Menopause is not a disease. Generally speaking, the average menopausal transition for women is 3 to 4 years, but it varies greatly from one individual to another. Moreover, the symptoms and the degree of symptoms that manifest themselves during this process vary from person to person. Among Chinese women, the most common symptoms of menopause are bone and joint pain, fatigue, emotional problems, insomnia, hot flashes and sweating, and heart palpitations. The likelihood of psychological problems and menopausal depression is also much higher than at any other stage of life.
Special emphasis: the more important issues to be concerned about during menopause are cardiovascular disease, osteoporosis, cerebrovascular lesions and other degenerative problems of old age after estrogen has been lowered.
The latest evaluation of MHT by the International Menopause Society.
1, MHT is part of an overall strategy to maintain the health of perimenopausal and postmenopausal women.
2. MHT is the most effective treatment for perimenopausal symptoms and is the first-line treatment for the prevention and treatment of osteoporosis in postmenopausal women.
MHT “window period” theory and progestin selection.
It is believed that MHT should be started early, with a greater benefit when initiated before the therapeutic window of 60 years of age and within 10 years of menopause; however, if it is not used early and is not started until older age, it will no longer provide multiple benefits and may even increase some risks. Another important development concerns the choice of medications, especially progestins. Different drugs have different benefits and risks, and the effects of one drug should not be extrapolated to all drugs. Breast cancer risk may be more associated with progestins, and when combined with systemic estrogens, the potential for adverse metabolic effects, cognitive effects, or associated breast cancer risk varies among progestins. Natural or near-natural progestins are safer for the breast.
MHT and quality of life in women.
There is no doubt that MHT can significantly improve the quality of life of women with menopausal symptoms. In the long run, MHT can lead to a significant increase in healthy life expectancy for women due to the benefits in bones and heart.
Individualization is the most important principle of treatment.
It is important to understand the background information of the patient and the drug. A combination of quality of life, health priorities and individual risk factors for women is needed; the dose and duration of medication should be consistent with treatment goals and safety and should be individualized. For women with premature ovarian failure, the recommended systemic application of MHT should be continued at least until the mean age of natural menopause. For women with symptoms of vaginal dryness or discomfort during intercourse only, topical low-dose estrogen therapy is preferred. Systemic estrogen alone is only indicated for women who have undergone hysterectomy, and progestin must be added to MHT in women with a uterus.
Main indications for menopausal hormone therapy.
Systemic menopausal symptoms; atrophy of the genitourinary tract; problems with osteoporosis. It should be applied only if there are clear indications for treatment, no contraindications and if the patient is willing to treat. Estrogen therapy must be properly carried out under the guidance of a physician. Moreover, the purpose of treatment should be clear: first, to relieve the various symptoms of menopause, and second, to prevent degenerative diseases that may occur later in old age due to low estrogen. It is not advisable to use estrogen supplementation as a means of maintaining youth.
Precautions in the use of estrogen therapy.
1. For women with a uterus, progestin must be used in conjunction with it to ensure that the endometrium does not become cancerous.
2. When supplementing estrogen, the medication regimen should be adjusted according to age, whether you want to continue having periods, and other specific circumstances.
Three recommendations.
1. Acquire physiological knowledge to eliminate the fear of menopause.
2.Actively self-adjust to control uncomfortable symptoms.
3. Carry out treatment reasonably to avoid the root of the disease.
Menopause is not a medical term, it is a common term in the daily life of the people. As the name suggests, ‘menopause’ refers to the change of age and ‘menopause’ refers to the period of transition from middle age to old age. Usually, there is no very precise age range for menopause. Cardiovascular disease, osteoporosis, Alzheimer’s disease, and other diseases can be laid down at this time. Menopausal women who are unable to reduce the impact of uncomfortable symptoms on their normal lives through life modifications should seek medical advice and start MHT as early as possible.
Before treatment, be sure to make specific judgments with your doctor based on the results of uterine and breast screening and routine health examination reports; then, choose a treatment plan that suits you based on your doctor’s recommendations and carefully do regular follow-up examinations.