What is perimenopausal syndrome?
Perimenopause, also known as menopause in the past, is the period from the onset of symptoms due to declining ovarian function until within one year after menopause. The period from the beginning of the menopausal trend to the last menstrual period is called the menopausal transition. Perimenopausal syndrome is a group of symptoms caused by fluctuations or decreases in estrogen levels in women around the time of menopause, mainly due to plant nerve dysfunction, accompanied by neuropsychological symptoms.
What should be the normal age of menopause?
In China, menopause occurs between 45 and 55 years of age, with an average of 49 years, in developed countries between 50 and 52 years, and 47 years in Africa. Menopause before the age of 40 is considered early menopause or premature ovarian failure. The age of menopause in women is influenced by various factors such as genetics, nutrition, weight, hobbies, fertility, disease, and environment. The symptoms of perimenopausal syndrome may begin to appear during the menopausal transition and persist until 2-3 years after menopause, and in a few cases until 5-10 years after menopause. 90% of women have mild or severe manifestations of perimenopausal syndrome, some of which require treatment and some of which can be self-managed.
Can surgical removal of the uterus or ovaries lead to perimenopausal syndrome?
If a woman has both ovaries removed before menopause, she may experience perimenopausal syndrome 2 weeks after surgery, peaking 2 months after surgery and lasting about 2 years. If the uterus is removed due to fibroids and the ovaries are preserved, perimenopausal syndrome may appear some time earlier because the blood supply to the ovaries is affected.
What are the main manifestations of perimenopausal syndrome?
The manifestations of perimenopausal syndrome are varied because female hormones have more than 300 “targets” throughout the body, so it is a combination of different systemic manifestations of a disease. Of course, if a woman is unwell before or after menopause, she should first go to a gynecological clinic for an examination to rule out the possibility of gynecological disorders before further diagnosis and treatment to avoid misdiagnosis and mistreatment.
Common symptoms: menstrual disorders, hot and sweaty flashes, anxiety and depression, irritability, dizziness and dullness, chest tightness and panic, vaginal dryness, frequent and urgent urination or poor urination, memory loss, dry and cracked or itchy skin, fat body shape, back and leg pain, fracture prone, etc.
1.Menstrual changes
Menstrual changes are often the first clinical manifestation of entering perimenopause. For example, irregular menstrual cycle, vaginal bleeding before (after) menstruation, or vaginal bleeding after a long period of amenorrhea, and the amount is as much as a note, and lasts for a long time, or the menstrual cycle is gradually prolonged, the period is shortened, and the amount of menstruation is reduced. In a few women, menorrhagia may occur after the age of 40 and lead directly to late menopause. The majority of perimenopausal menstrual changes are caused by the decline of ovarian function, not by tumors. However, if bleeding occurs after menopause or after sexual intercourse, it may be pathological and should be taken very seriously. The best way to determine if the lesion is organic (such as cervicitis, cervical cancer, endometrial cancer, etc.) is to immediately go to the hospital for examination, do not wait for the blood to be clean, if you do diagnostic scraping, scrape out the material sent to pathological examination.
2.Paroxysmal hot flashes
Paroxysmal hot flashes are a characteristic symptom of women entering the perimenopause. It often occurs 1-2 years before menopause, but mainly occurs after menopause, generally lasts 1-2 years and then disappears naturally, but some women last more than 5 years. The symptoms are sudden redness of the skin of the head, neck and chest, accompanied by a feeling of baking heat all over the body, and when the symptoms disappear about half of the women are dripping with sweat, followed by shivering and shivering. Some women are cold and do not have hot flashes. The duration of hot flashes varies from a few seconds to a few minutes, and the frequency of attacks varies, with more frequent at night or at dusk, and also with morning sweats. In severe cases, it leads to sleep disturbance, and chronic lack of sleep can be fatiguing and strenuous. In addition, hot flashes can also occur when nervousness, external stimuli such as stress, high room temperature, too much activity, too warm clothes and blankets.
