What is menopausal syndrome?

Perimenopause, commonly referred to as climacteric or menopausal transition, is a natural stage in women's lives. Due to the decline of ovarian function and the fluctuant reduction of estrogen levels in the body, some women may experience a series of significant physical and mental changes. Medically, it is called menopausal syndrome, and other more serious diseases often accompany it. In women over 40 years of age, two or more out of 10 menstrual cycles with a change in length from the adjacent menstrual cycle (≥7 days) is a sign of climacteric.

Does menopausal syndrome need treatment?

The decline of ovarian function is a prominent manifestation of aging in women, who will undergo menstrual changes until menopause, accompanied by a variety of menopause-related symptoms. Menopause has persistent adverse effects on cardiovascular, skeletal and cognitive functions. Therefore, menopausal women should undergo health management, including annual physical examinations, following a proper diet, increasing social and mental activities and undertaking exercise. Although most women can smoothly tackle menopause, for many others, the symptoms of menopause can affect their normal work and life. It is recommended that these women go to the menopause health clinic at a hospital to receive health management guidance from doctors and receive targeted treatment.

1. General treatment

Every woman should have a better understanding of the physiological process of perimenopause, relieve unnecessary stress, maintain a cheerful mood and get adequate sleeps, all while sustaining a healthy diet. Of course, menopausal women should exercise, cease smoking and limit alcohol consumption, drink less coffee, and take appropriate sedatives and drugs treating vegetative system dysfunction, such as tranquilizers and gamma oryzanol when necessary. According to the dietary habits of different regions, it is suggested that menopausal women should consume whole grains, sufficient vegetables and fruits and fish twice a week. Also, the intake of sugar (≤50 grams/day), oil (25-30 g/d), salt (≤6 g/d) and alcohol (ethanol amount ≤15 g/d) should be controlled, while sufficient water intake (1500-1700 milliliters/day) is also important. It is suggested that regular aerobic exercise should be done every day, such as swimming, jogging, cycling and aerobic gymnastics, for a cumulative 150 minutes per week. Two to three resistance exercises are also encouraged to increase muscle mass and muscle strength.

2. Menopause hormone therapy (MHT)

Most menopausal syndrome symptoms are associated with decreased estrogen levels, and estrogen supplementation is a direct and effective way to address a package of menopause-related problems. When general treatment has no effect, doctors recommend MHT for the suitable population.

3. Disease burden

China is rapidly becoming an aging society and will face a series of problems brought by its aging population, especially the enormous medical expenses of elderly citizens. China's aging society is characterized by a high proportion of women.

In 2010, women accounted for more than 60 percent of elderly people over 80 years of age in China, and the proportion will continue to rise in the coming decades. The data from the Chongqing Municipal Bureau of Statistics also shows that the female population in Chongqing is increasing annually. Hence, the problems associated with an aging female population deserve special attention.

The hallmark event of aging in women is menopause, and although life expectancy is increasing in women, the duration of menopause in women is generally stable. With the extension of the human life span, the menopausal transition period and the postmenopausal period have become the longest stage in a woman's life. At present, the total number of postmenopausal women in China has exceeded 200 million.

Menopause is an inevitable physiological process in women's lives, and its essence is ovarian function failure. With the decline of ovarian function and the decrease of estrogen levels, women will have a variety of menopause-related symptoms, tissue atrophy and degeneration and metabolic dysfunction, leading to a series of physical and mental health problems such as cardiovascular disease, osteoporosis, genitourinary tract infection and psychosocial symptoms, which not only affect the quality of life for women but also significantly increase the burden on families and society at large.

Therefore, women at this stage need comprehensive lifestyle guidance and health management, including diet, exercise and smoking control. The applicable population can be guided to receive MHT, and non-hormonal treatment should be carried out for the inapplicable community to alleviate menopause-related symptoms and improve their quality of life.

The core of MHT is estrogen supplementation, which is a therapeutic measure to compensate for ovarian failure. The 2018 Chinese Guideline on Menopause Management and Menopause Hormone Therapy clearly states that MHT is the top recommendation for menopause-related problems, reproductive and urinary tract atrophy-related issues, low bone mass and osteoporosis. After years of practice, it has been confirmed that – excluding contraindications to hormone therapy – the scientific application of MHT can effectively alleviate menopause-related symptoms. Early use of MHT can also prevent – to some extent – the occurrence of chronic diseases in the elderly.