Patient: 48 years old, irregular menstruation for 2 years, sometimes not for 2 months, the amount is also not normal, the last menstruation is 2 months ago, regular annual checkups, no abnormalities, now often bone and joint pain, always cervical spine is not good with Chinese medicine to regulate the normal menstruation for a period of time, after stopping the medicine is not normal again Can you use hormone therapy, what to use with little side effects, how to use, can you give some treatment advice. Kang Kai, Department of Obstetrics and Gynecology, Chongqing Ninth People’s Hospital: Hormone replacement therapy for perimenopausal women must be carried out under the guidance of a doctor, especially avoiding the use of so-called health products. According to your current situation, if there are no major problems with breast, blood sugar and thyroid, consider taking Clomid regularly. Patient: Thank you for replying to me in your busy schedule! I saw your classic reply before in which you started taking Clomid a few days after menstruation. I haven’t had it for more than 2 months, when and how do I start taking it? Kang Kai, Department of Obstetrics and Gynecology, Chongqing Ninth People’s Hospital: You are advised to go for an ultrasound. If the endometrial thickness (double layer) is less than 5mm (also less than 6-7mm in literature), you can start taking Clomid directly (take it regularly according to the instructions of the medicine box). Take 1 tablet daily for 21 days, stop taking it, wait for your next period (usually you will have your period in about a week), and start taking the next box continuously from the 2nd-5th day of your next period, and so on. If the endometrial lining is greater than the above value, you can start with 2mg of Tocopherol + 10mg of progesterone/day for 5-7 days, stop taking it, wait for your period (usually it will come in about 7 days), and start taking Clomid on the 3rd-5th day of your period, and the rest as above, and so on. By taking Clomid regularly for a long time, you can get the following benefits: 1. Regular menstruation is continued and your confidence is increased. 2. Relief of various menopausal discomforts. 3. Prevention of endometrial cancer and rectal cancer. 4. Prevention of osteoporosis. 5. Prevention of cardiovascular disease and Alzheimer’s disease in old age. Of course, you will also face the following risks: 1. 5 years of continuous use, you will have a rare level of increase in the probability of breast cancer . 2. increase in thrombosis (as an East Asian race is far less likely to occur than Westerners). Patient: Thank you, Dr. Kang. I (47.5 weeks old) used Clomid for one cycle and it worked very well, I got my period normally. Kang Kai, Department of Obstetrics and Gynecology, Chongqing Ninth People’s Hospital: The average age of menopause for women in China is 49.5 years old, so you can use it until you are about 50 years old and then consider replacing it with hormone replacement drugs that do not require menstruation, such as Anjingyi or Tibolone.