Why did my mother suddenly become a different person? Actually, she didn't want to be like this.

Author: Yu Qi, Chief Physician, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences

Hao Yanfang, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences

Reviewer: Tang Qin, Deputy Secretary-General and Researcher of the Science Popularization Expert Committee of the Chinese Medical Association

Many women, when they reach around 45, suddenly become irritable, easily angered, and prone to temper tantrums. They are dissatisfied with everything and feel particularly aggrieved. They also have difficulty controlling their emotions. They are often "good and peaceful" one second and inexplicably irritable the next, which creates a tense family atmosphere. The children also wonder, "Why does my mother seem like a different person..." The reason for such changes is most likely because the mother has entered menopause.

Today, let's talk about what menopause is and what women should do when they are in menopause. As long as they know and understand it correctly, I believe women and their families will be able to face it calmly and get through it smoothly.

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What is menopause?

Mentioning menopause, people will most likely think of: nagging, moodiness, bad temper, unreasonableness, hysteria... Menopause is a necessary stage in life for women. During this stage, physiological functions undergo major changes, which bring about many physical and psychological changes to women, and sometimes even make people feel at a loss.

Menopause is not a disease, but a physiological phenomenon, but it is the cause of many chronic metabolic diseases in the elderly. After most women enter menopause, they experience a lot of discomfort due to the occurrence of various symptoms. Therefore, from these perspectives, although menopause is not a disease, it is necessary to prevent diseases during menopause.

Let’s first look at the following four concepts.

Menopause: There is no clear definition of menopause. It generally refers to the stage when women go from having reproductive function to having no reproductive function and then gradually age, which lasts for 10 to 20 years.

Menopausal transition period: refers to the period from ovarian function beginning to decline, menstruation becoming irregular to the last menstruation. It may start at the age of 40 and last as short as 1 to 2 years or as long as more than 10 years. It usually occurs between the ages of 45 and 55.

Perimenopause: refers to the period from when ovarian function begins to decline and menstruation becomes irregular, until one year after the last menstrual period. Menstrual irregularity occurs when the length of the menstrual cycle changes by more than seven days twice within 10 months, marking the beginning of perimenopause.

Menopause: refers to the natural exhaustion of ovarian follicles and the loss of response to pituitary gonadotropin, resulting in ovarian failure and permanent cessation of menstruation. Women over 40 years old who have not had natural menstruation 12 months after their last menstrual period can be clinically diagnosed as menopause after excluding pregnancy.

A healthy woman can naturally develop and release 400 to 500 oocytes in her lifetime, and the total number of follicles is constant, that is, the number of follicles at birth. Therefore, as the follicles in the ovaries are naturally exhausted, the ovaries "retire" and cannot produce enough estrogen and progesterone, and menstruation stops naturally. It should be noted that young women who have undergone surgery to remove both ovaries or who have undergone radiotherapy for tumors may also experience menopausal symptoms.

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Menopausal syndrome

The five most common symptoms

After women enter menopause, their ovarian function gradually declines and then fails, the estrogen level in the body drops sharply, and a series of functional disorders occur in various organs in the body. This is what we often call menopausal syndrome.

Menopause generally occurs between the ages of 45 and 55, and menopausal symptoms are common in women between the ages of 40 and 60. It is estimated that more than 75% of women experience various discomfort symptoms during this period. The most common symptoms are the following five.

Menstrual disorders

Menstrual disorders are an obvious physiological change during menopause, which are often manifested as no menstruation for several consecutive months, or two menstruations in one month; prolonged menstruation, with one menstruation lasting more than 10 days or even longer; and menstrual flow that varies from time to time.

Menstrual disorders during menopause are prone to massive blood loss, causing complications such as anemia, and increasing the risk of endometrial cancer. Treatment should be guided by accurate diagnosis. When menstrual disorders occur during menopause, you must not take medications at will. You should go to the hospital to find out the cause, rule out pregnancy and organic problems, and then, under the guidance of a doctor, master the indications and contraindications and use medications rationally.

