We even don't know since when, "menopause" has been regarded as the synonym for "women's bad temper". When a husband and a wife are quarreling, the husband may say "are you in menopause?", which can make the wife speechless, as if a woman was definitely abnormal in physical and mental aspects when they reach a certain age .

This is not only unfair (because it implies age discrimination against women), but also unscientific: it replaces scientific understanding of how women's bodies change naturally with stereotypes.

In fact, the so-called "menopause" is similar to other life stages such as "adolescence", and features the periodic changes of hormone secretion. 

During adolescence, teenagers easily get bad-tempered, but not all of them are so cranky to smash tables and run away from home. So do the women during menopause. For most women, as long as they have a correct understanding of menopause and timely manage physical and mental changes, they can weather this period.

The "real" name of menopause: perimenopausal period

To understand menopause correctly, we should start by calling its proper name. As mentioned earlier, more and more doctors are using the term "perimenopausal period" instead because the word "menopause" implies prejudice and is not an accurate medical term.

Stages of female sexual function

• Adolescence: Sexual function begins to develop, with the transition from development to maturity generally occurring between the ages from 12 to 18.

• Reproductive period: It is also known as late sexual maturity period and generally lasts about 30 years. During this period, women can experience special physiological processes such as pregnancy, childbirth, and breastfeeding.

• Perimenopausal period: also known as menopause; refers to the transition period of sexual function from maturity to decline, generally between 40-60 years old.

• Old age: complete failure of ovarian function, low estrogen levels, further atrophy and aging of the reproductive organs.

The picture above describes four stages of women's sexual function. Among them, the "perimenopausal period" is between the reproductive period and the old age, and is a transition stage in which fertility gradually declines. Just as everyone has different manifestations and feelings of adolescence, perimenopausal period also varies among women, affected by social, economic, regional, family and many other factors, so the time of the start of this special stage is also different, with an age span of 40-60 years old.

Perimenopausal period does not only mean stopping menstruating; It also means the whole body is "rebuilt".

For women, the obvious change in perimenopause is the menstrual period. The menstruation will gradually become unstable and decrease until one day it disappears completely, as if to announce that the two organs responsible for reproduction, the "ovary" and the "uterus", can no longer fulfill their mission.

However, in addition to menstrual changes, women undergoing perimenopause often face a series of problems such as palpitations and chest tightness, irritability, decreased sexual desire, and vaginal infections. What's the reason?

This is because during perimenopause, apart from changes that occur in the ovary, almost all of the women's body systems are undergoing dramatic changes:

01 Cardiovascular system

Decreased estrogen levels cause dysfunction of lipoprotein metabolism, and atherosclerosis, increasing the risk of coronary heart disease and myocardial infarction.

02 Skeletal system

For women, bone metabolism begins to enter a negative balance from the age of 35, and bone loss occurs at the age of 40, which is mainly related to the decline of estrogen levels. Therefore, the incidence of osteoporosis in postmenopausal women is significantly higher than that in men, and women are prone to fractures, short stature, hunchback, and round back.

03 Urinary system

Postmenopausal women are prone to urinary tract infections due to the loss of estrogen support in the urinary tract mucosa and the weakened anti-inflammatory ability.

04 Skin and mucous membranes

When women are around 50 years old, the proliferation of skin epidermal cells decreases, and the skin loses elasticity, so it is dry, rough, flaky, and even itchy. The mucosa of vagina and urinary tract also changes (the latter has been mentioned above): the mucosa becomes thinner, the anti-inflammatory ability is weakened, and the secretion is reduced, causing pain during sexual intercourse and susceptibility to senile vaginitis. In addition, due to the relaxation of the fascia of the pelvic floor tissue, uterine prolapse, cystocele and rectocele easily happen and affect daily life.

05 Autonomic (vegetative) nervous system

Due to the mutual influence of various endocrine systems, there will be mild or severe dysfunction of the autonomic nervous system.

06 Obvious hot flashes, sweating, palpitations, dizziness, etc.

This is a series of manifestations of vasodilation and contraction disorders. In addition, fatigue, inability to concentrate, depression, tension, emotional instability, irritability, dizziness, tinnitus and palpitation all appear at different frequencies, and most of them will gradually decrease and then disappear completely.

This is why women have various menopausal symptoms: chest tightness, palpitation, and emotional instability happen because the nervous system is affected by endocrine; vaginal infections and other gynecological diseases are caused by the proliferative decline of the skin mucous membranes; osteoporosis and the disease of lumbar spine is a distress signal sent by the skeletal system; menopause may even lead to acute and serious diseases such as coronary heart disease.

The lock and key of perimenopausal period: estrogen

Faced with so many physical problems, does it mean perimenopausal women must go to the hospital every day? The answer is no. Because all these body changes have a common root, "estrogen".

Studies have shown that in addition to maintaining female reproductive system function and female secondary sexual characteristics, estrogen receptors also exist in many parts of the body, such as the cardiovascular system, bones, skin, fat, urinary tract, kidneys and liver. Estrogen is also involved in the metabolism of fat, glucose, protein and bone, causing metabolic changes in the above systems.

Effects of estrogen on menopausal women

Estrogen: cardiovascular system, urinary system, skin and mucous membrane, nervous system, reproductive system

If we compare various physical problems brought about by perimenopause as a lock, then the key to unlocking it is to solve the problem of estrogen secretion imbalance.

Human treatment of hormone secretion disorders has nearly a hundred years of medical history. A common method is "hormone replacement therapy", commonly abbreviated as HRT. Its basic idea is to "make up for what is lacking", that is, to stimulate the hormone-producing glands with drugs to balance their secretion, or directly supplement the corresponding hormones. For example, for patients with hypothyroidism, thyroxine tablets are directly supplemented; for those with insufficient adrenal function, dexamethasone or prednisone is used to stimulate adrenal hyperplasia.

Since the problem of perimenopause is the imbalance of estrogen secretion, then, using sex hormone when women are treated with HRT, that is, exogenously giving the medication with sex hormone activity, can relieve symptoms and prevent the related diseases caused by the lack of sex hormone.

Conjugated Estrogens (premarin) has been used to treat estrogen secretion imbalance since 1942, and it was called the "elixir of youth". However, this drug has large side effects and carcinogenic adverse reactions to endometrium and mammary gland. Therefore, in 1971, the International Health Foundation held a conference in Geneva to explore the appropriate dosage and use of HRT.

Since the 1990s, HRT treatment has become more mature. It is, generally speaking, more beneficial than harmful for menopausal women to use HRT.

"Real Health" is better than "Fake Youth"

With the economic development and the change of concept, "reverse growth" has become a popular term on the Internet. "Will I be able to go back young again?" is a common question many people ask when seeking treatment for perimenopause problems.

But the answer may be disappointing: the goal of HRT therapy is not to give women the hormone levels of their reproductive period (the so-called "youth"). It is unrealistic to hope that HRT therapy can help you achieve rejuvenation. HRT therapy is a medical method, and from the perspective of medical safety, the dosage of estrogen supplement needs to be controlled accurately. It is therefore advisable to seek medical advice before trying HRT therapy.