoms have basically disappeared and his annual physical examination indicators are normal.； The other, a 49-year-old menopausal woman, suffered from occasional irritability and shallow sleep. She drank tea substitutes for three months and danced square dance three times a week. She recovered smoothly without taking any medicine. The most taboo thing in popular science is to have a "single standard answer". It is more serious to clearly explain the application of different solutions and let everyone make their own choices.

Many players are prone to fall into a pitfall when doing science popularization: they open their mouths and say, "You have menopausal syndrome." I have met many aunties who frowned when they heard this word, thinking they were scolding her for having a bad temper and looking for trouble. If you put it another way: "For women of our age, it is normal for ovarian function to slowly decline and slight fluctuations in the body to occur." Your acceptance level will rise immediately. Some popular sciences like to make a one-size-fits-all approach, saying "menopausal women must drink 300ml of milk every day to supplement 1,000mg of calcium." However, many women are lactose intolerant and have diarrhea after drinking milk. If you say "If you are lactose intolerant, drink sugar-free soy milk, eat some sesame paste, and spend 20 minutes in the sun every day, the calcium supplement will have the same effect." It will suddenly become more grounded.

The work that won the grand prize last year was a small portable card made by a community doctor. On the front was printed "What should I do if a sudden hot flash comes". There were only three sentences: Don't panic, find a ventilated place and stand for 2 minutes.； Put a small fan in your pocket and blow it on your face for 30 seconds ； Take a sip of room temperature water and swallow slowly. Printed on the back are danger signs that should not be regarded as normal reactions to menopause: postmenopausal bleeding, inexplicable breast swelling and pain, and bone pain that affects walking. You must go to the hospital in time and don't carry it. Twenty thousand copies of that card were later printed, and every woman over 45 years old in the entire jurisdiction had one. It was almost a year after the competition ended. I went to that community last week to do research, and an aunt took out the card and showed it to me. She said that the last time her best friend had postmenopausal bleeding, she took out the card and took a look at it and rushed to the hospital. It was found that it was early-stage endometrial lesions. After the surgery, it was fine, which is equivalent to saving a life.

In fact, every time I serve as a judge in such competitions, what I don’t like to see the most is the contestants piling up all kinds of high-level theories, as if whoever has more references wins. In the final analysis, the original intention of the menopause science popularization competition was never to select the person who is best at memorizing the guide, but to select the person who can pass knowledge into the hands of the aunts and make them less panic, less aggrieved, and less misunderstood.

After the last competition, the little nurse who won the first prize told me that her mother is now quarreling with her father. Her father no longer says that she is menopausal and has nothing to do. He will take the initiative to hand her a cold drink and wait for her to calm down before talking. You see, this is the most valuable part of popular science, right?