Hello, Sina netizens!
Host: Famous doctors gather to talk about people's health. Good afternoon, all Sina netizens. Welcome to the famous doctor hall broadcast live by Sina Health and Medical Forum. I'm Cui Yinmo. While broadcasting the program, you can also communicate with our experts through our interactive platform. Nowadays, many women focus their work and life on their career, often ignoring their own health. In fact, with the growth of age, especially when entering the perimenopause, they should pay more attention to their own health. As an important role in life and society, women's health is not only related to the quality of personal life, but also to the quality of happiness of the whole family. In this program, we specially invite Professor Yu Qi, Deputy Director of Obstetrics and Gynecology of Union Medical College Hospital, Chief Physician and Doctoral Supervisor, Leader of the Menopause Group of the Society of Obstetrics and Gynecology of the Chinese Medical Association, and Member of the Gynecological Endocrinology Group of the Branch of Obstetrics and Gynecology of the Chinese Medical Association to talk with us about the topic of perimenopausal women's health, First, let's meet Professor Yu. Hello, Professor Yu.
Yuqi: Hello! Hello everyone!
Host: Professor Yu, let's take a look at an example first. It said that Sister Yang is 50 years old this year. In the past two years, she suddenly became very grumpy, and her mood was particularly vulnerable. She felt that she might be in menopause. And in recent months, she found that her menstruation was getting less and less, and now she has no menstruation, and she often sleeps. Sister Yang checked on the Internet and found that this was the performance of perimenopause. At the same time, she is particularly worried about whether menopause is prone to some diseases, and whether some measures are needed to prevent and alleviate them. In this case, we heard two words: "perimenopause" and "menopause". We may often hear the word "menopause" in our daily life, but we have hardly heard the word "perimenopause". First of all, Professor Yu helps us to explain whether there is any difference between these two periods?
Yu Qi: There is no essential difference between these two terms for ordinary people, because perimenopause is a medical term, and its exact definition is that the period from the beginning of menstrual disorder to the year after the last menstruation is called perimenopause.
Menopause is a Chinese term, which is a traditional term from the perspective of traditional Chinese medicine. To break the word down, "more" means change, and "year" should not mean one year or two, but one era. That is to say, the change of the times is about such a stage that we can understand it in this way. So this word really deserves its name.
For women, the characteristic of women is that they have ovaries and estrogen, and these endocrine functions. The change from having such a function to not having such a function really means the change of an era.
There is a saying in the ancient medical skill Yellow Emperor's Internal Canon, "The qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi qi. Not only the appearance, but also the character and temper will change greatly.
As the elder sister Yang said just now, she suddenly lost her temper. As you can imagine, the Chinese people's understanding of the so-called menopause now seems to be a curse. Why does it become a curse? It refers to the phenomenon that these people, who are usually good, suddenly become angry and unreasonable. This is the most prominent symptom of Chinese menopause, and foreigners also have menopause abroad. The highest symptom of menopause in foreigners is hot flashes and sweating. Temperament changes account for 30%, 40%, 40%, 50%. On the contrary, Chinese people sweat only 40% and 50% with hot flashes. There are certain differences in the spectrum of fever among different races.
As for the so-called menopause, menopause and menopause are also good, so it is unnecessary to investigate such terms. People call menopause, we call it menopause. The reason why menopause occurs is because of the loss of ovarian function. There are all kinds of organs in human body. After a long period of evolution of about one million years, each organ has its own role. But at the age of 50, as a woman, she will lose an organ, that is, an ovary.
The loss of ovarian function will bring a series of problems to people. The ovary has two functions: one is to give birth and ovulate, and the other is to secrete hormones. These two functions have disappeared as women around the age of 50. You can understand that the probability of pregnancy has declined greatly since the age of 40, which is not an ordinary decline, but a rapid decline. By the age of 50, the ability to secrete hormones will be lost. You may have questions. If there is no estrogen, there will be no estrogen. What problems will it bring? It doesn't matter. There is an old saying that the older you get, the more you smoke. One gets shorter. Why does one get shorter? People get shorter when they get old. It is caused by osteoporosis.
