What is menopause?
“Menopause” is a natural process of life. It refers to the decline of women’s ovarian functions from having regular menstrual period to the cessation of menstruation, which takes approximately 2-5 years. It has been reported that approximately 70%~80% of women will experience discomfort during menopause, which usually occur in women between the ages of 45 and 55.
 
Symptoms during menopause:
As the age increases, the ovarian functions gradually decline decreasing estrogen secretion, leading to many psychological and physiological discomforts. The symptoms include:
  1. Irregular menstruation cycles: abnormal bleeding caused by irregular ovulation. 
  2. Vasomotor symptoms: hot flushes are the sudden sensation of heat, and redness in the face, upper body or whole body, usually lasting for approximately 2-4 minutes and is sometimes accompanied by palpitations, chest discomfort, and night sweats. 
  3. Vaginal atrophy and decreased libido.
  4. Frequent urination and urinary incontinence: the vaginal wall and the urethral wall become more relaxed and inelastic after menopause, which weakens the control of urethral muscles.
  5. Osteoporosis: osteoporosis caused by bone loss and may easily lead to bone pain and fractures.
  6. Cardiovascular aspect: due to the decrease in the amount of high-density lipoprotein in the body, arterial atherosclerosis is prone to occur, and the rate of cardiovascular diseases increases year by year.
  7. Sleep disorders: vasomotor symptoms interfere with sleep and may lead to chronic insomnia.
  8. Headache: Commonly manifests as tension headache which will be alleviated after menopause.
  9. Cognition and Emotion: menopausal women may experience depression, mood swing, anxiety, and paranoia.

Menopausal All-round Self-care: 
  1. Proper Diet
    1. Adopt a balanced diet, eating more fruits and vegetables, cereals and high-calcium foods, supplementing water, and avoiding excessive intake of calories.
    2. Reduce foods with high cholesterol and saturated fatty acids, control the intake of sugar and salt, and avoiding tobacco and alcohol.
    3. Increase intake of potatoes, tofu, soy products etc. which have isoflavones, a phytoestrogen, which is similar in structure and function to estrogen.
  2. Regular exercise
    1. Menopausal women should choose appropriate exercise, according to their age and physical condition and persist on it. Appropriate exercise can not only promote blood circulation, increase metabolism, reduce the incidence of osteoporosis, but also can eliminate depression and enhance physical and mental health.
    2. Exercise regularly 3 times a week. Aerobic resistance exercises, such as swimming, jogging, walking, Tai Chi, pelvic floor muscles exercises and aerobics are recommended and should last for at least 20 minutes.
    3. Maintain correct posture to prevent falls and fractures.
  3. Methods for improving physical and mental discomforts during menopause
    1. Depending on personal preference, physical and mental status, menopausal women can choose a variety of traditional treatments, such as acupressure, massage, Qigong, yoga, and others, to relieve discomfort.
    2. Following physician's order, appropriate hormones, vitamins or other treatments may be administered to alleviate the discomfort of menopause.
    3. Menopausal women are encouraged to take more phytoestrogen and to eat more potatoes, carrots, and soy products such as tofu, to reduce hot flushes.
    4. To facilitate sexual intercourse, a vaginal hormonal cream or vaginal gel can be used under the instruction of a physician.
  4. Periodic Self-health Examination
    1. Monthly self-breast examination, annual Pap smear examination, and breast ultrasound examination can help achieve early diagnosis of breast cancer or cervical cancer. In addition, menopausal women should receive regular bone density examination according to the doctor's instructions.
    2. Women receiving hormone replacement therapy should receive periodic follow-up on hepatic function, blood lipid, and cholesterol.
    3. Women experiencing any vaginal bleeding 1 year after menopause need to seek medical attention immediately because it may be a disease warning.
  5. Health consultation
    In order to respond to the health problems associated with menopause, women should actively consult and discuss problems with their physicians and communicate frequently with family and friends.
  6. Active participation in social activities
    Active participation in social activities, such as participation in volunteer or mutual aid groups to create opportunities for interpersonal interactions, can not only help people, but also enhance individual self-worth and affirmation and regain the meaning of life.
 
References
  1. Bacon, J. L. (2017). The menopausal transition. Obsterics and Gynecology Clinics of North America, 44(2), 285-296. https://doi.org/10.1016/j.ogc.2017.02.008  
  2. Chiu, C. T. (2017). Abnormal Bleeding before and after Menopause. The Taiwanese Menopause Society Journal, 54, 14-17. 
  3. Holloway, D. (2018). Menopause symptom management in the United Kindom. Nursing Clinics, 53(2), 263-277. https://doi.org/10.1016/j.cnur.2018.01.004
  4. Moser, S. S,, Chodick, G., Bar-On, S., & Shalve, V. (2020). Healthcare utilization and prevalence of sympoms in women with menopause : a real-world analysis. International Journal of women's health. 12, 445-454. https://doi.org/10.2147/IJWH.S246113
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