Vasomotor symptoms

Vasomotor symptoms refer to hot flashes and night sweats, which are typical symptoms of women in the menopausal transition and postmenopausal period. About 80% of menopausal women have experienced hot flashes and night sweats. Hot flashes usually last for 2 to 4 minutes, often accompanied by sweating, occasional palpitations, and some people will have chills and shivers, and some people will experience anxiety. Most women's hot flashes and night sweats will stop spontaneously in 4 to 5 years, but some will last for more than 10 years and be severe, affecting their quality of life and mental health.

Studies have shown that the occurrence of vasomotor symptoms is closely related to changes in sex hormones, especially estrogen, and is also related to changes in the autonomic nervous system and central nervous system. It may be caused by the complex interaction between the central nervous system and multiple peripheral nervous systems. Frequent vasomotor symptoms can affect blood pressure, blood lipids, insulin and other indicators, and thus affect women's cardiovascular health.

Urogenital syndromes associated with menopause

During menopause, urogenital syndrome is mainly caused by the decline of estrogen levels, atrophy of vaginal and urethral tissues, and decreased elasticity and secretion function. The main symptoms include vaginal dryness, burning sensation, stinging and sexual dysfunction, and urinary tract symptoms include recurrent urinary tract infections, frequent urination, urgency, and urinary incontinence.

The above symptoms are common, but patients often avoid talking about them when seeking medical treatment. Some women also think that this is an inevitable part of menopause and choose not to seek medical treatment.

Mood disorders

Anxiety and depression are the main characteristics of menopausal mood disorders. This may be related to the decline in ovarian function, which leads to a decrease in estrogen levels, an increase in blood monoamine oxidase levels, and further increases in the decomposition and metabolic inactivation of dopamine, norepinephrine, and 5-hydroxytryptamine in the body, as well as a decrease in the activity of monoamine transmitters, causing neuroendocrine imbalance, and thus causing mood disorders and a decline in cognitive function.

Studies have shown that adjusting the balance of the nervous system and endocrine system can be beneficial for improving the mood and cognitive function, as well as anxiety and depression in menopausal and postmenopausal women.

Sleep disorders

With the increase of age and the arrival of menopause, the incidence of sleep disorders in women is gradually increasing. Sleep disorders in menopause and postmenopause include difficulty falling asleep or staying asleep, frequent waking at night, and poor sleep quality. The reasons are partly due to nighttime hot flashes, night sweats, frequent urination, etc., and partly due to anxiety and depression. In addition, primary sleep disorders are also common.

For these women, medication to treat urogenital syndrome and relieve emotional disorders can help alleviate sleep disorders and improve sleep quality and quality of life. However, due to the existence of many other factors that may disrupt sleep, it is difficult to completely solve sleep problems. In addition, cognitive behavioral therapy, aerobic exercise, etc. can also help menopausal sleep disorders.

Other symptoms

Since estrogen receptors are widely present in various parts of the body, fluctuations and lack of estrogen affect almost all systems in the body. Each organ can produce a variety of, sometimes even "weird" symptoms, such as tingling sensation on the skin, foreign body sensation in the throat, palpitations (that is, abnormal heart beat rhythm), persistent nausea, vomiting, and so on.

Depression and anxiety caused directly by a sharp drop in estrogen or secondary to a drop in estrogen fluctuations, after excluding organic diseases in related parts and undergoing menopausal hormone therapy, or after some patients with severe symptoms receive anti-depression and anxiety treatment, these "strange" symptoms are miraculously alleviated. It can be seen that estrogen can maintain women's health, and estrogen deficiency has many adverse effects on women's health.

A Guide to Healthy Living During Menopause

If disease factors are ruled out and menopause is confirmed to have arrived, what should women do to get through this period smoothly?

