I. Definition of menopause
Menopause is the stage that women must go through from adulthood to old age. It is a period of time between childbearing and old age, and it is also the transition stage from reproductive ability to non-reproductive ability for women. It is a process of gradual change, and generally we divide it into three stages: premenopause, menopause and postmenopause. Since the age of menopause varies greatly among individuals and is influenced by many factors such as social, economic, regional, and contemporary factors, the time of menopause onset also varies. Nowadays, menopause is generally positioned between the ages of 40-60.
Second, the physiological and psychological characteristics of menopausal women
The physiological and psychological changes of menopause are closely related to the aging of the ovaries, which is mainly manifested in the reduction of follicles and changes in ovarian morphology and functional decline.
In women, there are about 700-2 million follicles at birth. Ovulation and atresia of follicles lead to a decrease in the number of follicles to only a few thousand by the age of 45, and by the time of menopause there are very few follicles left.
Both the reproductive and endocrine functions of the ovaries decline as the ovaries age. Reproductive function declines early, with women’s fertility beginning to decline between 30 and 35 years of age and declining significantly as they approach 45 years of age. Fertility, expressed as live birth rate, has been reported to decline by 50% at age 35 and 95% at age 45 in a natural population not using contraception compared to age 25.
The main endocrine changes are the changes in both estrogen and progesterone. The main estrogen in fertile women is estradiol, which decreases sharply until 1 year after menopause and then decreases slowly until 4 years after menopause, after which it remains at a very low level. The level of progesterone further decreases after menopause to about 1/3 of that of young women, and the level of androstenediol in the blood after menopause is only half that of women of childbearing age. The ovarian sex hormones decline significantly during perimenopause and do not form a negative feedback to the hypothalamus and pituitary gland, so gonadotropin follicle stimulating hormone (FSH) and luteinizing hormone (LH) are elevated. The decline in ovarian function, especially the decrease in estrogen levels, causes a series of physiological changes in menopausal women, mainly in the form of changes in the menstrual cycle until menopause, atrophy of the reproductive organs and the loss of secondary sexual characteristics.
The psychological changes in menopausal women are mainly as follows.
1. Psychological fatigue.
Menopausal women suffer from long-term mental overload, which leads to psychological fatigue. They are always under the pressure of thinking, anxiety, fear and depression in terms of work, career creation, interpersonal relationship handling and family role playing, as well as the constant trade-off between career and family, and seem to be always suffering from a kind of mental pain and feeling tired of living.
2. Anxiety psychology.
This is a common emotional reaction to menopause. Lifelong or intermittent anxiety and tension for no reason, restlessness, or objectless and unexplained panic. There are a variety of autonomic nervous system dysfunction and somatic discomfort. Fidgeting, rubbing hands and stamping feet are common distinctive features of anxiety disorders.
3. Pessimism.
Depression and pessimism, emotional depression. There is a lot of concern about some of the symptoms that often follow menopause, and suspicion that their illness is very serious. Negative speech and behavior, sluggish thinking or a preference for gray memories, i.e., recalling some unpleasant events in life.
4. Changes in personal behavior.
These changes are manifested as sensitivity, suspiciousness, selfishness, nagging, easy impatience and even insensitivity when things go wrong. Unexplained distractions, sometimes easily excited, sometimes sad, interpersonal relationships in the unit and social interactions are often inconsistent.
5. Psychosexual disorders.
Many menopausal women encounter menstrual disorders, vaginitis, painful intercourse and other manifestations during menopause, and have a negative psychology about sexual life, mistakenly believing that women’s menopause is the termination period of sexual ability and sexual life. Some women mistakenly equate “menopause” with “menopausal desire”. This sexual psychological disorder suppresses their sexual physiological needs and aggravates sexual dysfunction, which not only prematurely terminates sexual life, but also easily causes mutual indifference and alienation between husband and wife, and deteriorates women’s mood.