This phenomenon is caused by osteoporosis. The spine bone is compressed one by one, and people who can't bear the weight of people become shorter, not only become shorter evenly, but also become uneven. The elderly have hunchback, and scoliosis will slowly appear. These phenomena are the manifestations of osteoporosis. How did osteoporosis come about? It is the lack of estrogen that affects the bone. Then there are some metabolic aspects. Osteoporosis is actually a disorder of calcium metabolism, and other substance metabolism is affected at the same time. Estrogen is not only a hormone with reproductive function, but also a hormone with metabolic function.
In addition to the calcium metabolism problem in bones just mentioned, it will also cause other substances, such as fat and lipid metabolism problems. It can be easily seen from a statistical data that few women had heart disease before the age of 55. It can be seen from a look around that men had heart disease before the age of 50, and almost no women had heart disease before the age of 55. But by the age of 60, 65, 70, and 65, women had almost the same heart disease as men.
Host: Before menopause, estrogen in her body still protects her heart.
Yu Qi: Estrogen is the best substance to protect the heart from heart disease before women are 50 years old. When estrogen is gone, cardiovascular diseases such as dyslipidemia and arteriosclerosis will occur.
Compere: We suddenly found that menopause is not only about temper changes, but also about other changes in the body. It should be treated, right?
Yu Qi: Yes. Many people think that everyone has menopause, and everyone has a physiological phenomenon. Why treat the physiological phenomenon? This question often arises. Can you imagine when this physiological phenomenon will come into being? As a physiological phenomenon, it should be a normal physiological phenomenon for all human beings. But when is menopause a common phenomenon for all human beings? You can see the changes in the average life span of people. In fact, in the 1930s and 1930s, the average life span of the world was only 30 years old, and the average life span was 42 years old. According to the fact that not many people can menopause, At that time, it should be Qianlong who held a banquet for thousands of old people every year and invited 70 year old people to the imperial palace to have dinner. Now the state leaders have to go bankrupt to do this.
Therefore, as the average life span of human beings increases, these organs will degenerate and these problems will occur, and menopause will become a problem. At that time, people could not live, and generally died in their 40s. Who would have menopause? Menopause is accompanied by the extension of the average life span. The extension of the average life span is what everyone pursues. Of course, the longer you live, the better. This pursuit brings about the problem of longevity. So longevity may bring many problems, and menopause is one of them.
Moderator: As you said just now, menopause is a period of change. In fact, it is a sign of women's aging. Many women pay special attention to whether they are young, and can we try to prolong it, because some people may have menopause in their 40s, and some people in their 50s. Can we try to delay the menopause?
Yu Qi: It's not likely. I can only say that. Because the number of eggs in the ovary is as many as they are born, one egg will be discharged every month, but this one does not mean that one egg will be used, but there may be one or two thousand eggs in the ovary will develop at the same time. Finally, people have a preferred mechanism to select the best eggs from them, and finally they will mature and be discharged, and more than one thousand eggs will die during the development process. Although one egg is laid every month, one or two thousand eggs are consumed. This gradually changes. By the age of 50 or so, all the eggs in the ovary are used up. Of course, different people have different basic follicles and different development status. Maybe she will be one or two years earlier and one or two years later. However, the overall trend is about 50 years old on average, and she will have no menopause.
Host: Now many female friends have heard that if the body hormone changes when the menopause comes, the image and temper may be changing as you said. But many people choose drugs that can supplement estrogen or other nutrients. Then let my hormone change as slowly as possible. Although I can't let the natural law change, I can at least make some changes in my appearance from the inside of the body. We found that there are all kinds of drugs, and we don't know how to choose them? Will choosing these estrogens have side effects on the body?
Yu Qi: That's right. Because everyone now lives an average of 80 years in Beijing. Women may live longer than men. So in such a life expectancy state, it is very important for everyone to pay attention to this problem, and they will try to solve it, but they can't misuse it.
Estrogen should be supplemented, only when estrogen is lacking. When there is no shortage, it is not necessary to supplement. And what do you say? There are all kinds of problems after menopause. For example, we say that the problems caused by menopause can be divided into several categories. One is the recent problems. Just now, Sister Yang's symptoms, hot flashes, sweating, and temper tantrums are recent symptoms.
With the extension of menopause, there will be atrophy problems, skin wrinkles, and urinary and reproductive tract infections. Later, I just mentioned that osteoporosis, cardiovascular disease, Alzheimer's disease caused by the nervous system, and the gradual occurrence of metabolic problems in the long term are related to estrogen. The lack of estrogen will bring about these symptoms and metabolic problems, but not all of them are caused by estrogen. With the growth of age, lifestyle changes, Will have a certain impact on the occurrence of these problems.
