更年期是人生的一个阶段,影响了足足半人口,但在许多圈子,它仍是“忌讳”,与女人不好意思讨论。正如#noperiodshame已经开始引发了关于一个完全正常的生物过程开放的对话,它的时间为更年期柱头内部和外部结束了。无论您是想了解早期迹象,经历荷尔蒙的变化,或者是已经全面更年期和寻找最好的治疗方法,所以你可以再次感受到自己喜欢,我们在HealthCentral在这里帮助。
我们的专业面板绝经
We went to some of the nation’s top menopause experts to bring you the most up-to-date information possible.
戴安娜比特纳,医学博士妇产医院和author of "I Want to Age Like That! Healthy Aging Through Midlife and Menopause"
Monica Christmas, M.D.Assistant Professor of Obstetrics and Gynecology and Director of the Menopause Program
朱莉安娜克林,医学博士Associate Professor of Medicine and Associate Chair of Research in the Division of Women’s Health
What Is Menopause, Actually?
Though it's got the word “pause” in it, this life stage would more aptly be called menostop(你在这里听到它第一次!)。这是因为更年期的官方定义是,当你还没有超过一年过一段(或者,换句话说,连续12个月)。它是由与年龄有关的荷尔蒙的变化引发的,虽然这些可以真正开始(EEP)十年你打真正更年期以前。60名多万妇女在美国目前正处于更年期,因此,尽管它可能看起来像没有人在谈论它,你肯定不处理独此过渡。
是什么原因导致更年期?
Every woman is born with a finite number of eggs. As we age, the ovaries begin to slow in releasing functioning eggs—until they stop when we have no functioning eggs left. At the same time, the ovaries begin to produce less and less of the reproductive hormones progesterone and estrogen——the first triggers the lining of the womb to grow so it can house a fertilized egg, while the second helps with that but also keeps the growth of that lining in check so it doesn't get too thick, leaving adequate room for the egg to grow. (When the egg isn't fertilized, the lining sheds, and you get your period.) Here’s a simple step-by-step:
- The eggs in your ovaries are surrounded by cells that make up what’s known as the follicle.
- 由于鸡蛋的成熟,卵泡细胞繁殖,并毛囊开始分泌雌激素。
- 一旦卵子从卵巢,空卵泡释放出来,留下来的,然后也开始推出孕激素和雌激素的荷尔蒙,帮助你的身体对于刚刚出炉的鸡蛋准备受精,并定居在长途。
- But remember, you have a set number of eggs—so eventually, the number of functional eggs decline and you eventually just run out. When there are no more eggs or follicles, your ovaries stop—or at least drastically reduce—their production of the two reproductive hormones
- 在这一点上,你的月经平时变得不那么频繁,往往较轻,虽然对某些妇女,他们却反其道而行之,成为更重,更长,更加紧密;这两种类型的周期变化是绝经前正常。当你不再有月经全是因为没有鸡蛋释放,该过程完成后:你在更年期。
我什么时候过了更年期?
有一个广泛的年龄,在妇女撞上更年期,虽然平均来说,魔术今年是51。
That doesn’t mean symptoms wait till then, however. You may be in绝经前, 也叫围绝经期早在你的30年代中期到40年代后期。你会在更年期的典型长度为4年,但它可以持续长达10年(!),或者是短则几个月。需要明确的是,更年期是绝经不是的实际开始;它是大M.之前发生的时间段
围绝经期间,在激素移位可能会造成广泛的症状阵列。时代的变化 - 无论他们进一步远离或紧密联系起来,或长或短,更重或更轻,是第一个指标,你已经进入围绝经期土地(欢迎!)。其他生理和心理的变化可以包括睡眠问题,情绪波动,体重增加或缺乏对性的兴趣。有时,特别是如果遇到在较早的侧面说的这些症状,在你30岁,你可能会误以为是压力或只是一个忙碌的生活的轰击的反应,而不是荷尔蒙的变化的结果。
还有被称为两个条件更年期提前,45岁前绝经,和过早绝经,其发生之前40.这些是不起作用的因素罕见的现象。其实,女人的不到5%,通过早期或过早绝经去,而无需其他健康状况。
大多数情况下,早期或过早绝经发生,因为女人已与切除卵巢,无论是因卵巢癌或子宫颈癌,子宫肌瘤,或其他原因的子宫切除术。化疗(有或没有手术)还可以破坏你的卵巢和触发更年期提前。更年期提前的一个其他潜在的预测:如果一个或更多的女性亲属的经历吧。
Do I Have the Symptoms of Perimenopause or Menopause?