Most of these symptoms and problems of menopausal women will disappear naturally with the gradual adaptation of the body and the re-establishment of balance in the internal environment. However, if they are not taken care of, they will not only affect their physical and mental health, but also lead to psychological disorders and physical and mental diseases.
Three, health care
From ancient times to the present day, health care has always been respected by the people of China, and traditional Chinese medicine in China can be called a broad sense of health care. Wellness is the study of human beings’ ability to improve self-organization and self-healing, or the study of improving human vitality so as to eliminate diseases. It is therefore different from the modern Western “medicine” that treats diseases. What is commonly referred to as “health care” is narrowly defined as the study of self-healing through non-pharmaceutical methods. In the fiftieth century B.C., the formation of the holistic view of the unity of man and heaven marked the maturity of the concept of health maintenance; in 610 A.D., during the Daiye period of the Sui Dynasty, Chao Yuanfang, then a doctor, concentrated on the origins and symptoms of various diseases in the Treatise on the Origin of Diseases. From this, it can be seen that health care has been used as a regular method of treatment in China since then, and has been officially promoted.
The purpose of health care is to prolong life and to be healthy and free of disease. From the time of conception to the time of infancy, adulthood, and old age, as long as one is still alive, one must maintain health. Every living creature has its normal life span, and there are different opinions on how long the normal life span of human beings is. According to the “Inner Classic”, excluding the real people who died away from the commonplace, accumulate the essence of the whole spirit and the real people who live to infinity, and the heaven and earth forever, the normal life expectancy of the world should reach 100 years, which is basically consistent with the modern understanding of human life expectancy, but so far only a few longevity can reach. Nowadays, the longest average life expectancy in the world is not more than 80 years old, so it is clear that health is indeed a major issue facing all human beings.
The theories of health maintenance all start from maintaining the normal state of human beings, taking reducing consumption, strengthening regeneration, maintaining smoothness and stability as the important focus links. The basic principles include adapting to the laws of nature, attaching importance to spiritual conditioning, paying attention to physical exercise, balancing the diet and preventing disease and evil attacks.
It is evident that health care has been an important means of protecting health and improving the quality of life in China since ancient times. Menopausal women still do so, seeking various ways to achieve the purpose of health maintenance. However, there are some misconceptions in these ways, and the following is a brief description of common menopausal health care misconceptions.
4. Common menopausal health care misconceptions
Common misconceptions about menopausal health care are: that ovarian maintenance can slow down ovarian aging, that calcium supplements can be taken when you have osteoporosis symptoms, and that health supplements are good for you. The following three aspects are highlighted.
1, ovarian maintenance can slow down ovarian aging
First of all, let’s take a look at the steps of ovarian maintenance advertised by beauty salons.
The first step is to take the appropriate amount of menstrual conditioning oil or ovarian maintenance oil after bathing and cleaning, evenly applied to the abdomen, from the collarbone to the navel in the direction of homeopathic massage.
Step 2: Rub and press along the waistline on both sides towards the navel, strengthening the diaphragm in the upper abdomen and the uterus-ovary area in the lower abdomen.
Step 3: With both hands centered on the navel, massage the lower abdomen deeply in a clockwise direction to strengthen the absorption of essential oils in the ovarian area.
Step 4: Take an appropriate amount of menstrual toning oil or ovarian maintenance oil, apply to the renal pelvis and rub until the body is warm.
Almost all beauty salons claim that the above methods allow essential oils to penetrate the ovaries and help treat gynecological disorders such as menstrual disorders, dysmenorrhea and delay premature ovarian failure.