So for menopause, we should first have a correct attitude, and actively face it. Don't let it go. It must be wrong, and we must be positive. In addition to seeking help from drugs, there is also a healthy mentality. In addition, it is also very important to have a good lifestyle. From the International Menopause Society, we proposed a plan for the treatment of menopause last year, taking hormone supplement treatment as a part of a healthy lifestyle, including a series of measures such as diet control, exercise, smoking cessation, and drinking less, On the basis of these measures, a very ideal state can be achieved only when a part of the so-called hormone supplement treatment is carried out among the appropriate population.
Judging from the various drugs available today, many people go to the doctor randomly, buying one thing and another. This is also the menopause, which is also the menopause. In fact, this is a medical measure, not a problem that can be solved with health care products. It is better to go to the hospital and seek the help of medical students. As you have just introduced, I am the leader of the menopause group of the Society of Obstetrics and Gynecology of the Chinese Medical Association. Our group is now committed to carrying out an activity to set up a menopause clinic, or menopause clinic, in major hospitals across the country. I hope it can help the majority of menopausal women.
Compere: Recently, I found that a friend in his 30s went to the hospital and found that he had postmenopausal premature ovarian failure. Can you supplement estrogen in this situation?
Yu Qi: If it is really premature senility, it is more urgent for her to supplement estrogen, and she should actively supplement it. However, in fact, many people in their 30s come to my clinic to see a doctor, so they may have two problems. One is that some people, as you just said, do not have ovarian function, which is also true. In fact, the number of such people is not very large. In terms of incidence, it accounts for about 1% of women of childbearing age.
But now it seems that there are so many people who always feel that they have symptoms of menopause. People in their 30s come here. In fact, this is a modern urban disease, which is caused by too much work pressure. If we used to call these diseases neurosis and neurasthenia, it is actually a mental problem.
Compere: Especially for this symptom, it is very easy to cover myself. Recently, I have a short temper. I love insomnia. I am easy to dream or sweat. When you think about whether I have this problem, you want to add it. As you said, we should go to the hospital and let the doctor help us analyze it.
Yu Qi: Psychological problems should be solved psychologically, and drug treatment should be sought again if the ovaries really decline.
Compere: Just now we mentioned that medicine can treat the symptoms of menopause, except that you said that the hospital should let the doctor give us a detailed analysis of our condition. What kind of drugs are commonly used to treat menopause?
Yu Qi: Medication has been used to treat menopause for about 60 years, more than half a century. So this road has been rough and bumpy, and it is indeed a process of being praised to the sky and trampled underfoot. The first kind of estrogen treatment agent really used for menopause is a kind of drug called conjugated estrogen, which is extracted from horses, such an estrogen. After such a drug was used, it was the only estrogen preparation for a period of time. After this drug is used for the treatment of menopause, it has achieved very outstanding effects. It really improves the symptoms of menopause, prevents osteoporosis, and so on. But at the beginning, people may be confused about these excellent effects, and forget the basic knowledge. To supplement estrogen, they also need to supplement progesterone. These people are old and have heart disease or something. It is useless to supplement estrogen again. These common knowledge are confused by this superior effect, so they have such ups and downs at the beginning.
But now the experts in this field all over the world have basically reached a common view. I would like to say that, at present, the overall advantages and disadvantages of hormone replacement therapy, experts in this field have such a consensus, that is, hormone replacement therapy should be started as soon as possible. This is not what you said just now. When you are in your 30s, you feel a little lack of energy and start to supplement estrogen. This is not. What is an early start? It should be started as early as possible when estrogen is deficient, so it must be judged by doctors, not by themselves. Estrogen deficiency starts to supplement estrogen as soon as possible. We call this period before the age of 60, which is within ten years of menopause, the window period of treatment.
In this period of time, it can achieve the best effect, and it also has the least side effects, so its efficacy is the best and safety is the highest. Why do you say that? Because this period is the beginning of all metabolic diseases, including osteoporosis, cardiovascular disease, Alzheimer's disease, which we just mentioned, and these degenerative diseases, all started in the first few years of menopause.
