Don’t be afraid of “vegetarianism”, seize the golden period of treatment - “Be a sister who rides the wind and waves”

Hormones shape a woman's life, and estrogen and progesterone are the basis of a woman's charm.

The ovaries are the source of female hormones.

Estrogen is not only a woman’s physiological hormone, but also a woman’s youth hormone and health hormone.

Progesterone - allows women to realize their dream of becoming a mother. Under the action of estrogen, it completes a series of tasks such as conception, pregnancy, and lactation.

Estrogen deficiency causes changes in all systems of the body

The three main symptoms after ovarian function decline (vasomotor symptoms such as hot flashes and night sweats, and urogenital atrophy symptoms such as vaginal dryness and sexual intercourse pain)

Hot flashes, mood changes, vaginal dryness, painful intercourse, sleep disturbances, memory loss

Perimenopause is commonly known as menopause

Start sign:

Changes in the length of your menstrual cycle occurred twice

The period starts from the period before menopause (>7 days compared with the previous menstrual cycle length) (i.e., from the onset of endocrinological, biological, and clinical features approaching menopause) to the first year after menopause.

How do Chinese women survive today?

Ignore treatment: ~61%

Self-medication with nutritional and health supplements: ~ 25%

Seeking medical treatment: ~14%

Stories around us

Ms. Li, 62 years old, suffered from an unspeakable disease half a year ago. She had discomfort in her lower body, a burning sensation, yellowing and increasing leucorrhea, occasional itching of the vulva or vagina, dull pain in the lower abdomen, and sometimes frequent and urgent urination. "I usually pay attention to hygiene. I have been menopausal for nearly 9 years, my vagina is dry and I have no sex life. How could I have this problem?" Later, she was diagnosed with senile vaginitis in the hospital. After local anti-infection treatment, the disease recurred and she was very distressed.

The doctor will comprehensively evaluate the patient's condition and develop an appropriate treatment plan if there are no contraindications. "Local anti-infection treatment + topical estrogen" and regularly monitor the whole body. Follow-up visits are generally conducted 1 month, 3 months, 6 months, and 12 months after the start of medication, and at least once every 12 months thereafter. Ms. Li's unspeakable problem was solved.

There are three ways to use hormone therapy: oral, transdermal and topical. For patients with symptoms of urogenital tract atrophy, vaginal administration is recommended. For senile vaginitis or even urethritis caused by estrogen deficiency, anti-infection can only "treat the symptoms". Estrogen therapy is the real cause treatment, which can prevent recurrence of the disease.

The global consensus statement on menopausal hormone therapy (2013), (2016) and the latest recommendations of the International Menopause Society (IMS) (2013), (2016) point out that the benefits of menopausal hormone replacement therapy (MHT) far outweigh the risks.

MHT positive benefits

◆ Menopausal symptoms (for those aged < 60 years)

◆ Osteoporosis (for patients under 60 years old)

◆ Coronary heart disease (for patients under 60 years old)

◆ Urogenital tract atrophy (topical medication)

Possible side effects of MHT:

◆ Breast cancer risk - related to progesterone

◆ Risk of blood clots and stroke - related to oral estrogen

How can MHT provide greater benefits and fewer risks?

Four lines of defense, lower risk

◆ The most suitable women - window period, with indications, no contraindications, and willing to use

◆ The most suitable drug - non-oral estrogen, natural or near-natural progesterone

◆ The most appropriate dose - the lowest effective dose (equivalent to 1/5 to 1/10 of the reproductive period)

◆ The most standardized follow-up - regular testing and annual evaluation

In short: Grasp the golden period of treatment - the "time window" starts from the perimenopause. If timely treatment is given during the window period, it can not only alleviate the various problems mentioned above, such as menstrual disorders, mood changes, sexual intercourse difficulties, etc.; it can also prevent the more serious long-term consequences of perimenopause! Studies have shown that the reasonable use of natural estrogen and progesterone will not increase the risk of endometrial cancer, breast cancer, etc.

Note: There is no copyright issue for the pictures in this article

Author: Liu Zhou, Wang Ying, Zhao Jiangxia, Zhoupu Hospital, Pudong New Area, Shanghai