●更年期近期症状多人知， 远期对心血管的影响却往往被忽略

Menopause symptoms had recently many people know, Forward on the cardiovascular influence is often neglected

　　●专家指出，规范化使用激素补充治疗利大于弊，更年期后5~7年内使用激素补充治疗是安全的，且能有效预防心血管疾病

- experts point out that,Standardization using hormone replacement therapy more good than harm,After menopause 5 ~ 7 years using hormone replacement therapy is safe,And can effectively prevent cardiovascular disease

　　美剧《绝望的主妇》的粉丝应该都会记得这么一幕：第七季第七集里，女主角之一Bree与男朋友玩轮滑时，突然遇到一阵莫名的热浪：“感觉就像有人生起了炉子。一阵热浪流过全身。”她惊慌地以为自己中风了，实际上她只是经历了潮热这一女性更年期的典型症状。

Beautiful play[Desperate housewives]Fans will be remember such a scene:The seventh season in the seventh set,One of the leading lady Bree and boyfriend when play skidding,Suddenly encountered a burst of and difficult to heat:"It felt like a life on the stove.A heat wave through the whole body."She disconcertedly thought he had a stroke,In fact she's just experienced hot flash this female menopause is the typical symptoms.

　　人们常说“多事之秋”，女性的更年期也相当于人生的秋天。由于体内雌激素分泌水平的下降，女性身心都将发生一系列的改变，除潮热汗多、心烦失眠、月经紊乱等近期症状外，女性在更年期后的冠心病和骨质疏松的风险也会随年龄增加而增加。在目前来说，激素补充治疗是改善更年期症状、降低远期心血管疾病和骨质疏松风险的根本方法，但是“激素补充致癌说”的阴影在不少女性的心头挥之不去。专家表示，研究显示，早期开始治疗，即在更年期后5~7年内接受激素补充治疗是安全的，而且对于预防心血管病的效果最好，只要规范治疗，是利大于弊的。

People often say that"An eventful year",Women's menopause is equivalent to the autumn of life.Due to a decrease in the level of estrogen secretion,Female body and mind will occur a series of change,In addition to hot flash sweat is much/Upset insomnia/Menstrual disorder and the recent symptoms,Women in menopause after the risk of coronary heart disease and osteoporosis will also increases with age.At present,,Hormone replacement therapy is to improve menopausal symptoms/Reduce forward cardiovascular disease and osteoporosis risk basic method,but"Hormone supplement carcinogenic said"In the shadow of a lot of women's heart linger.Experts say,Research shows that,Early start treatment,That is after menopause 5 ~ 7 years accept hormone replacement therapy is safe,And to prevent cardiovascular disease is the best,As long as the standard treatment,Outweigh the drawbacks of.

女性绝经后冠心病风险明显上升 Postmenopausal women coronary heart disease risk increased obviously

　　中山大学附属第二医院妇产科主任医师谢梅青教授介绍，大多数女性的更年期是从40~45岁开始的，除了出现月经不规则的现象外，女性身体还将出现一系列变化，比如“绝望主妇”Bree所出现的潮热出汗。根据北京协和医院妇产科主任医师郁琦教授等人的统计，潮热在北方更年期女性中高达50%左右，南方女性估计在30%~40%之间。中国女性在更年期里，精神、情绪方面的改变以及躯体方面的症状比较严重，比如焦虑、多疑、抑郁、失眠、心悸、记忆力下降、尿频尿急、阴道萎缩导致性交疼痛等。

The 2nd affiliated hospital of sun yat-sen university professor in the department of obstetrics and gynecology chief physician XieMeiQing is introduced,Most of the women's menopause from 40 ~ 45 years old start,In addition to appear the phenomenon of irregular menstruation outside,Female body will also appear a series of changes,For example"housewives"Bree in hot flash sweating.According to the Beijing union medical college hospital department of gynaecology and obstetrics chief physician, professor YuQi of statistics,Hot flash in the north menopausal women as high as 50%,Southern female estimated at between 30% ~ 40%.Chinese women in the menopause,spirit/Emotional changes and physical aspects of the more serious symptoms,Such as anxiety/suspicious/depression/insomnia/palpitation/Memory decline/Frequent micturition urgency/Vaginal atrophy leads to sexual intercourse pain, etc.

　　然而，以上这些只是更年期的近期和中期症状，从长远的角度看，更年期对女性健康的影响远远不止这些。谢梅青介绍，更年期后女性体内的雌激素分泌下降，体内脂肪分布开始发生变化，更趋向于男性，原本在臀部、大腿部较多的脂肪逐步堆积到腰部，腰围增粗，就容易引起代谢异常及胰岛素抵抗，是造成冠心病的非常重要的危险因素。研究发现，与同龄男性比，女性冠心病的发病率本比男性低，但在女性绝经后15~20年内，患冠心病的风险不断上升，到了70岁时赶超男性；同年龄段已绝经女性与没有绝经的女性相比，前者比后者发生冠心病的风险高出2~6倍。另外，更年期对女性健康另外一个远期危害就是骨质疏松症高发。

however,These just menopausal symptoms of the recent and metaphase,From a long-term point of view,To affect the health of female menopause far more than these.XieMeiQing introduced,Menopause in women after the estrogen secretion decline,Body fat distribution began to change,More tend to be men,Originally in the hip/Huckle more adipose accumulation gradually to the waist,Waistline coarsening,It is easy to cause metabolic disorder and insulin resistance,Coronary heart disease (CHD) is a very important risk factors.The study found that,With their peers than men,Women the incidence of coronary heart disease the low than men,But in postmenopausal women 15 ~ 20 years,The risk of coronary heart disease with rising,In the 70 years old catch up with men;With age already postmenopausal women with no postmenopausal than women,The former risk of coronary disease than the latter more than 2 ~ 6 times.In addition,The health of the women menopause another forward hazard is the high incidence of osteoporosis.

