1. Nursing Instruction
  2. Overview
  3. Women's Health
【Major Points】
  1. Menopause (climacterium) is a natural aging process that women must go through, and ovarian function will gradually degenerate.
  2. By keeping a balanced diet, adequate sleep and regular exercise, menopause-related discomfort symptoms can be alleviated.
  3. Persevering moderate exercise can slow down the rate of bone loss.
What is menopause?
Menopause is a natural physical aging that women will lose their fertility function. Menopause starts around the age of 40 to 60, and it lasts on average of 15 to 20 years. During this period, ovarian function and female hormones are being reduced, and the menstrual cycle as well as the menses will go irregular and become less and less, then the menstruation period will stop eventually. On average menstruation is naturally stopped at around 45-55 years old. 
  1. Hot flashes: Due to the dysfunction of neurovascular control, the body will suddenly feel hot, especially on the face, neck and upper body, it usually lasts for 2 to 4 minutes, and sometimes there will be an increment of heartbeat, chest discomfort and a lot of sweating.
  2. Menstrual abnormality: The period becomes irregular, and the menstrual fluid becomes very much or little, then menstruation stops eventually.
  3. Osteoporosis: The loss of calcium is influenced by female hormones, reduction which leads to decrease of bone density and strength, causing osteoporosis.
  4. Vaginal and urethral atrophy: When the vaginal epithelium shrinks, it causes atrophic vaginitis, and the patient is prone to feel vaginal itching, stinging, and dyspareunia (pain during sexual intercourse). When the urethra epidermis shrinks, it can cause symptoms such as urinary frequency and urinary incontinence, leading to urinary tract infection.
  5. Skin: Due to insufficient female hormones, the skin will gradually lose its luster and elasticity, dryness and itching, and the breasts will gradually shrink and become mastoptosis. 
  6. Mental issues: There will be symptoms like unstable emotion, anxiety, blue mood, depression, headache, and insomnia during menopause. 
The symptoms above do not necessarily mean menopause. If you have the symptoms above, go to the gynecologist for clinical evaluation.

 Self-Care Principle：
  1. Diet
    1. Take foods that are rich in natural estrogen, such as peanuts, potatoes, milk and soy products. It may help alleviate menopause symptoms.
    2. Eat foods that are rich in antioxidant nutrients to fight aging, including vitamin A (ex. whole grains and dark vegetables), vitamin C (ex. orange, tangerine and guava), and vitamin E (ex. almonds, peanuts and spinach).
    3. Be conscious of calcium intake to replenish the loss of bone mass. Foods with high calcium content include milk, cheese products, anchovies, spinach, sesame, nostoc and soy products. In addition, vitamin D is beneficial for calcium absorption. But overdose should be avoided and better take it under doctor's instructions.
    4. Reduce the intake of saturated fat and cholesterol foods, and eat a high-calcium, low-fat, high-fiber diet.
    5. Drink fewer diuretic beverages like beer and caffeinated drinks. Caffeine and alcohol will aggravate menopause women's anxiety. If urinary frequency presents, it is advisable to avoid taking a lot of water before sleeping.
  2. Moderate and consistent exercise, such as running, climbing and walking, can slow down the rate of bone loss and reduce menopause discomfort symptoms. Regular exercise is helpful in the maintenance of bone health and elimination of depressed mood. The recommended exercise frequency is 3 to 5 times a week and 20 to 30 minutes each.
  3. Keeping life wellness and happy. Avoid wearing turtleneck clothes and take stimulated food to reduce the discomfort caused by hot flash.
  4. In terms of sexual life, vaginal hormone ointment or vaginal lubricant are feasible under the instructions of a doctor. 
  5. Regularly self-health check
    1. Self-examination of the breasts once a month, and cervical cancer screening and breast ultrasound screening every year. Periodic bone density examination as directed by the doctor.
    2. Women receiving hormone replacement therapy should monitor liver function, blood lipids and cholesterol levels regularly.
    3. When any vaginal bleeding is noted after 1 year of menopause, seek medical advice from a doctor immediately. It may be a sign of severe disease. 
  6. Health consultation: In order to cope with the health problems associated with menopause, you should actively seek consultation and discuss it with a trusted physician and share your feelings with your family and friends.
  7. Social activity engagement: Be active in participating social activities, such as volunteering or participate in mutual association, increase the opportunity to interact with others, not only helping the others, but also increasing one's self-worth and affirmation, and regains the meaning of life.
References 
  1. Cheng, Y. C., (2019). Menopause and cognition decline. The Newsletter of The Taiwanese Menopause Society, (60), 10-14. https://doi.org/10.6651/TMS.201911_(60).01
  2. Lee, P. S., & Lee, C. L. (2021). Prevalence of symptoms and associated factors across menopause status in Taiwanese women. Menopause, 28(2), 182-188. https://doi.org/10.1097/GME.0000000000001662
  3. Liang, S. C., Huang, J. F., & Chen, K. W. (2020). Menopause and diabetes. The Newsletter of Taiwanese Association of Diabetes Educators, 16(4), 2-6. https://www.airitilibrary.com/Publication/alDetailedMesh?DocID=P20141022001-202012-202101050011-202101050011-2-6
  4. Santoro, N., Roeca, C., Peters, B. A., & Neal-Perry, G. (2021). The menopause transition: signs, symptoms, and management options. The Journal of Clinical Endocrinology & Metabolism, 106(1), 1-15. https://doi.org/10.1210/clinem/dgaa764
  5. Tang, Y. Y. & Chyi, A. M. (2019). Menstruation related Problems. In Feng, R. C., Yeh, Y. C., Lu, M. F., Tang, Y. Y., Chyi, A. M., Lin, L. C., Lee, H. L., Pan, W. L., Chen, S. C., Tien, S. F., Chang, F. W., Chan, H. L., Zen, S. S., & Chang, B. F. (Eds.), Practical gynecologic nursing. (6th ed., pp. 141-147). Farseeing.
     
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    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
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    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
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