Any of the below symptoms can signal that you’re starting perimenopause, and they usually accelerate as you get closer to actual menopause; once you hit menopause, these symptoms can continue for months or even years afterward (the average: four to five years).
你可能不会有这些症状,但每个女人的经历是独一无二的。间歇性症状,比如潮热,可能会消失,你的身体调整到缺乏在你的身体,其实,有些女人谁采取激素治疗(更多的在一分钟内)发现,当他们停止雌激素,那是当他们得到潮热。其他症状,如阴道干涩,可能只是成为绝经后生活中的事实。
Among the most common symptoms of perimenopause and menopause:
- 潮热。感觉突然焦虑不安,但温度热actually困扰(a.k.a:在苏茨基,不性感,“焦虑不安”。)这些可以在任何时候来吧,有冲洗一起,你的心脏加速,出汗,甚至寒战。他们可以持续10秒会持续三到五分钟。有些妇女得到潮热每天,有的只是每周几次,这是令人难以置信的变量。
- 盗汗。Hot flashes that happen at night—they can wake you in a pool of your own sweat.
- Insomnia.想想你的感觉在一个房间里,晚上的时候太烤面包。解释了为什么下午可爱出汗可以让你清醒。日益恶化的问题?一般老化造成对咖啡因的敏感性增加,更多的困难打瞌睡,和更少的深度睡眠。
- 尿频或尿急。觉得你有小便更频繁?怪就怪在雌激素水平的下降。它也负责对难以让你当你真的拿着它做有to go—further compounding sleep issues, all while feeling the bathroom urge at night.
- 情绪波动。If you experienced anger or sadness during PMS while you were menstruating, or had postpartum depression earlier in life, you are more likely to have the same symptoms from menopausal hormone dips, though they can also affect women with no prior history. This can include crying jags or feeling quicker to anger than usual.
- 抑郁和焦虑。同样,如果您之前更年期有抑郁或焦虑发作,你更有可能看到他们再次出现。This can happen for both physical reasons (changing hormone levels can disrupt the smooth working of your brain’s neurotransmitters and throw your moods off track) and psychological ones—it can be disorienting to go through any life change, especially one that means you’re coming to the end of your fertile years. Plus: Insomnia! Hot flashes! It’s normal if those are upsetting.
- 阴道干涩和疼痛性交时。浸雌激素。再次。它可以使阴道组织的感觉干燥和刺激,从而减少自然润滑,从而导致从性的摩擦疼痛微打磨。这就是技术上称为泌尿生殖系统综合征,这也可导致感染,包括尿路感染和细菌性阴道病的风险增加。
- 性欲减退。这荷尔蒙滴+所产生的阴道干燥和刺激可以使一些女性感到性生活不感兴趣干脆。
- 内存变化和脑雾。关于女性围绝经通过持续的三分之二和更年期有困难时记住的东西和聚焦。
多久更年期持续多久?
症状通常是最明显的前两年更年期,而对于一些女性来说,问题往往消退,他们已经在停经一年或两年后。但不幸的是,它并不少见,这些副作用,要坚持,只要8至10年,开始在围绝经期和持续绝经后四到五年。
什么是最好的治疗更年期?
