It has been documented for over a hundred years that there are as many as 135 symptoms of menopause. In addition to typical symptoms such as hot flashes, night sweats and excessive chills, symptoms can occur in many organs and systems throughout the body, varying in type, degree and timing from person to person, and are complex and variable. More than half of menopausal women experience a variety of menopausal symptoms. It is because of the wide range of symptoms that they are collectively referred to as the menopausal syndrome. The many manifestations of menopausal syndrome are often difficult to explain in terms of organic disease, and symptomatic treatment does not provide satisfactory relief, leading to repeated visits to the doctor. Moderate and severe symptoms significantly affect work and quality of life, affect family harmony, and increase the risk of doctor-patient disputes. The occurrence of menopausal symptoms depends on several factors, including physical, psychological and social. Where there is optimism about aging and a better social support system for aging, the population has less severe menopausal symptoms and psychoneurological symptoms are less common than somatic symptoms. Physiological factors are the underlying factors of menopausal symptoms, which are reflected in the large fluctuations and rapid decline of sex hormones and the failure of the central nervous system to make timely adaptive adjustments, resulting in the loss of precision and coordination of various neurotransmitters such as 5-hydroxytryptamine, norepinephrine, and dopamine, leading to a variety and variability of symptoms. Organs or systems that are sex hormone-dependent or sensitive are atrophied due to lack of sex hormones. The mammary glands and female reproductive tract are sex hormone-dependent and gradually atrophy with prolonged sex hormone deficiency. The more common and obvious symptoms are: 1. vasodilatory symptoms, i.e. hot flashes, night sweats, chills, etc., which are the manifestations of abnormal function of the thermoregulatory center and abnormal contraction and diastole of peripheral blood vessels. 2. Psychoneurological symptoms: irritability, depression, irritability, insomnia, anxiety, paranoia, headache, dizziness, forgetfulness and other neuropsychiatric symptoms are commonly seen during menopause, and occasionally panic attacks. These symptoms are closely related to various social, physical and psychological factors, such as shouldering professional responsibilities, working under great pressure, leaving the familiar working environment due to retirement, children growing up and leaving the family, poor relationship between husband and wife, illness or death of friends and relatives, new illnesses, fear of aging, etc., as well as hot flashes and night sweats leading to interrupted sleep, all of which can trigger psychoneurotic symptoms. Depression, anxiety, and insomnia in menopausal women increase the risk of coronary heart disease in old age. Basic research has shown that psychoneurological symptoms are closely related to abnormalities in central nervous function. The hypothalamus contains important thermoregulatory centers as well as centers regulating mood, feeding, sleep-wake, circadian rhythm, and hormone metabolism, which are involved in the regulation of various physiological functions of the body. In the case of neurotransmitter disorders, the function of these areas may also become abnormal, and therefore the corresponding symptoms appear. Clinically, 5-hydroxytryptamine reuptake inhibitors, 5-hydroxytryptamine and norepinephrine reuptake inhibitors are used to treat depression and improve the corresponding symptoms, and the mechanism lies in the regulation of neurotransmitters. 3. Cardiovascular system symptoms About 1/4 of menopausal women experience palpitations, unstable blood pressure, and occasionally severe symptoms such as chest pain and a sense of near death, leading to repeated emergency visits to the doctor. After several specialized tests, even including 24-hour electrocardiogram monitoring, 24-hour blood pressure monitoring, and coronary angiography, it is difficult to explain such symptoms. Symptoms of the cardiovascular system can be very worrisome. After repeated visits to the doctor, it is difficult to explain these symptoms satisfactorily by “vegetative dysfunction” or “cardiac neurosis”, which can easily lead to doctor-patient disputes. In fact, the stability of cardiovascular function depends on the coordination of autonomic (sympathetic and parasympathetic) function, and estrogen also acts directly on the vascular endothelial system, playing a role in stabilizing vasomotion. 