3.Psychoneurological symptoms
The main psychiatric symptoms are depression, anxiety, paranoia, etc., and for the first time, most of them are accompanied by the decline of sexual function. Most of them are of two types: one is excitement type, such as irritability, agitation, insomnia, inattention, talkative, loud crying and other neurotic-like symptoms; the other is depression type, such as irritability and anxiety, inner turmoil, fear and dread, memory loss, lack of self-confidence, slow action, and in severe cases, apathy towards external things, disinterest in life and work, and even developing into severe depression.
4.Cardiovascular symptoms
Mild hypertension can occur in 15.2% of women. It is characterized by elevated systolic blood pressure but not high diastolic blood pressure, paroxysmal episodes, blood pressure is more likely to fluctuate, sometimes normal and sometimes abnormal. In 28.9% of women, pseudo-angina is present, which is characterized by boredom and discomfort in the precordial region, palpitations, shortness of breath, and ST-segment decrease on ECG.
5. Genitourinary tract changes
Genitourinary tract changes include vaginal dryness, burning sensation, vulvar itching, painful intercourse; overactive bladder with urinary frequency and urgency (urinary frequency: ≥8 times/day, ≥2 times/day at night, urine volume <200ml each time), and recurrent urinary tract infections with urinary pain; uterine prolapse, anterior and posterior vaginal wall bulge with urinary retention, and difficulty in defecation.
6.Skin and hair changes
Skin hair changes are characterized by dry or cracked skin, thinning of the skin, loss of elasticity and wrinkles. Due to endocrine disorders leading to skin nutrition disorders, prone to dermatitis, sweating, swelling, hair loss, no obvious skin lesions and feel itchy skin.
7.Osteoporosis
There are estrogen receptors on bones, and estrogen has the function of promoting intestinal calcium absorption and inhibiting the activity of osteoclasts. The decrease of estrogen level is the main cause of perimenopausal osteoporosis. It is often manifested as low back pain, bone and joint pain, height shortening, and in some cases, hunchback and tooth loss, and in serious cases, fracture will occur without obvious external force.
8.Obesity or body shape change
In the perimenopausal period began to obese people accounted for 15%, fat appeared asymmetric accumulation, mainly in the lower abdomen and buttocks. And obese people suffering from diabetes is non-obese people 4 times, half of them and at the same time accompanied by hypertension. Obesity is the source of all diseases, it will also increase the burden on the heart, prone to atherosclerosis, coronary heart disease, cholecystitis, uterine cancer, etc..
The above symptoms may not occur in every woman, and even if they do, the performance and severity of the symptoms vary. Except for 10-15% of women whose symptoms are more serious and affect their normal life and work and require treatment, the majority of women can successfully pass this period through self-regulation, increased knowledge about menopause and appropriate health care services.
What are the modern medical treatment methods?
The main treatment is estrogen replacement therapy, either cyclically with progestin or continuously, depending on the patient’s age and specific conditions. According to current medical research, there is a potential therapeutic window for perimenopausal hormone replacement therapy, meaning that patients who start hormone therapy before the age of 60, or even early in the excessive menopause around the age of 45, will experience far more benefits than drawbacks. In contrast, those who start hormone therapy after the age of 60 or 70 years do not show significant improvement in osteoporosis, but the incidence of coronary heart disease rises, thus reversing the benefits and drawbacks of hormone replacement therapy with increasing age. The use of hormone replacement in perimenopausal women in developed countries can reach 40%, while in China it is only 2%. Chinese women generally resist the hormone replacement approach and turn to TCM for help.
How can the emergence of perimenopausal syndrome be understood from a TCM perspective?