要知道的第一件事是,你不有to treat menopause at all. This isn’t an illness, it’s a natural process. But there are lots of things you can do to help lessen (and, for some women, eliminate) the symptoms.
对于潮热和盗汗:
The most effective treatment to stop them is激素治疗(orH T)。(This is also known as更年期激素治疗,MHT,而此前被称为激素替代疗法, orHRT)。你的医生会开雌激素非常低剂量,有时用黄体酮结合起来。大多数激素替代正丸,但也有皮肤贴片,阴道乳膏和凝胶,和阴道环。
有争论hormo的安全ne therapy. Based on the latest research, FDA-approved hormone therapies are safe for the majority of women having menopausal symptoms when taken under a doctor’s supervision and for a finite period of time.
这并不意味着没有风险,虽然。谁拥有或女性有过乳腺癌,卵巢癌,或子宫内膜癌不宜服用激素治疗。也不应该谁曾中风的妇女。对于一些女性,激素治疗可能会增加他们的心脏发作,中风和乳腺癌的几率;你和你的医生将需要仔细去了你的风险因素,并决定这是否是你正确的治疗。
现在,这是谁的妇女通过过早或更年期提前去不同。他们是在心血管疾病的风险较高(以及骨质流失和胰岛素抵抗),以及FDA批准的激素治疗是推荐的。在这个年龄组(而不是女性在50岁或60岁),HRT有助于防止心脏风险,同时缓解更年期的常见症状。
不管你是什么年龄,当你开始HT,大多数文档将要重新评估每三至六个月。对于一件事,你可能有不同的剂量和更好的结果时序你和你的医生可能会决定尝试几种不同的协议。另一个原因是,如果激素治疗是不是给你从你的症状(每个人的经历不同而不同)减免,你可能想完全阻止它。
对于性交时阴道干涩和疼痛:
H T是also a first-line treatment for dryness and the irritation it can result in—in this case, your doctor will prescribe the therapy in the form of a vaginal ring, pill, suppository or cream rather than orally. HT helps some women regain their sex drive, but if that’s not your problem, or you just want to try a nonprescription treatment, you can also use an over-the-counter vaginal moisturizer or lubricant (K-Y, Replens, Astroglide—there are lots of versions at the drugstore).
有一些证据表明,大麻都THC(让你“高”的化合物)和CBD,大麻植物的其他主要成分,可提高性欲。然而,也有发现正好相反的研究。If your loss of libido is related to anxiety—maybe you’re less prone to have sex because you worry about your lack of lubrication or just feel uncomfortable with the changes your body is going through—then it might be worth trying cannabis sheerly for its ability to lower inhibitions. This is a total personal-choice call, but definitely don’t underestimate the boons to your总体健康,定期(不痛苦!)做爱可以有。
对于抑郁症和情绪的变化:
正如在人生的任何阶段抑郁症,这是值得考虑服用抗抑郁药,以帮助悲伤,易怒和情绪低落,往往伴随更年期。治疗这些症状也可以让路性欲回报,有些妇女发现,抗抑郁药低剂量可以减轻潮热(最后,奖金)。As with any prescription, your doctor can help choose the right medication and work with you to fine-tune how much of it you take, how often, and for how long. (Some antidepressants can dull libido, for instance, so you'll want to make sure your M.D. knows if that's already an issue for you.) It’s also worth talking to a therapist about how you’re feeling—or even just to others going through menopause.
For insomnia:
虽然确实有一些可以采取对失眠(包括处方药和非处方)药物,你的医生可能会建议你看一下生活方式因素第一:你喝太多咖啡因?使用您的智能手机或平板电脑直接睡前?保持你的卧室太热情?避免所有的这些东西可以帮助你更快入睡,贪睡更REST风格,并减少中间的的夜唤醒。
对于小便的冲动:
在这里,行为改变可能会帮助:
- Cut back on the coffee and soda (yep, and on alcohol, too)
- 做凯格尔运动(收缩和放松你的骨盆及生殖器部位的肌肉)定期加强骨盆肌肉,在那些控制尿流。
- 尝试采取侧重于加强整个盆底,如普拉提,这也可以改善性生活的好处运动课程。
是自然绝经疗法有效和安全的?