However, can the above methods really achieve the purpose of ovarian maintenance? The answer is no. First of all, from the anatomical structure, the ovaries are located in the pelvic cavity with the bladder in front and the rectum at the back, which cannot be touched in the lying position, so massage cannot touch the ovaries at all. The essential oils are at best penetrating into the skin, not into the ovaries. In addition, from the process of ovarian development and development, in the human ovary, the development of follicles begins in the embryonic period, and there are about 700-2 million follicles in the ovary at the birth of a newborn. After puberty, the number of follicles gradually decreases. At the end of the reproductive years, only 300-400 follicles develop and are expelled, while the rest of the follicles develop to a certain level and degenerate on their own. As the number of residual follicles in the ovaries decreases, estrogen levels gradually decline and menopausal symptoms appear. When the number of residual follicles in the ovary is less than a certain number, ovulation and menstruation will cease. The average age of menopause for women in China is about 49 years old, and menopause before the age of 40 is considered premature ovarian failure. Usually, the number of follicles in each woman’s body is a certain number from birth. In other words, the ovarian function of each woman is inherent. Of course, ovarian function is also related to some diseases. It can be said that it is difficult to slow down the decline of ovarian function by artificial means. Finally, from the female endocrine point of view, the female menstrual cycle is governed by the hypothalamic-pituitary-ovarian endocrine axis, and the regularity of menstruation reflects the normal function of this endocrine axis. Problems in the secretion function of any one of these organs will affect the secretion function of the other organs. From this point of view, only massage on the ovaries can not improve the function of other endocrine organs, nor can it achieve the so-called activation of ovarian secretion function and delay the role of premature ovarian failure.
2, with osteoporosis symptoms and then calcium supplementation
Many women do not pay attention to the problem of calcium supplementation during menopause, believing that as long as there are no symptoms of osteoporosis such as menstrual cramps and bone pains, it means that the bones are healthy and do not need calcium supplementation. In fact, this view is very wrong. First of all, look at the law of bone mass change with age. Bone mineral density (bone mineral mass) in healthy people is rising before 30 years old, reaches a peak at 30-39 years old, and gradually decreases after 40 years old, mineral decline is often not felt or felt slightly, only when it decreases by 12% or more will clinical symptoms such as stooping, hunchback, shortening, etc., and worsen with age and mineral loss. Mineral loss by the time a fracture occurs has already reached 25% or more. As mentioned earlier, symptoms of osteoporosis only appear when the bone mass is reduced by 12% or more, so that the absence of these symptoms does not mean that the bone mass is normal.
There are many risk factors for osteoporosis, including disease, insufficient sun exposure, low-calcium diet, lack of exercise, unbalanced diet, medications, genetics, race, thin body size, age greater than 65, and menopause. Among them, menopause is a more important factor for menopausal women. After menopause, estrogen levels drop sharply, bone conversion increases, bone resorption is greater than bone formation, and the result is bone loss, the degree of bone loss is related to the level of estrogen in the body; the rate of loss is faster in early menopause than late menopause, and loose bone is faster than cortical bone. It has been reported that the rate of bone loss in the lumbar spine was 0.3% per year before menopause, 5.4% per year near menopause, 6.7% per year within 2 years after menopause, and 0.9% per year in late menopause when measured by two-photon absorption method.
Therefore, menopausal women should take calcium as a regular, preventive health care measures, if you wait until the appearance of osteoporosis symptoms and then to supplement calcium, in fact, it is too late.
3, health supplements are much better
Now that the standard of living has improved, some women are afraid of not eating enough to make up for the lack of a little condition on the body to supplement the health care products, a myriad of health care products. In fact, health supplements are not the more the better, take vitamins, too much vitamin supplementation is harmful, including animal experiments, clinical observations or epidemiological studies have found that excessive vitamin supplementation can bring a series of harmful effects.
Let’s look at fat-soluble vitamins, including vitamins A, D, E, and K. These vitamins tend to accumulate in the body’s fatty tissue and are not easily excreted, and excesses are prone to accumulation toxicity.
The most important effect of vitamin A overdose is that it can lead to the development of malformations, including eye malformations, and malformations of internal organs, in addition to headaches, hair loss, liver enlargement, muscle stiffness, itchy skin, pain at the end of long bones, and other toxic symptoms.
Vitamin D overdose causes nausea, vomiting, headache, and metastatic calcification of tissues of the heart, kidneys, lungs, and trachea.