Chinese medicine refers to the perimenopausal syndrome as the symptoms before and after menopause. Perimenopause is a turning point in the body’s aging process. According to TCM, after the age of 35, the yin and yang of women begin to gradually decay, and from the age of 42, this decline is accelerated, which is very consistent with the modern medical study of the “broken stick phenomenon” after the age of 40, and thus the relationship between yin and yang is prone to “vibration”, resulting in a loss of balance and thus the development of perimenopausal syndrome. This leads to a loss of balance, resulting in various uncomfortable symptoms. However, once this eventful period is successfully passed, the path of life will still be smooth and harmonious, and post-menopausal women can also live a healthy and happy life.
What does TCM believe is the best way to survive perimenopause?
Chinese medicine emphasizes that prevention is better than cure. A regular rhythm of life, a good lifestyle, a reasonable dietary structure, and a healthy and calm state of mind are very important for people of any age and in any disease state, and women in the perimenopausal period need to pay particular attention.
1, a regular rhythm of life
The yin and yang of the human body is through the day and night changes in heaven and earth to achieve this and that, with each other. On time, do not stay up late, do not sleep late, to ensure that good, adequate sleep can nourish the body, maintain the balance of yin and Yang. Regular living, diet, and even regular bowel movements can play a role in coordinating the balance of internal and external, up and down.
2.Good lifestyle
Poor nutrition, low weight, vegetarians may cause the exacerbation of Yang and Yin deficiency; frequent smoking, excessive drinking, coffee and spicy food will lead to internal heat and Yin, early menopause and even premature ovarian failure; drinking carbonated beverages and lack of exercise will easily hinder the digestion of the spleen and stomach, causing the accumulation of waste in the body, poor blood flow and imbalance of Yin and Yang. Modern medical research has proven that these poor lifestyles have a significant impact on female ovarian function. If you can eliminate these bad habits and maintain a good lifestyle you can ensure the balance of yin and yang.
3.Rational diet structure
The kidneys are the first and the spleen is the second, and the kidneys are declining earlier than the spleen. 50 and 60 year olds can still eat and drink, but have lost their fertility. So it is very necessary to take some kidney food after 40 years old, the key problem is to grasp the amount and frequency of supplementation. Chinese medicine is concerned about individual differences, because different people have different physical qualities, different spleen and stomach functions, different daily activities, and different emotional changes may affect the absorption and transformation of food supplements. This requires a good self-assessment and adjustment of the individual, and the tonic should also be balanced in order to make the originally turbulent body functions reach a coordinated state, otherwise it will help, so I always emphasize that health care is a kind of learning and practice.
4, a healthy and calm state of mind
Anger is gas, fear is gas, shock is gas, worry is gas, sadness is gas, joy is gas slow, the extreme performance of emotions on the human body internal impact is huge, harming the five organs, damage to yin and Yang, are the perimenopausal women’s taboo. How to cultivate the body and mind, peace of mind, to achieve the state of calm and spirit within the guard can be smoothly through the perimenopause.
Commonly used foods for the kidneys
The kidney is the main water, the color is black, so the kidney food black for more. Such as black rice, black beans, black fungus, black sesame, black dates.
The spleen and kidneys have a relationship of successive heaven, and strengthening the spleen and earth of the latter can also achieve the effect of nourishing the innate kidneys, such as yam, lotus seeds, beans, chestnuts, etc. There is also the role of the same qi, commonly known as “what to eat to supplement what”, you can use pig bone marrow, pig kidney, sea cucumber, cordyceps, etc. can achieve the role of kidney. It is important to take less and more, to be persistent, not to rush, but to be counterproductive, so that the balance of yin and Yang will be lost, leading to disease.
How does Chinese medicine treat perimenopausal syndrome?
As mentioned above, TCM believes that perimenopausal syndrome is caused by the imbalance of yin and yang in the body, so the treatment is to address this imbalance, harmonize yin and yang, and achieve the purpose of relieving the symptoms. For patients with milder symptoms, they can pass through the syndrome with their own adjustments, while those with more pronounced symptoms need to be treated with medication under the guidance of a doctor.