But for example, take osteoporosis for example. When calcium is dropped from bones, there is no feeling at all. When you lose a little calcium, there is no feeling at all. When you are 65 years old, you will have a feeling after fracture. It is useless to use estrogen again.
Therefore, estrogen has a preventive rather than a therapeutic effect on these chronic metabolic diseases of the elderly. It can only prevent the basic occurrence of these diseases. It is useless to treat these diseases after they have occurred. Therefore, we must seize the first few years of menopause to achieve the best results and have the highest safety. This is our first basic view.
Second, not everyone can use this estrogen. It must be under the guidance of a doctor. Some people have various diseases and cannot use estrogen. Therefore, we also need to go to the doctor to judge. Any medical method has its indications and contraindications. Estrogen is no exception. Doctors need to judge its indications and contraindications. This is the second, our basic view.
Third, there are all kinds of things that people worry about, such as endometrial cancer.
Compere: Many people say that eating estrogen has changed their image and mood, but if they have endometrial cancer, they might as well not add it.
Yu Qi: This problem has been solved. We should supplement a little progesterone while supplementing estrogen, because the ovary itself can produce estrogen and progesterone. The problem of supplementing progesterone while the uterus is under the action of endometrium has been solved. According to the current standard formula of these drugs, there will be no increase in endometrial cancer. At present, we use any drugs, After long-term research, it does not increase the incidence of endometrial cancer. This is a consensus at present.
In addition, getting fat is also a question many people will ask. Eating hormones will make you fat. There will always be such a question. In fact, estrogen has nothing to do with being fat or thin. Regardless of estrogen, there may be hundreds of hormones in the body. Why do people always think that once you eat hormones, you will become fat? Maybe you are too familiar with the adrenal hormone. In a word, the hormone is the adrenal cortical hormone, and the adrenal cortical hormone will really get fat.
Moderator: And I think that hormone obesity is an inevitable obesity.
Yu Qi: But estrogen is not the same thing as that. It is totally a cognitive misunderstanding. So these two things have been solved. As for the others, such as breast cancer and thrombosis, the probability of these events is extremely small.
Take breast cancer as an example. As we all know, it is common for you to drink a little wine. For example, if people get fat and do not exercise, these bad living habits will increase the incidence of breast cancer, which is much more than estrogen, which is particularly bad after 15 or 20 years of use. It is also much more than these increases in breast cancer. Bad living habits are the main reason for cancer, not estrogen supplements. Now it seems that the combination of estrogen and other drugs will not increase endometrial cancer or breast cancer if they are used alone for people without uterus. According to the current research results, this is the case. So this problem should not be feared. These things can be solved. In particular, we say that under the guidance of doctors, we especially emphasize that we must use it under the guidance of doctors, use it under the guidance of doctors, and do physical examination every year. These problems can be solved or avoided, at most they can be found early, or they can be solved early.
Compere: Without uterus, can estrogen be used after hysterectomy?
Yu Qi: After hysterectomy, there is no endometrial cancer problem. You don't need to supplement progesterone, just estrogen.
Compere: It can also protect the body. Estrogen will not only prevent obesity, but also make the female curve more obvious.
Yu Qi: The reason why a woman looks like a woman is because she has estrogen. You can see that a woman has no estrogen since she was very young, when she was just born in infancy and adolescence. Her waist, hip, waist and chest are the same. At the childbearing age, when there is too much estrogen, the curve of a real woman is reflected. So after menopause, this is a gimmick on the noun. What is human? What is animal? Estrogen in human body should belong to animal estrogen according to classification. Phytoestrogens The so-called phytoestrogens and animal estrogens are also good. It is just a matter of source. Finally, they are used to make medicine and become tablets. Everything there is the same. There is no difference, whether it is from animals or plants. Generally speaking, plants, such as the basic raw materials from yam potatoes, are transformed to some extent, The final formation of a certain estrogen is actually the final product of its transformation, which is the estrogen in the human body, and that is the animal estrogen. So there is no difference between animal estrogen and plant estrogen.
Moderator: So we should look at the needs rather than choose this term, which may help the body and change the same.
Yu Qi: Yes.
Netizen: Hello, Doctor Yu. I'm 50 years old and I'm in menopause. I'm very irritable and sweaty. My menstruation is not clean. Is there any medicine that can help me relieve it?