1. Eat a balanced diet

Menopausal women should appropriately reduce their intake of sugar (also known as carbohydrates) and control their fat intake. They can appropriately increase their intake of foods rich in protein, calcium, iron and vitamins, such as meat, eggs, milk, fresh vegetables and fruits, increase their intake of dietary fiber, and eat refined grains, whole grains and whole grains together. The total calorie intake should be less than that of younger women, and the dietary characteristics should be low in calories, fat, salt and sugar.

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2. Say no to smoking and passive smoking

Lung cancer is the leading cause of malignant tumors caused by smoking. The impact on women also includes early menopause or changes in the menstrual cycle. Secondhand smoke contains a large number of harmful substances and carcinogens. Non-smokers who are exposed to secondhand smoke will also increase their risk of developing a variety of smoking-related diseases. Secondhand smoke exposure can increase the risk of lung cancer, breast cancer, coronary heart disease, and stroke in non-smoking women.

3. Limit alcohol intake

Drinking should be limited. For menopausal and postmenopausal women, daily alcohol intake should not exceed 10 g.

4. Exercise

Menopausal women should try to avoid "muscle-joint-bone" injuries during exercise. It is recommended to perform moderate-intensity aerobic exercise at least 3 times a week for 30 minutes each time. The intensity of exercise should be controlled according to the heart rate during exercise (moderate-intensity exercise heart rate). In addition, it is recommended to add 2 additional muscle strength exercises per week and accumulate physical activities equivalent to walking more than 6,000 steps per day for greater benefits.

5. Weight Management

The normal body mass index (BMI) should be maintained at 18.5-24 kg/㎡, and menopausal women are no exception. Intake of more calories than consumption is the root cause of obesity. Obesity can have many adverse effects on physical health. Among postmenopausal women, obesity has become an increasingly serious health problem.

The calculation method of body mass index is: body mass index (BMI) = weight (kg) / height (㎡). When BMI ≥ 24 is overweight, BMI ≥ 28 is obese, and a waist circumference of ≥ 80 cm for women is the limit of abdominal fat accumulation.

It is generally believed that if overweight people lose 5% to 10% of their body weight, it can effectively improve various abnormal symptoms related to obesity. However, avoid sudden weight loss. It is recommended that mildly obese adult patients lose 0.5 to 1 kg steadily per month, and moderately obese adult patients can lose 0.5 to 1 kg per week. Calorie control should also be based on the principle of gradual and step-by-step reduction. For safety reasons, it is recommended to reduce calories by 125 to 250 kcal per day, while increasing calorie consumption.

6. Sleep

It is recommended that menopausal women ensure 7 to 8 hours of sleep every night. If a nap is needed, the duration should be controlled to 15 to 20 minutes.

7. Sexual life

During menopause, estrogen levels drop, vaginal tissue shrinks, and glandular mucus secretion decreases, which can easily cause dryness, burning, and tingling. In addition, menopausal pelvic floor dysfunction causes vaginal loosening, which can easily lead to urinary incontinence and other problems, reducing the quality of sexual life. In addition, the various menopausal symptoms cause menopausal women to gradually show resistance and disgust towards sexual life.

However, sex is still an integral part of the life of menopausal women. If health permits, moderate sex can promote blood circulation, improve the pelvic environment, enhance the relationship between husband and wife, and make family relationships more harmonious. There is no need to be ashamed to talk about sex during menopause. Let your partner understand your feelings and discomfort, and get the support of your family, which will help you get through menopause smoothly.

8. Go to the hospital promptly

The latest opinion of The Lancet is that menopause is actually just a hormone deficiency that requires estrogen treatment. If you experience menopausal symptoms, it is recommended to see a doctor. After excluding organic diseases, the doctor will develop a targeted treatment plan for the patient based on individual conditions and personal needs.

For menopause, you don't need to be overly nervous, nor can you ignore it. You must learn to treat it correctly. The problems faced by menopause are multi-faceted and multi-systemic. Therefore, health care measures for menopause should also be based on multiple levels and dimensions. The health concept of prevention first can help menopausal women reduce the occurrence of postmenopausal related diseases.