让我们来谈谈更年期

绝经是a phase of life that affects a full half of the population—yet in many circles, it remains “taboo,” with women embarrassed to discuss it. Just as #noperiodshame has begun sparking open conversation about a completely normal biological process, it’s time for menopause stigma—internal and external—to end, too. Whether you’re wondering about early signs, experiencing hormonal shifts, or are already in full menopause and looking for the best treatments so you can feel like yourself again, we at HealthCentral are here to help.

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。

What Causes Menopause?

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:

1. The eggs in your ovaries are surrounded by cells that make up what’s known as the follicle.
2. As the egg matures, the follicle cells multiply, and the follicle begins to secrete estrogen.
3. Once the egg is released from the ovary, the empty follicle, left behind, then also begins to put out progesterone and estrogen—the hormones that help your body prepare for that just-released egg to be fertilized and settle in for the long haul.
4. 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
5. At that point, your periods usually become less frequent and often lighter, though for some women they do the opposite and become heavier, longer, and closer together; both types of period changes are normal before menopause. When you no longer menstruate at all—because there are no eggs to release—the process is complete: You’re in menopause.

我什么时候过了更年期？

There is a wide range of ages at which women hit menopause, though on average, the magic year is 51.

That doesn’t mean symptoms wait till then, however. You may be in绝经前， 也叫围绝经期, as early as your mid-30s to late 40s. The typical length you’d be in perimenopause is four years, but it can last as long as 10 years (!) or be as short as a few months. To be clear, perimenopause is not the actual beginning of menopause; it’s the period of time that occurs before the big M.

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。

Most often, early or premature menopause happens because a woman has had a hysterectomy with removal of the ovaries, whether because of ovarian or cervical cancer, fibroids, or some other reason. Chemotherapy (with or without surgery) can also damage your ovaries and trigger early menopause. One other potential predictor of early menopause: if one or more of your female relatives experienced it.

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).

You probably won’t have all these symptoms, but every woman's experience is unique. Intermittent symptoms, like hot flashes, might go away as your body adjusts to the lack of estrogen in your body—in fact, some women who take hormone therapy (more on that in a minute) find that when they stop,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:

• Hot Flashes.感觉突然焦虑不安，但温度热其实困扰（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。
• Night Sweats.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。
• Urinary Frequency or Urgency.感觉你必须更频繁地尿尿吗?怪the decrease in estrogen levels. It’s also responsible for making it difficult for you to hold it when you really做have to go—further compounding sleep issues, all while feeling the bathroom urge at night.
• Mood Swings.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。Similarly, if you had bouts of depression or anxiety before menopause, you are more likely to see them reappear. 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。
• Loss of Libido.That hormonal drop + the resulting vaginal dryness and irritation can make some women feel less interested in sex altogether.
• 内存变化和脑雾。关于two-thirds of women going through perimenopause and menopause have a harder time remembering things and focusing.

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。

What Is the Best Treatment for Menopause?

要知道的第一件事是，你不haveto 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.

For hot flashes and night sweats:

The most effective treatment to stop them ishormone therapy(orH T）。（这也被称为menopausal hormone therapy, MHT，而此前被称为hormone replacement therapy, orHRT）。Your doctor will prescribe a very low dose of estrogen, sometimes combined with progesterone. Most hormone replacements are pills, but there are also skin patches, vaginal creams and gels, and vaginal rings.

还有的是关于激素疗法的安全性争议。根据最新的研究，FDA批准的激素疗法，为广大当医生的监督下，为在有限时间内采取有更年期症状的妇女的安全。

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recommended. In this age group (as opposed to women in their 50s or 60s), HRT helps prevent heart risks while also alleviating other common symptoms of menopause.

No matter what your age when you start HT, most docs will want to re-evaluate every three to six months. For one thing, you might have better results with different dosages and timing—you and your doctor might decide to try several different protocols. For another, if the hormone therapy isn’t giving you relief from your symptoms (everybody’s experience varies), you might want to stop it altogether.

For vaginal dryness and pain during sex:

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).

There’s some evidence that cannabis—both THC (the compound that makes you “high”) and CBD, the cannabis plant’s other main component—can increase sex drive. However, there are studies that have found just the opposite. 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。

For depression and mood changes:

Just as with depression at any stage of life, it’s worth considering taking antidepressants to help with the sadness, irritability, and moodiness that often accompany menopause. Treating those symptoms can also make way for a return in libido, and some women find that a low dose of antidepressants can lessen hot flashes (finally, abonus）。正如任何处方，医生可以帮助选择合适的药物，并与您携手微调多少呢拿，多久，多长时间。(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：

Here, too, behavioral changes might help:

• 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, which are molecularly identical to the hormones women’s bodies naturally make but are constructed with plant chemicals (mostly from yams and soybeans); manufacturers often market them as “natural.” There are FDA-approved options (including bioidentical and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？

If you’re going through menopause, you really are in good company: Remember, a gajillion other women in this country are menopausal, too. If you need more information or just want somebody to talk to who gets it immediately, check out these resources.

前更年期Instagrammers和Blogger

• Anna Cabeca, D.O.,@drannacabeca,https://drannacabeca.com

遵循这是因为：Dr. Cabeca doesn’t just know what it’s like to go through menopause, she’s also triple-board certified (in internal medicine, obstetrics and gynecology, and regenerative and anti-aging medicine), so she fully understands the science behind menopause. She recommends integrative approaches to make sure you兴旺, not justsurvive, the transition.

• Meg Matthews,@megsmenopause

遵循这是因为：It’s not just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红magazine and was a former music-industry events planner and designer for the Brit Pop scene in the '90s.

• Jo Harvey-Graham,@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。是的，按照登记的营养治疗师成龙林奇，你可以在更年期幸福。她专注于身心和营养的方法来管理中年荷尔蒙的变化。
• 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). This nonprofit has afunction,您可以输入您的邮政编码和找到医生吗in your area who have gone through the NAMS Certified Menopause Practitioner (NCMP) program. Meaning: a doc who really gets it.
• 红Hot Mamas。Created by Karen Giblin—who in 1991, when she held public office in Connecticut, had a total abdominal hysterectomy and bilateral oophorectomy—this group’s goal is to outsmart menopause. How? With tons of evidence-based guidance paired with insights from the menopause community. These are your type of people: smart, sassy, and supportive.
• American Society for Reproductive Medicine。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should），你说他们的语言。