Yu Qi: There was a period of time before menopause when menstrual disorders occurred. We should pay great attention to this period of time, because this period of time is exactly the age when endometrial cancer occurred. At this time, there is no estrogen supplement, which has nothing to do with medication, but this time because of the ovarian function decline, after the ovarian function decline, it first lost its ovulation function. At the same time, the ovary is still growing, which can produce estrogen but not progesterone. As we mentioned just now, when replenishing estrogen, If only estrogen is added but not progesterone, endometrial cancer may increase. For a period of three to five years before menopause, only estrogen and no progesterone are in this state. This state, on the one hand, can cause the abnormal menstruation that the netizen just said, and also increase the risk of endometrial cancer. So we must go to the hospital and tell the doctor about her situation in detail. If there is no such bad change, we need to supplement progesterone regularly, and supplement progesterone every month. On the one hand, we can regulate menstruation regularly, and have menstruation every month. At the same time, we can protect the endometrium and prevent it from further canceration.
Netizen: 52 years old, the menopause has come. It is manifested by hot flashes, frequent sweating at night, sometimes high blood pressure, frequent irritability, bad mood, lack of gas in dizziness, and people are particularly prone to fatigue. Can you take some medicine to alleviate it?
Yu Qi: This person has no bleeding problem. She has completely menopause. She describes it as a typical menopause symptom. In addition to losing temper, she also has hot flashes and sweats. This hot flashes and sweats are unknown reasons. It is impossible to imagine that she would stay quiet, suddenly sweating and sweating all over her body. This is a typical menopause symptom.
In addition, there are some people who are tired and do not want to move, which can be called depression. This person is a very typical symptom of menopause. From her question, she needs to take estrogen supplements. I suggest that this netizen go to the hospital to have a comprehensive physical examination before implementing estrogen supplementation. When I mentioned the physical examination, many people wondered whether it was a gynecological examination or something. No, it was necessary to have a comprehensive physical examination so that they could have a comprehensive understanding of this person, and then they could decide whether it could be used and which one was more appropriate.
After using estrogen, she must have a uterus. Both estrogen and progesterone must be used. After using estrogen, she will have a follow-up visit once a year and a physical examination once a year to reassess. She is within the window period, and should be within this range, so as to achieve the effect of preventing long-term chronic diseases.
Host: As Professor Yu told us just now, estrogen may affect various organs of the body. When we do physical examination, we should check all the body.
Netizen: I used to sleep very well, but I began to lose sleep after menopause. Now I have to eat valium every day to sleep. Is there any good way to treat menopausal insomnia?
Yu Qi: Some people suffer from insomnia, while others suffer from heart symptoms. They feel angina, irregular heart rate, and heart problems. They do a lot of heart tests, but they don't have any problems. In fact, when we enter the menopause or perimenopause, some cardiac symptoms do not mean that the heart itself has a problem. The heart itself has no problem. As we just said, women before the age of 55 rarely have heart disease. At this time, the heart problem is due to the so-called autonomic nervous dysfunction caused by the lack of estrogen, resulting in some irregular heart rate. In fact, it is good to supplement estrogen. There is no need to do complex or even traumatic heart examinations, especially at the stage of menopause.
Moderator: We should pay attention to the menopause, when estrogen supplementation and prevention are the most effective.
Yuqi: Yes.
Host: After a period of time, you said that it was useless to supplement if there was a heart problem. Three or five years after menopause, there was no problem. Hearing this theory, you decided to supplement estrogen. Is it useful?
Yuqi: It's OK to have menopause within ten years, and it's still in the window period before 60 years old. Why is it so good? For example, in osteoporosis, the main inorganic component in the bone is calcium. During a woman's life, she may lose several kilograms of calcium from the bone, and calcium will be lost from the bone. When you lose five kilograms, the person's bones are very crisp and loose, and it's nothing to lose half a kilogram. In the first few years of menopause, calcium in the bones is lost bit by bit. At this time, taking calcium tablets does not mean that it is useless, it can not play a fundamental role. At the same time, we should also supplement estrogen, As soon as possible, we should seize the stage of just menopause and going to menopause for medical treatment. We must seek the help of a doctor. We can't buy some medicine at the drugstore, but we must go to the hospital.