Vitamin E overdose leads to blurred vision, headache, extreme fatigue, impaired nail function in animal experiments, and blood clotting.
Water-soluble vitamins, including B vitamins and vitamin C. These vitamins do not accumulate in fatty tissues and are relatively unlikely to produce accumulation toxicity, but oversupplementation can be harmful.
Vitamin C overdose can lead to nausea, abdominal discomfort, diarrhea, diminished granulocyte bactericidal capacity, red blood cell destruction, kidney stones, and bladder stones.
Excess B vitamins can bring a range of adverse effects, including hyperuricemia, hyperglycemia (nixic acid), peripheral neuritis, progressive gait instability, and numbness in the hands and feet (vitamin B6).
Therefore, for those menopausal women whose diet is relatively homogeneous and who do not eat many vegetables and fruits, etc., if the appropriate supplementation of vitamins or minerals is comparable to the recommended intake or the appropriate intake proposed by our Nutrition Society, then the amount is on the same order of magnitude as the amount in the diet, it is safe to take and will not show adverse consequences after stopping. However, if blindly taking large amounts of supplements exceeds the quantity category of supplements, the vitamin at this time is no longer a nutritional effect, but more of a pharmaceutical effect. Once the level of pharmaceuticals is reached, there is a risk of toxic side effects.
Five, menopause scientific health and wellness
Scientific menopausal health care should aim to promote the physical and mental health of menopausal women, so that they can successfully pass this “eventful” transitional period. Menopausal health care should be aimed at the physiological, psychological and social characteristics of menopausal women and common health problems during menopause, and take effective preventive and curative measures and eliminate the interference of adverse social and environmental factors. In summary, the main points are as follows.
1.Balanced diet, reasonable nutrition and moderate exercise
Menopausal women can arrange a day’s meal according to our balanced diet pagoda, including the selection and intake of major food groups. Cereals and potatoes and mixed beans 250-400 grams, vegetables 300-500 grams, fruits 200-400 grams; livestock and poultry meat 50-75 grams, fish and shrimp 50-100 grams, eggs 25-50 grams; milk and dairy products 300 grams, soybeans and nuts 30-50 grams; oil 25-30 grams, salt 6 grams; drinking 1200 ml of water a day.
When women reach menopause, they are good at being still and bad at moving, which is a risk factor for obesity, cardiovascular and cerebrovascular diseases, diabetes and osteoporosis. So insist on regular physical exercise, at least 30 minutes a day, or walk at least 6,000 steps a day as recommended by our dietary pagoda.
2, intake of calcium-rich food, appropriate calcium supplementation
We consume calcium from food, to achieve the purpose of promoting bone health, but also need the help of many factors, including vitamin D to promote the absorption of calcium, vitamin C to help the synthesis of collagen, vitamin K to help calcium deposited on the collagen. Therefore, many factors in the diet can affect the deposition of calcium in the bones. In addition, potassium and magnesium in food can reduce calcium loss; protein and other substances containing phosphorus and sulfur in food can increase the excretion of calcium. If you eat too much meat, fish, eggs and refined white rice and white flour, and consume too little vegetables, fruits, potatoes, coarse grains and beans, then the loss of urinary calcium is greater, and even though you consume a lot of calcium elements, you may not be able to use them for bone building. On the contrary, if the intake of animal food is less, vegetables, fruits, coarse grains, potatoes and beans are more, then the excretion of calcium will be reduced, and with the same intake of calcium, osteoporosis is less likely to occur.
In addition, exercise will promote the health of the bones. Exercise too little, sitting all day, even if the intake of enough calcium, the bones may not be solid. Space researchers are aware that astronauts in space lost the role of gravity, the bones do not get pressure and stimulation, after a long time will occur after the signs of osteoporosis, precisely for this reason.
