When the years quietly go to middle age, mothers not only need to face some trivial matters at work and family, but also encounter physical "abnormal" situations, tired and at a loss.
On the special day of Mother's Day, we not only sing about the greatness and selflessness of mother's love, but also want to talk about this topic that may not be often covered with gifts and flowers, but it deeply affects the quality of life of many mothers - menopause.
100 menopausal women, only 15 "lucky ones"
The average age at the beginning of perimenopause (menopause) in Chinese women is 46 years old, the average age of menopause is 48~52 years old, and about 90% of women are menopause between the ages of 45~55 [1]. Menopause is a necessary part of most women's lives. According to statistics, the prevalence of "menopausal syndrome" is about 85%, that is, only 15 out of 100 menopausal women can go through menopause naturally as if nothing happened.
For most people, menopause can be the chaos of the menstrual cycle, sudden flashes of hot flush and sweat, as well as the gradual appearance of spots and fine lines on the face, and the skin seems to tell the story of age. The ups and downs of emotions are also common "visitors" during this period. And further, back pain, joint discomfort in the limbs, and even cardiovascular problems – such as dizziness, heart palpitations, chest tightness – can creep into everyday life.
In addition, the prevalence of coronary heart disease in menopausal women is 5 to 6 times higher than that in nonmenopausal women. Menopause is also a common stage for tumors, such as uterine fibroids, ovarian cysts and even breast cancer.
At the root of this problem, the main driving force behind menopausal syndrome is the sudden drop in estrogen levels. Therefore, in clinical practice, hormone therapy is often recommended as one of the effective means of relieving symptoms.
Hormone "code" to unlock painless menopause
For a long time, sex hormone therapy for menopausal women has been a complex and delicate topic in the medical community, and it is regarded as a "double-edged sword":
On the one hand, it can alleviate menopausal symptoms, effectively reduce hot flashes, sweating, mood swings, and improve quality of life. At the same time, it can prevent some chronic diseases, such as cardiovascular disease, osteoporosis, etc. In addition, it can also relieve depression and anxiety, which has a positive effect on maintaining mental health.
On the other hand, long-term or inappropriate use of hormone therapy may increase the risk of breast cancer, endometrial cancer, especially for specific types of hormone formulations and usage patterns. In addition, it may increase the risk of blood clots, stroke, and may cause adverse effects such as breast tenderness and headache in some women.
But for women who are troubled by menopause, there is no need to talk about hormonal discoloration. We need to understand that:
first
Hormones are normal in the human body and play an important role in regulating the growth and development of the body. From a therapeutic point of view, menopausal hormone therapy needs to be done as early as possible. Judging from the actual situation of many clinical studies, hormone therapy has many advantages, which can improve a variety of menopausal symptoms, such as cardiovascular symptoms and menstrual disorders, and alleviate patients' depression and anxiety.
second
Professional matters are the responsibility of professional people. During a gynecological/endocrinology visit, the doctor will weigh the pros and cons and develop a personalized treatment plan based on the patient's specific situation, including age, health status, family medical history, and other factors. Patients receiving menopausal hormone therapy also need regular physical examinations, including breast examinations, gynecological examinations, etc., in order to detect and deal with potential problems in a timely manner.
It is important to note that modern medicine has many treatments for "menopause".
In the past, most Chinese women believed that the symptoms of menopause were a sign of natural aging that did not require treatment. In fact, menopause-related symptoms persist for a long time, with a median duration of up to 4.5 years, taking the characteristic "hot flashes and sweating" symptoms of menopause as an example [3]. In fact, if the symptoms of menopause are mild, symptomatic treatment can easily solve the problem; If the symptoms of menopause are severe, consider hormone therapy, and through close cooperation and full communication with doctors, you can maximize the treatment benefits on the basis of ensuring safety, and help women go through menopause smoothly and enjoy a healthy life.
For example, for premature hypoestrogen status (ovarian failure before the age of 40), the Chinese Guidelines for Menopause Management and Menopausal Hormone Therapy 2023 Edition recommends that hormone replacement therapy should be started as soon as possible, specifically based on the estrogen and progesterone sequential regimen, and the estrogen dose should be higher than the conventional dosage of menopausal hormone therapy in normal menopausal women, and emphasize that the progesterone dosage should be matched with estrogen to fully protect the endometrium. For some women who have gone through menopause and do not want to have menstrual bleeding anymore, continuous combination therapy with estrogen and progesterone can also be selected to maintain a low level of continuous protection, prevent excessive endometrial hyperplasia, and relieve menopausal symptoms.
When is menopausal hormone therapy appropriate?
To summarize briefly, there are four indications for menopausal hormone therapy:
01
Menopausal related symptoms
Such as menstrual disorders, sleep disorders, fatigue and weakness, mood disorders, etc. When hot flashes, mood swings, etc. disturb daily life and work, hormone therapy can effectively alleviate them, and generally the symptoms are reduced after 3-5 months, and the dose can be adjusted or discontinued.
Premature low estrogen status
02
Women who have gone through menopause before the age of 40 are faced with a sudden drop in estrogen, which can lead to rapid bone loss and recurrent infections, and estrogen supplementation is crucial at this time.
03
Osteoporosis early warning
If there is a risk of osteoporosis with menopausal symptoms, hormone therapy can be effectively intervened after confirmation by examination.
Symptoms associated with genitourinary atrophy
04
For example, dryness, burning, irritation of the genital tract, sexual problems and pain caused by lack of lubrication of the vagina, urgency, frequency, dysuria, and recurrent urinary tract infections.
There are a few things to focus on when administering hormone therapy:
01
The science of estrogen and progesterone ratio
If the dose of progestogen is insufficient, it is difficult to achieve the effect of protecting the endometrium. If you stop progestogens without permission, the benefits often outweigh the losses.
02
Dose is individualized
The therapeutic dose should be set according to the minimum physiological needs of the individual and overdose should be avoided to reduce the potential risk.
03
Personalized dosing
The dosing method is adjusted according to the patient's specific situation. For example, some postmenopausal women with incomplete atrophy of uterine fibroids, senile vaginitis symptoms are very serious, or menopausal women with vaginal dryness can take topical vaginal medication; Oral estrogen may increase triglycerides, and women with lipid problems are more candidates for transdermal absorption.
04
Monitor and adjust treatment regularly
Especially for patients with uterine fibroids, it is necessary to pay close attention to fibroid changes and bleeding, and adjust or terminate treatment in time once abnormal growth or bleeding is found.
In the special journey of menopause, every woman is a brave explorer, facing both physical and mental changes. Just as the drizzle in spring moistens all things, proper medical support and the warm companionship of family and friends weave a gentle net to protect every mother and woman. May every mother and every woman be able to go through menopause "painlessly" and age gracefully in the passage of time.