Host: Maybe many women are reluctant to communicate with others about such problems. After listening to this program, they can go to the drugstore to buy some medicine at random. It may be like Professor Yu said, which may add something wrong. Be sure to go to the hospital and ask the doctor to analyze it for you.
Netizen: Is it better to take Chinese medicine or western medicine during menopause?
Yu Qi: This problem is a trap. Because I don't know much about traditional Chinese medicine, let's not talk about traditional Chinese medicine. I do gynecological endocrinology, and I know a lot about hormones. We have studied hormones for about 60 years, and all kinds of preparations are very, very clear about their benefits and possible side effects. Take conjugated estrogen as an example. There may be more than 6000 authoritative documents on this kind of large-scale research. Around the world, almost all countries have done corresponding research. I think this kind of understanding of conjugated estrogen is so thorough, so we can rest assured that what is wrong with it is already within our expectations, So these are OK. As a doctor, we can know the possible effects and side effects of this medicine in great detail. But as for other drugs, we don't know much about them, and it's not particularly easy to comment on them. At present, estrogen supplementation is a very good choice for menopause in the world.
Host: In fact, just now you told us about the problem of body shape. We have solved this problem. Whether there will be other problems, such as endometrial cancer, may be our idea long ago, but now it has been solved in the scientific community. In fact, when people ask all kinds of questions, they often mention that traditional Chinese medicine is better than western medicine, which is not easy to compare. Some people like to ask the question, can we not take medicine and eat tonic, such as yam, soybeans, soymilk just mentioned, where there is a lot of estrogen, not only drink soymilk in the morning, but even use it as a drink as water. Many people say that after drinking it, their skin will become better. Is it possible to supplement estrogen?
Yuqi: Soya bean milk is a kind of food, which has existed for many years. Especially in Beijing, many people are the necessary food for breakfast. Not only women but also men drink it. Men drink it very much. These men who often drink soy milk or drink a lot of soy milk are also full of children and grandchildren. They don't look like eunuchs. I think it is very, very absurd to say that there is a lot of estrogen in soy milk. Food is food, health care products are health care products, and medicine is medicine. This is totally different from three levels of things. Food is to make people eat full and nutritious, which is its role. Some aspects of this nutrition are more prominent, that is, health care products, which can help food absorb better. Food supplements are insufficient, such as vitamins. All these can not replace medicine, which can not cure diseases, If you have a disease, you can't rely on food, you can't rely on health care products to treat it. You should still use drugs to treat it. Otherwise, everyone will not get sick. It is impossible to eat health care products often to live forever.
So from the perspective of medicine, the role of medicine must be better than that of health care products and food. Don't make health care products and food too mythical. It can only play a role that it can bear. The role of medicine is borne by drugs.
Compere: We should keep good habits in our daily life, which is more useful than the selective food tonic.
Netizen: Can estrogen be taken for a long time? This year, 42 years old, the hospital checks premature ovarian failure, low estrogen, how should we do?
Yu Qi: Hormone supplementation is particularly important for people who have already passed menopause at the age of 42. Just now I said that there was no heart disease before I was 55 years old, and I was almost a man when I was 65 years old. Without estrogen, there is a high incidence stage of various chronic diseases, including fractures, heart disease, nervous system degeneration, and memory loss, which are more common at the age of 65.
For example, she became postmenopausal at the age of 40. This decade, she was only 55 years old. Fractures may occur at the age of 55, which is very, very harmful to her health. Therefore, it is particularly necessary for her to supplement estrogen in a timely manner. The long-term use of estrogen does not mean that she can or cannot answer such a simple question. She must go for a physical examination every year, which needs to be emphasized again.
We will have a physical examination once a year, and then go to the doctor with the results of the physical examination, so that the doctor can judge whether she can continue to use, whether to adjust the dose, whether to change the type of estrogen and progesterone, which is something we should do every year.
In addition, the netizen should be reminded that she must have good living habits. In fact, a healthy lifestyle is the most important feature to maintain people's health, which is more important than medicine. Including breast cancer, including fracture, chronic disease, diabetes, etc. just introduced, it is the most important to have a healthy lifestyle. It is recommended that as a middle-aged and elderly woman, her healthy lifestyle should be based on diet control, because when she gets older and her activity decreases, she may not need so much food. She should have some control, but it is definitely not advisable to diet without eating. It is necessary to properly control her diet, Appropriate activities.