In addition, there are also matters that need attention in the choice of calcium, first of all, choose a better absorption of calcium, such as the third generation of amino acid chelated calcium. The absorption rate of this type of calcium can reach 80-90%, compared to the first two generations of calcium absorption rate greatly improved, while the incidence of gastrointestinal adverse reactions is also lower. Secondly, choose a single tablet with a lower dose of calcium, so that it will not cause an increase of one too many minus one too many. In addition, calcium should be taken in small doses, not in large doses, because free calcium is absorbed by binding with intestinal calcium-binding protein, the intestinal calcium-binding protein is limited, if a large number of calcium supplements, calcium-binding protein is saturated that excess calcium can not be combined with calcium-binding protein absorption, equivalent to waste. Finally, it is best to take calcium supplements after meals.
3, maintain a happy mood
It is important for menopausal women to pay attention to mental health care and maintain mental health to help reduce the various symptoms that often occur during menopause; if you are often in an anxious and pessimistic state of mind, it will aggravate these symptoms and delay their fading. The methods of mental health care during menopause are.
(1) Maintain a good mood and make emotional adjustments.
The most important thing for menopausal women to do to overcome psychological abnormalities is to learn how to adjust their emotions. Exercise is the most effective way to change bad moods; listening to music is also a proven way to improve moods. In addition, you should learn to divert your attention; learn humor and be good at revealing and sublimating the comic elements in life to dilute or even dispel unfavorable emotions and turn negative emotions into positive ones.
(2) maintain mental balance. Effective methods are the following.
① to adapt to the changing situation, adapt to the environment, adapt to life ;
(2) to maintain a moderate degree of mental tension, to do what they are willing and able to do, and strive to do more, to find fun in life;
③ to be the master of emotions, learn to get rid of the entanglement of negative emotions, good at transient ice solution;
④To learn to positively imply, think of the good things, do not look for trouble;
⑤ to be broad-minded, do not take the bull by the horns, not overly self-respect; try to be confused, can reduce a lot of unnecessary worries;
⑥To keep in touch with society, attend more gatherings of friends and relatives, do not confine yourself to your home;
(7) To make life full of interest, rhythm and interest;
(8) To overcome self-centeredness, speak up when you have something to say, and be more understanding of others;
⑨ to create a harmonious family atmosphere, whether between children, or daughters-in-law, sons-in-law should be fair, treat each other with courtesy, couples love each other;
⑩To learn to relax, to relieve physical and mental fatigue.
4, regular medical checkups
After women enter menopause, on the one hand, the long-term influence of various adverse factors in the living environment on the organism will gradually reflect, which may affect health or even cause disease; on the other hand, the physiological and psychological changes in the body are also more. It is another important part of self-care to master the criteria of health and the early symptoms of common diseases, improve the ability of self-testing and self-examination, and conduct regular tests and records, so that we can find out the deviations of our physical and mental health in time and detect the diseases early, correct them early and maintain our health. The content of self-examination for menopausal women includes the following aspects.
(1) Self-assessment of health. In recent years, the World Health Organization (WHO) has specifically put forward the criteria for physical health and mental health, namely five fast and three good. Five fast that: eat fast; poop fast; sleep fast; talk fast; walk fast. Three good that: good personality; good ability to deal with the world; good interpersonal relationships.
(2) Regularly measure your weight and waist circumference. If you appear to be over the standard weight, you should adjust your diet and increase your exercise. Unexplained wasting and weight loss must also be taken seriously.
(3) Record your menstrual card. When menopause occurs, the number of anovulatory periods increases, and the period and cycle as well as the volume of menstruation may change. Keeping a record on time will help to detect abnormalities in time and serve as a reference for the doctor’s treatment and medication.
(4) Identification of early symptoms of common gynecological diseases during menopause. In addition to the symptoms of menopausal syndrome, abnormal leukorrhea and postmenopausal bleeding are all symptoms of gynecological diseases and should be treated promptly. After entering menopause, women should take the initiative to attend regular gynecological screening or go to gynecological clinics regularly for a routine examination, including cervical scraping cytology examination, which is conducive to early detection of gynecological diseases.
(5) Breast self-examination.