　　更年期10年内 Menopause 10 years

　　激素补充治疗才有用 Hormone replacement therapy are only useful

　　郁琦表示，潮热汗多、精神抑郁或焦虑等症状，都各自有药物可以缓解症状，但是从根本上来说，缓解更年期相关症状、降低远期相关疾病的风险，激素补充治疗是目前为止的“一揽子解决方案”，因为这些问题出现的源头就是女性体内雌激素分泌下降。

YuQi said,Hot flash sweat is much/Depression or anxiety wait for a symptom,All have their own drug can relieve symptoms,But fundamentally,Relieve menopausal symptoms related/To reduce the risk of forward related diseases,Hormone replacement therapy is so far"Package solution",Because of these problems is the source of estrogen secretion decline in women.

　　从长远看，雌激素可以维持血脂水平，保持血管内皮的弹性，当更年期体内分泌的雌激素下降，胆固醇水平会上升，随着时间的推移，会发生动脉硬化，“在这个阶段患者并没有感觉到有什么问题，大约65岁时，动脉粥样硬化形成，进入不可逆的状态。激素补充治疗可以改善血脂代谢，降低心血管病的发生率。”但郁琦强调，补充激素预防心血管疾病存在一个“治疗窗口期”，也就是更年期10年内，“并非什么时候开始激素补充治疗都能预防心血管疾病的发生，必须在血管还没有发生本质性的病理变化之前使用，也就是刚刚开始雌激素缺乏时就开始服用才有用。”

In the long run,Estrogen can maintain blood lipid level,Keep the flexibility of the vascular endothelium,When menopause body excretive estrogen decline,Cholesterol levels will rise,With the passage of time,Arteriosclerosis will happen,"In this stage patients did not feel what's the problem,About 65 years old,Atherosclerosis formation,Enter the irreversible state.Hormone replacement therapy can improve blood lipid metabolism,To reduce the incidence of cardiovascular disease."But YuQi emphasize,Supplementary hormone prevent cardiovascular disease there is one"Treatment window period",Is also the menopause 10 years,"Is not when to start hormone replacement therapy can prevent cardiovascular disease,Must be in vascular hasn't happened the pathological changes of essential before use,Also is just beginning because of the lack of estrogen started taking just useful."

　　激素补充治疗 Hormone replacement therapy

　　尽早开始利大于弊 Start as soon as possible more good than harm

　　郁琦介绍，国际绝经学会对绝经期管理有一个综合指导建议，在健康饮食、规律运动、控制体重、戒烟限酒等外，还把激素补充治疗作为维持绝经妇女健康全部策略当中的一部分，“实际上在国外确实有不少妇女把激素补充治疗作为生活方式的一部分。欧洲女性中有40%~45%的妇女更年期时使用激素补充治疗，女性妇产科大夫服用激素补充治疗的占90%以上，男性妇产科大夫的老婆占80%左右。而在中国，最多时只有不超过2%的更年期女性使用激素补充治疗。”

YuQi introduced,The international menopause society to menopause management have a comprehensive guidance advice,In a healthy diet/Regular exercise/Control weight/Give up smoking limit alcohol substandard,The hormone replacement therapy as maintain postmenopausal women's health all part of strategy,"In fact many women abroad is the hormone replacement therapy as a part of the way of life.European women 40% ~ 45% of women climacteric using hormone replacement therapy,Women in the department of obstetrics and gynecology doctors taking hormone replacement therapy 90% above,Male department of gynaecology and obstetrics the doctor's wife accounted for 80%.In China,Only the most long time no more than 2% of menopause women using hormone replacement therapy."

　　郁琦表示，一方面，和中国女性能“忍”、小问题能不吃药尽量不吃药有关。另一方面，“激素补充治疗致癌说”也吓退了不少有心尝试的人。郁琦介绍，国际绝经学会综合60年以来的文献发现，乳腺癌与绝经后激素补充治疗的关联程度还存在较大争议，不同地区的数据并不相同，而最悲观的数据是激素补充治疗会使乳腺癌发病几率增加少于0.1%。“有一点可以确定，规范化使用利大于弊，让这些风险达到最小化。更年期后5~7年内使用激素补充治疗是安全的，因此要尽早开始治疗。”郁琦同时提醒，喝酒、缺少锻炼、体重增加等危险因素对于乳腺癌发病风险增加的作用，比激素补充治疗更大。(记者伍仞）

YuQi said,On the one hand,And Chinese women"endure"/Small problem can not take medicine not to take medicine as far as possible about.On the other hand,"Hormone replacement therapy carcinogenic said"Also scare a lot to try.YuQi introduced,The international menopause society comprehensive 60 years literature found,Breast cancer and postmenopausal hormone replacement therapy association degree also has the big dispute,Different parts of the data is not the same,And the most pessimistic data is hormone replacement therapy can make the breast cancer increased risk of less than 0.1%."One thing is for sure,Standardized use more good than harm,Let these risks to minimize.After menopause 5 ~ 7 years using hormone replacement therapy is safe,So to start treatment as soon as possible."YuQi also remind,drink/Lack of exercise/Weight gain and risk factors for breast cancer risk increases role,More than hormone replacement therapy.(Reporter wu towering)