But for the elderly, osteoporosis is easy to fracture, and you can't do too strenuous activities to prevent tumbles and fractures, so it is also very important to do appropriate activities for the elderly. Regular work and rest, regular three meals and regular sleep, certain sports activities every day, no smoking and a little alcohol can be drunk. On this basis, under the guidance of the doctor, she will take physical examination every year, and then give hormone supplement treatment appropriately, so as to maintain her overall health.
Compere: Even though she began to supplement estrogen under the guidance of a doctor, she still went to see a doctor for physical examination every year. Is there any drug resistance or her body changes?
Yu Qi: It's mainly the change of body. Many problems will appear with the growth of age. That is to say, estrogen can't solve all the problems just now, because people are bound to get old. When they get old, they will suffer from various aging problems, not only caused by estrogen. These age-related problems, including changes in blood lipids, are sometimes uncontrollable, even with estrogen. To a certain extent, they will still suffer from heart disease. At that time, they will suffer from various diseases. People always end up with the final result because of a certain disease.
Such a state needs to be found through annual physical examination, which is not only for the need to supplement estrogen, but also very important for the health of this person. Of course, it can be found early for some early diseases. Even if cancer is found at an early stage, it is also very good for treatment. There is really no good way to treat it at an advanced stage.
Host: Just now I talked about all kinds of problems. Most of the questions raised by netizens are about how to treat my symptoms. Do we have any way to prevent the onset of menopausal symptoms?
Yu Qi: This is an objective law. It is impossible for anyone to escape such an event as menopause. But prevention should be said that there is no good way to prevent, menopause in the face of everyone's head this is inevitable. But we can't. As a woman, around the age of 50 in the menopause, you can think about how important this woman is. She is a backbone force in the family, work unit and society. Many people are still leaders in a small department, or maybe a leader in a small department or a large department. There are elderly people at home, There are 7 - and 80 year old people, and then there is another one, who may also bring adolescent children. There is a movie called "Adolescence meets Menopause". Women around 50 years old in this state are very important people in all fields, so we must take care of ourselves. Even if there are any symptoms, we should see a doctor in time to solve them in time, so that we can safely survive the menopause and maintain our health.
Host: If we are about 50 years old, we encounter menopause, which is a very normal natural law. Just now, we also said that the problem of premature ovarian failure may be that we encountered this problem around the age of 40. Is it possible to know in advance of this situation, use estrogen or treat and prevent it in advance?
Yu Qi: It's a pity that there is no way to judge premature ovarian failure in advance. We just said that even if premature ovarian failure really happens, the problem will be solved by adding estrogen. The main purpose of judging premature ovarian failure is to let it retain its fertility, because after premature ovarian failure, she will not be able to have children, If we can find out early, it is impossible for her to get married quickly. At least we can take some of her ovaries and save them for later use. This should also be gradually possible.
Compere: Is premature senility a short period of time, or does it develop in half a year?
Yu Qi: It must be a slow development process, but it is relatively fast for a person in his life. It would be good if he could find it early, but it is a pity that there is no such method to find ovarian function decline early. Therefore, as a woman, she should take care of herself and do something at any time.
Netizen: I saw you sick last year, and my symptoms have improved significantly after taking Leviathan. It's said that taking this medicine for a long time has a lot of side effects. Now I use Lifumin one tablet every night, OK?
Yu Qi: These medicines have different focuses and different uses. For example, Lifumin is a plant medicine extracted from black cohosh, not estrogen. It mainly relieves menopausal symptoms, which is good. But it has no effect on osteoporosis, cardiovascular disease, senile dementia, etc. The prevention of these chronic diseases mentioned just now has no effect, at least not yet. In addition to alleviating symptoms, drugs such as tibolone and livial can also prevent short-term complications. There are contraindications. If you can't use estrogen, you can use drugs such as Lifumin. If there is no problem in the annual physical examination, you can still use estrogen.
Netizen: Is it possible that joint pain is related to menopause?
Yu Qi: It should be judged according to his age and menstruation. In fact, we did a survey in Beijing to find out which kind of menopause is the most confusing for this patient. The first one is muscle joint pain. Therefore, muscle joint pain is the first symptom of menopause symptoms in Chinese women. If his symptoms meet the menopausal age, it is probably a manifestation of menopause symptoms.