目前已经有很多议论周围的生物同质性荷尔蒙,这是分子等同于激素女性的身体自然会使但植物化学物质(主要来自山药和大豆)的构建;制造商经常销售这些“天然”。有FDA批准的选项(包括生物同质性和自然衍生选择)是安全的,因为他们已经过测试,并且已经设置数量。但是,不要被非美国FDA批准的诱惑荷尔蒙,你可以得到的非处方药。他们可以在强度和浓度危险程度而变化。
你一定会注意到的自然绝经补充剂在当地药店摆了。一些草药和补充,如马卡和黑升麻,已经在研究中发现,在绝经控制系统,尤其是潮热有效。也有一些研究显示,这些非处方药的补救措施没有做任何优于安慰剂,所以当他们没有危险,可以采取糖丸,并得到同样的结果。
但是,嘿,那安慰剂效应仍然是一个效果,所以如果你想要的话,我们不怪你!只是不要DIY这一点。有一个巨大的补充阵列在那里,而这之前,你甚至想你可能需要剂量范围或补救措施的组合。新的尝试任何事情之前,请务必跟你的医生。如果你已经对激素治疗,你需要了解与您讨论过的处方药特别警惕医生可能有不良反应,或者你可能会破坏HT正在做的工作。
在哪里可以找到更年期社区?
如果你正在经历更年期,你真的是在良好的公司:记住,gajillion其他妇女在这个国家是更年期了。如果您需要了解更多信息,或者只是想有人说话了谁马上得到它,看看这些资源。
前更年期Instagrammers和Blogger
- 安娜Cabeca,D.O.,@drannacabeca,https://drannacabeca.com
遵循这是因为:Cabeca博士并不只知道是什么样子的过了更年期,她也是三板认证(内科,妇产科,和再生和抗衰老药物),所以她完全理解背后更年期的科学。她建议综合的方法来确保让你兴旺, not just生存, 过渡。
- Meg Matthews,@megsmenopause
遵循这是因为:这不只是她的更年期,这是你的了。她提出的问题,以福斯特对话,让每个岗位就像是自己的开放式论坛。它不会伤害她加进了这样的风格,无论是:尤伯杯时尚马修斯是一个专栏作家Red杂志,是在90年代曾是音乐行业的活动策划者和设计师为英伦摇滚现场。
- 乔哈维 - 格雷厄姆,@50sowhatofficial
遵循这是因为:她是50,所以什么- 谁说过,生命不可能在50及以后是神话般的?于是,她对了的文档做Q&至于有关激素和她的故事更年期,她的职位等极好在她的饲料五十岁的孩子,却如此淡,凉,而真实。像,也挡不住你的膀胱,发芽疣,所以。许多。灰色,多 - 那种真实的。
前更年期播客
- 快乐的更年期。Yes, according to registered nutritional therapist Jackie Lynch, you can be happy during menopause. She focuses on mind-body and nutritional approaches to managing mid-life hormonal changes.
- 翻转50显示。While the main focus of this podcast is on menopause,it also touches on everything else that changes when you’re approaching or past 50, including how your fitness, diet, and lifestyle should all shift with your age—and not in a “your life is now over” kind of way. The tips are trustworthy: Host Debra Atkinson is a fitness pro (she’s a certified trainer with a master’s in exercise and sports psychology) and wellness coach.
