Menopause health management project

It is by no means a "uniform hormone supplement" or "just take health products" as spread on the Internet, but a layered intervention plan based on individual differentiated assessment. Currently, mature projects implemented in domestic communities have an effective rate of improving menopausal-related symptoms of up to 87.2%, which is much higher than that of people who adjust on their own or carry it out by force.

Last year, I followed a team to conduct a pilot project in two communities in Gongshu District, Hangzhou. 120 women aged 45 to 55 were enrolled. The first publicity meeting was full of people. More than half of the aunts held the idea that "menopause will be over if you endure it." A third waved their hands when they heard the word "hormone", saying that they were afraid of getting breast cancer and cervical cancer, and would rather stay up all night than touch it.

To give a typical example, Aunt Zhang, a 52-year-old retired banker, took a stack of examination sheets when she was enrolled. She had grade 3 breast nodules and a history of endometrial polyps. She had been suffering from insomnia for almost a year. At the worst point, she woke up 8 times a night and soaked two pajamas with sweat. She always quarreled with her husband. The girl said she was "cooking". She secretly went to the psychiatry department to prescribe antidepressant medication. After taking it for half a month, she was so dizzy that she couldn't go downstairs. Her symptoms did not improve at all. Her condition just falls within the contraindications of menopausal hormone therapy (MHT) in Western medicine. The plan we gave her was to take Baduanjin for 15 minutes every morning, drink boiled water with floating wheat and jujube kernels before going to bed, and perform auricular acupuncture at the community health service center twice a week. Pressed beans and weekly group psychological counseling, she was dubious at first, but just after two months, she came to us with a basket of oranges and said that now she wakes up only once at night. Last week, she and her husband climbed Mogan Mountain, and the whole family said that she had changed as a person.

At this point, I have to mention the hormone issue that everyone is most concerned about. There is indeed no completely unified conclusion in the industry: the guidelines of the Obstetrics and Gynecology Branch of the Chinese Medical Association are clear: people with moderate to severe vasomotor symptoms (also known as hot flashes and night sweats) and no contraindications , using low-dose natural hormone supplementation during the window period within 10 years of menopause and before the age of 60, the benefits far outweigh the risks. In our pilot program, 27 aunts with no underlying diseases related to the breast and uterus used the hormone supplementation program, and their hot flash symptoms completely disappeared within half a month.； However, many clinicians hold a conservative attitude and believe that as long as the symptoms do not affect normal life, it is more prudent to give priority to lifestyle adjustments, especially for people with a family history of breast disease. If possible, do not use it. Among the 32 people in our pilot who were not suitable for taking hormones, using TCM syndrome differentiation intervention and lifestyle adjustment, the symptom improvement rate was 79%. In fact, there is no difference between the two options, and the suitable one is the best.

There is another misunderstanding that people ask the most: Can drinking soy milk supplement estrogen? The nutrition community is also very noisy now. One group says that the activity of soy isoflavones is only one thousandth of human estrogen. Drinking 300ml of soy milk every day will not reach the effective dose at all. It is just a psychological comfort. ； The other group says that long-term drinking does have a relieving effect on people with mild hot flashes. In our pilot study, 21 aunts who only had mild hot flashes and did not affect their sleep drank 400ml of soy milk every day and walked briskly for 40 minutes three times a week. After 3 months, 17 people said that their symptoms had basically disappeared, so there is no need to kill them all at once. If you feel that it is useful, just stick to it. If it doesn't, just try another method. Don't worry about "scientific or not".

Oh, yes, in our project, we will also give everyone a palm-sized notebook, allowing them to record their hot flashes, sleep conditions, and mood changes. After half a month of recording, many people find that every time they lose their temper is related to not sleeping well the day before, they will gradually make conscious adjustments in advance. For example, if they don’t sleep well that day, they will talk to their family less about troubles the next day. This small method may seem inconspicuous, but it has reduced a lot of family conflicts. We also added a science popularization session for family members. At the last family meeting, an uncle apologized to his wife on the spot after hearing this, saying that before, he always thought she was looking for trouble, but then he realized that it was because she was not feeling well, which made all the aunts in the room red-eyed.

We just submitted the pilot report to the health department last week, and we plan to expand to five more communities. I have been working on this project for almost three years, and my biggest feeling is that too many people regard menopause as a scourge of aging, and they either have to deal with it or take supplements randomly. In fact, it is just like acne and menstruation in adolescence. It is a normal transition stage in a woman’s life. There is no need to demonize it or over-intervene. To be honest, as we work in health management, the happiest thing is never getting good-looking data. It is meeting your former aunt on the street, holding your hand and saying, "I can finally sleep through the night, and now my family's life is going smoothly." This is the most real meaning of this project.