Netizen: 55 years old, the vagina is dry, itchy and dull. Can I use conjugated estrogen? Before vaginal surgery, the doctor asked me to use domestic estrogen ointment for dull pain. Why?
Yu Qi: In the age of lacking estrogen, the mucosa became thinner, which would cause some symptoms. It is known that if there is estrogen in the vagina, it will have glycogen, and then there will be a normal bacterium called lactobacillus, which lives in the environment. Lactobacillus will make this environment acidic. This environment is not easy for bacteria to grow, but after menopause, there will be no lactobacillus glycogen, and the environment will change from acidic to neutral. Bacteria are easy to breed after becoming neutral, so we often call it senile vaginitis or something like that. At this time, it is OK to use some cream combined with estrogen to prevent and treat senile vaginitis.
If the elderly need surgery, it is also difficult to repair the broken mucosa with surgery. It is easier to repair the broken mucosa with a period of time to recover the mucosa.
Netizen: 53 years old. Now, my menstruation is very irregular. I can come twice a month, but sometimes my menstruation is small. This situation lasts for more than a year. Would you like to go to the hospital for examination in my case?
Yu Qi: We still suggest that she go for an examination. As just said, before menopause, there will be an average of three to five years. It is such a state of menstrual disorder. The biggest harm of menstrual disorder to people is the pathological changes of the endometrium. If there are pathological changes in the endometrium, it is called endometrial cancer, At this time, endometrial cancer is at a high incidence, so we still need to go to the hospital to have a look at her current endometrial status. If there is no disease, we need to regularly supplement progesterone to adjust menstruation and protect endometrium on the one hand.
Netizen: Is there any side effect when you eat too much estrogen?
Moderator: You have just said that.
Netizen: Are there many users now? Which estrogen is better?
Yu Qi: Strictly speaking, the difference between various estrogens is not much. In fact, there are no several estrogens. Now there are some estrogens on the market, including estradiol valerate, 17- β- There is no essential difference between these kinds of estradiol. In fact, you can use any of these kinds of estradiol. Are there any side effects? The answer is yes. No drug has no side effects. The key problem is to use it at a reasonable dose and time under the guidance of the doctor, and ensure that the side effects are within a controllable range from the doctor's point of view, because the doctor knows these things best. As patients, we should not make wild guesses. Estrogen is terrible, and there must be many side effects. In fact, the doctor knows best, and should follow the doctor's guidance to use it. Side effects can be controlled in the minimum range, and its incidence is the lowest. You can see that almost everyone can't run away from such problems as osteoporosis. The incidence is almost 80%, 90%, and the so-called estrogen effect is one in ten thousand. The relationship between advantages and disadvantages is very clear.
Host: So as you said, should we take estrogen supplements? What kind of estrogen should we choose and when should we start? We should listen to the doctor's detailed analysis of patients.
Netizen: 51 years old, menopause for two years, but suddenly there was a small amount of blood outflow. Does this situation need treatment?
Yu Qi: This should be paid close attention to. Postmenopausal bleeding should be paid close attention to. This may mean that there are many diseases, of course, endometrial problems, cervical problems, etc. You must go to the hospital to see them. Of course, these malignant diseases are not necessarily. At the age of 52, because she has been menopause for two years, there may be some remaining follicles in her ovaries. It is also possible for her to have menstruation. Don't be afraid, but you should go to the hospital to check it.
Netizen: Menstruation is always irregular. The doctor suggests that estrogen test be done. If there is a lack of estrogen, can we take combined estrogen to treat it?
Yu Qi: This irregular menstruation is not the main target group for estrogen supplementation. More importantly, she has no symptoms, so she should go to the hospital. If she has symptoms, she should be supplemented. If there are no symptoms but irregular menstruation, it is OK to supplement progesterone regularly.
Moderator: Maybe this problem is still like you said. Although we have been analyzing this problem for so long, she may still have different specific conditions for each netizen and patient. It is still necessary to tell Professor Yu that we should go to the hospital to have professional doctors do appropriate examinations and judgments for us. Today, our program is coming to an end. Thank you very much, Professor Yu, for coming to our studio. At the same time, thank you for your attention to our program. Famous doctors gathered to talk about people's health. See you in the next program.
Yuqi: Goodbye.