前更年期支持团体和非营利组织
- 北美绝经学会(NAMS)。这个非盈利性有功能在这里你可以输入你的邮政编码和找到你所在地区有谁通过NAMS认证更年期医生(NCMP)计划了的医生。含义:一个DOC谁真正得到它。
- Red Hot Mamas。创建者卡伦·吉布林,谁在1991年,当她在康涅狄格州举行的公职,有腹全子宫及双侧附件切除术,该集团的目标是智取更年期。怎么样?随着与更年期社会的见解配对吨循证指导。这些都是你的人类型:聪明,时髦,和支持。
- 美国生殖医学学会。当你想在合法的医疗方面的细节,这样当你在谈论你的医生(和你应该),你说他们的语言。
Frequently Asked Questions绝经
什么是更年期的平均年龄?
51, but it varies from woman to woman. Pre-menopause—a period of time when symptoms begin but during which you still have your period—can begin in your mid-30s. Only a small percentage of women go through early menopause, which is considered before age 40.
Can you get pregnant after menopause?
当你真正是绝经你的月经已经停止,不中断了整整12个月,你不再肥沃,不能怀孕。But don’t throw caution (or a condom) to the wind if you’re in perimenopause (you have menopausal symptoms but still get a period, even if only sporadically): At this point, your reproductive hormones and functional eggs are declining, but it is still possible to get pregnant.
更年期是否导致体重增加?
As we age, our metabolism slows down, and we begin to lose muscle mass, so we need to consume fewer calories (but often don’t). The lower estrogen levels that are a part of menopause also cause our metabolism to get sluggish, so it’s a double whammy. Add in menopause’s typical sleep issues, and you may exercise less and snack more. No matter what the cause, the fix is familiar: Eat fewer calories, avoid sugar and simply carbohydrates that quickly convert to sugar, and exercise as regularly as you can.
我的时间现在不规则,有时我跳过了一个月,甚至两个。我在更年期?
还没有,但看起来你的方向是这样(除了一些医疗原因缺乏时期)。If you’re beginning to experience more time between your periods, lighter periods, or just a general “I’m not sure what in the heck is happening with my periods!”, you’re likely in perimenopause—think of it as the lead-up to menopause. It can last a few months or a few years. True menopause is defined as when your periods have stopped altogether for one year.
- 激素的变化更年期:The Cleveland Clinic. (2019). Menopause, Perimenopause and Postmenopause.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause
- 绝经症状:北美绝经学会。(不详)。“什么是更年期的症状34?”。menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/are-we-there-yet-navigate-now-with-our-guided-menopause-tour
- HRTBenefits:绝经:该杂志的北美绝经学会。(2017年)。“北美绝经学会的2017年激素治疗立场声明。”menopause.org/docs/default-source/2017/nams-2017-hormone-therapy-position-statement.pdf
- HRT与心脏病风险:绝经。(2019)。“克罗诺斯早期雌激素预防研究(KEEPS)。”ncbi.nlm.nih.gov/pubmed/30939537
- Solutions for Menopause Symptoms:Faubion,萧蔷,医学博士梅奥诊所。(2016)。 “The Menopause Solution: A Doctor’s Guide To: Relieving Hot Flashes, Enjoying Better Sex, Sleeping Well, Controlling Your Weight, and Being Happy!"
- Vaginal Dryness Info: JAMA。(2014)。“尿路感染的老年妇女。”ncbi.nlm.nih.gov/pmc/articles/PMC4194886/
- Updates on HRT:Nature Reviews, Endocrinology。(2017年)。激素替代治疗:目前的想法。https://www.ncbi.nlm.nih.gov/pubmed/27716751
- Pilates for Better Sex:Journal of Sex & Marital Therapy。(2016)。"Pilates for Better Sex: Changes in Sexual Functioning in Healthy Turkish Women After Pilates Exercise."ncbi.nlm.nih.gov/pubmed/25826474
- 更年期发病率在美国女性:Gunter, J. (2019).阴道圣经:外阴及阴道 - 从医药分开的神话。多伦多:兰登书屋加拿大。
- 记忆丧失和更年期:绝经。(2013年)。“认知和绝经过渡期:是感知现实?”。journals.lww.com/menopausejournal/Citation/2013/12000/Cognition_and_the_menopausal_transition___is.3.aspx