How to stop being irritable during menopause

This is the 3872nd article of Da Yi Xiao Hu

Menopause is also known as perimenopause. People often associate "menopause" with "irritability". The most common soul-searching questions in the outpatient clinic are: "Doctor, I have been irritable recently. Is it menopause?" "Doctor, I have a bad temper recently. They all say that I am in menopause. Is it true?"...

1. What is perimenopause?

Perimenopause is the transitional period from regular menstruation in women's reproductive period to menopause, and menopause can only be determined after 12 months of amenorrhea. A series of related symptoms that occur before and after menopause are called menopausal syndrome.

2. What are the clinical manifestations of menopausal syndrome?

The decline of ovarian function during perimenopause leads to estrogen deficiency, which in turn leads to a series of endocrine disorders, vasomotor symptoms, mental and nervous system symptoms, and physical symptoms, mainly manifested as:

1. Menstrual changes

1) Shortened menstrual cycle and reduced menstrual volume;

2) Irregular menstruation, prolonged menstruation, heavy menstrual flow or prolonged bleeding;

3) Menstruation suddenly stops.

2. Vasomotor symptoms

Hot flashes and sweating. Hot flashes start from the chest, flow to the head and neck, and then spread to the whole body. The hot flash area is burning and the skin is red, followed by explosive sweating, which can last from seconds to minutes. The frequency of attacks ranges from several to dozens of times a day, and is easily triggered at night or under stress.

3. Psychoneural symptoms

Emotional symptoms include irritability, anxiety, suspicion, depression, reduced self-confidence, and inability to control oneself; memory loss, lack of concentration, sleep disorders, etc.

4. Urogenital tract symptoms

Urogenital tract atrophy, vulvar itching, vaginal dryness and pain, dyspareunia, decreased libido, frequent urination, urgency, stress urinary incontinence, and recurrent urinary tract infections.

5. Metabolic disorders and cardiovascular diseases

The incidence of palpitations, arrhythmias, abnormal glucose and lipid metabolism, coronary heart disease and myocardial infarction increases with age.

6. Osteoporosis

Starting from the perimenopause period, the rate of bone absorption is greater than the rate of bone formation. About 1/4 of postmenopausal women suffer from osteoporosis, which is often manifested as pain in the back, limbs, joint pain, and hunchback. Severe cases may lead to fractures, the most common of which is cone fracture, and others include distal radius and femoral neck fractures.

How to determine whether you are in perimenopause

It mainly relies on clinical symptoms and signs combined with hormone testing. Selective hormone testing can determine the ovarian function, such as: an increase in FSH. When FSH>40U/L, it indicates ovarian failure.

4. How to safely survive the “troubled period” of perimenopause

1. Self-psychological adjustment

Correctly understand some of the changes currently occurring in the body, realize that the current discomfort is a natural and necessary process in a woman's life, fully accept it, and be mentally prepared to overcome it.

2. Maintain harmonious family relationships

Perimenopausal women are easily emotional and prone to conflicts with their families. During this period, they should always remind themselves to stay calm. At the same time, they should maintain full communication with their family members to let them fully understand certain phenomena and problems that may occur during perimenopause. This way they can get more comfort, encouragement and help from them, and avoid unnecessary anger caused by some minor frictions.

3. Cultivate hobbies and increase interest in life

Most perimenopausal women are approaching retirement or have already retired, and will have some sense of loss to a certain extent. At this time, they should enrich their spare time and cultivate some hobbies, such as: growing flowers, raising fish, listening to music, etc. They can also go to senior citizen universities to study some subjects they are interested in, such as: musical instruments, painting, calligraphy, etc. This will not only maintain good brain function, but also maintain good social adaptability through communication with the outside world.

4. Proper exercise to improve physical fitness

As we age, the functions of various organs begin to decline. Proper exercise can promote metabolism and enhance the physiological functions of various organs, but strenuous and fast exercise is not suitable for this age group.

It is advisable to choose some slow-paced sports such as yoga, jogging, walking, Tai Chi, etc. You can also choose some group sports such as square dancing, aerobics, etc. This way, you can not only meet like-minded people during exercise, but also exchange views and ideas through communication, and give each other support and encouragement.

5. Appropriate hormone supplementation

Hormone supplementation can improve menopausal symptoms and prevent postmenopausal osteoporosis. However, before hormone treatment, the indications and contraindications should be fully evaluated, the pros and cons should be weighed, and a personalized treatment plan should be developed based on the patient's age, uterine and ovarian function, and other risk factors. During the treatment process, the efficacy, adverse reactions, and changes in the individual risk/benefit ratio should be monitored to decide whether to continue the medication or adjust the plan. It should be used strictly under the guidance of a physician, and self-supplementation is not recommended.

Author: Department of Gynecology, Huadong Hospital, Fudan University

Zhu LihongDeputy Chief Physician