4, skeletal muscular system symptoms The soreness of the vertical spinal muscles is a typical manifestation of early osteoporosis. The two long and powerful muscles in the back near the spine are important muscles to maintain the body from hunching over, commonly known as the “inner spine”. In the early stage of vertebral bone loss, when the bones tend to be compressed, the vertical spinal muscles contract with great effort to maintain the external appearance of the person, resulting in the accumulation of lactic acid and making the person feel sore. In advanced, severe osteoporosis, fractures are frequent and difficult to heal, and half of the patients are deformed or disabled for life as a result. The soreness and stiffness of large and small joints may also be related to menopause. 5. Abnormal sensation The ankylosis of the skin is a typical symptom of menopause. Some menopausal women feel a localized cold or burning sensation in the skin without any abnormal skin appearance. Burning mouth syndrome is also closely related to menopause. Some abnormal symptoms of the respiratory and digestive tracts, such as total throat distress and strong hunger, which cannot be explained by physiological conditions or organic diseases, should also be considered to be related to menopause. 6. Atrophy and prolapse of the genital tract The female genital tract is sensitive to sex hormones. After the lack of sex hormones lasts about 3-5 years, there may be thinning of vaginal epithelium, decrease of vaginal elasticity, almost disappearance of vaginal discharge, shrinking of cervix, shallow vaginal vault, shrinking of uterus volume, thin endometrium, ultrasound suggests that the uterus becomes smaller in the meridian and the thickness of endometrium is less than 5 cm. postmenopausal women often have vulvar itching, vaginal dryness, painful intercourse and even burning sensation, thus affecting the relationship between husband and wife . The lack of glycogen in the vagina decreases the proportion and activity of lactic acid bacteria, raises the pH level, and causes a dysbiosis of the flora, making the micro-ecological environment “poor” for the growth of pathogenic bacteria, which can lead to senile vaginitis, manifested as increased leucorrhea with a bad odor and yellow color, and even retrograde infection, leading to pelvic inflammatory disease. The muscles and fascia of the perineum are important tissues that maintain the normal position of the pelvic organs. Due to various factors such as pregnancy, childbirth, long-term constipation, chronic cough, obesity, and aging, they lose strength and are difficult to support, and the position of the uterus, urethra and bladder, and rectum gradually moves down and even prolapses outside the perineal opening, i.e. pelvic organ prolapse. At the beginning of prolapse, there is no discomfort; when the organs prolapse out of the perineal opening, you will feel friction and discomfort, and you can return it in the morning, but gradually prolapse gradually aggravates from afternoon to night; when the prolapse is serious, the above organs completely prolapse out of the vaginal opening, and it is extremely inconvenient to move, which greatly affects the quality of life. 7. Repeated urinary tract infections and urge incontinence The urethra and bladder are the immediate neighbors of the reproductive tract. When estrogen is lacking for a long time, the supporting tissues around them and the mucous membrane of the urethra become thinner, and the substances secreted by the urethral epithelium to resist retrograde bacterial infections are reduced, making retrograde urinary tract infections easy to occur. After menopause, there are more pathogenic bacteria in the vagina, which collect in the perineum and are the main pathogenic bacteria causing retrograde urinary tract infections. About 1 in 10 postmenopausal women suffer from recurrent urinary tract infections, which seriously affects the quality of life and is one of the main causes of renal insufficiency in older women. Urge incontinence is a condition closely related to estrogen deficiency. Patients need to urinate as soon as they feel the urge to urinate; many women have wet their pants before they have time to go to the toilet. Urinary frequency and urgency are the characteristic symptoms of urge incontinence. The decrease in the function of the nerve center for answering the urge to urinate, urination control and local atrophy of the perineum are the main causes of urge incontinence. 8, skin thinning, breast atrophy The breast is an estrogen-sensitive organ. After menopause, breast tissue atrophies, breast volume shrinks, and different degrees of sagging and relaxation occur. The elasticity of the skin depends on estrogen, and the ratio of elastic fibers and collagen fibers decreases when estrogen is lacking; the secretion of sebaceous glands depends on androgen, and the skin becomes dry when androgen decreases. Itchy skin and skin irritation are also more common during menopause.