20250218 - 更年期的诊断与治疗 - 更年期 - 诊断和治疗 - 梅奥诊所 --- Menopause - Diagnosis and treatment - Mayo Clinic¶

分类: Clippings
创建: 2025-02-18
标签: 更年期, 激素疗法, 健康, 女性健康, 生活方式

更年期 - 诊断和治疗 - 梅奥诊所 --- Menopause - Diagnosis and treatment - Mayo Clinic¶

摘要 (Summary)¶

这篇文章讨论了更年期的诊断和治疗，包括症状识别、激素水平测试、治疗方法（如激素疗法、阴道雌激素、抗抑郁药等），以及生活方式改变和替代医学的选择。

要点 (Key Facts)¶

更年期的症状包括月经不调和热潮红。
诊断通常不需要测试，但可以通过血液检查来检测激素水平。
治疗方法包括激素疗法、阴道雌激素、抗抑郁药等。
生活方式改变包括均衡饮食、规律锻炼和避免吸烟。

正文 (Content)¶

Diagnosis 诊断¶

Most people can tell by the symptoms that they've started menopause. If you have worries about irregular periods or hot flashes, talk with your healthcare professional.
大多数人在出现症状时就能判断自己是否进入了更年期。如果你对自己的月经不调或热潮红有担忧，可以与你的医疗保健专业人士谈谈。

Tests most often aren't needed to diagnose menopause. But sometimes, your healthcare professional may suggest blood tests to check your levels of:
通常不需要测试来诊断更年期。但有时，您的医疗保健提供者可能会建议进行血液检查以检查您体内的激素水平：

Follicle-stimulating hormone (FSH) and estrogen (estradiol). FSH goes up and estrogen goes down during menopause. Because hormones go up and down during perimenopause, it can be hard to tell from these tests whether you're in menopause.
促卵泡激素（FSH）和雌激素（雌二醇）。在更年期，FSH 水平上升而雌激素水平下降。由于围绝经期激素水平上下波动，仅凭这些测试很难确定是否处于更年期。
Thyroid-stimulating hormone (TSH). Overactive thyroid, called hyperthyroidism, can cause symptoms like those of menopause.
促甲状腺激素（TSH）。甲状腺功能亢进，称为甲亢，可引起类似更年期的症状。

You can get home tests to check FSH levels in your urine without a prescription. The tests show whether you have higher FSH levels. This might mean that you're in perimenopause or menopause.
你可以无需处方即可获得在家测试 FSH 水平的试纸。这些测试可以显示你的 FSH 水平是否较高。这可能意味着你正处于围绝经期或绝经期。

But FSH levels rise and fall during your menstrual cycle. So home FSH tests can't really tell you whether you're in menopause.
但是 FSH 水平在你的月经周期中会上升和下降。所以家用 FSH 测试并不能真正告诉你是否处于更年期。

Treatment 治疗¶

Menopause needs no treatment. Treatments aim to ease symptoms and prevent or manage ongoing conditions that may happen with aging. Treatments may include:
更年期无需治疗。治疗的目的是缓解症状并预防或管理随着年龄增长可能出现的持续性状况。治疗方法可能包括：

Hormone therapy. Estrogen therapy works best for easing menopausal hot flashes. It also eases other menopause symptoms and slows bone loss.
激素疗法。雌激素疗法对缓解更年期潮热最有效。它还可以缓解其他更年期症状并减缓骨质流失。

Your healthcare professional may suggest estrogen in the lowest dose and for the time needed to relieve your symptoms. It's best used by people who are younger than 60 and within 10 years of the onset of menopause.
您的医疗保健专业人员可能会建议使用最低剂量的雌激素，并且仅在需要时使用以缓解您的症状。它最适合 60 岁以下以及绝经后 10 年内的人群使用。

If you still have your uterus, you'll need progestin with estrogen. Estrogen also helps prevent bone loss.
如果你仍然有子宫，你需要雌激素加上孕激素。雌激素还有助于防止骨质流失。

Long-term use of hormone therapy may have some heart disease and breast cancer risks. But starting hormones around the time of menopause has shown benefits for some people. Talk with your healthcare professional about whether hormone therapy may be safe for you.
长期使用激素治疗可能会增加一些心脏病和乳腺癌的风险。但在更年期前后开始激素治疗已被证明对某些人有益。与您的医疗保健专业人士讨论激素治疗是否可能对您安全。 - Vaginal estrogen. To relieve vaginal dryness, you can apply estrogen to the vagina using a vaginal cream, tablet or ring. This treatment gives you a small amount of estrogen, which the vaginal tissues take in. It can help ease vaginal dryness, pain with intercourse and some urinary symptoms.
阴道雌激素。为了缓解阴道干涩，你可以使用阴道霜、片剂或环将雌激素应用于阴道。这种治疗给予你少量的雌激素，阴道组织会吸收。它可以帮助缓解阴道干涩、性交疼痛以及一些尿路症状。 - Prasterone (Intrarosa). You put this human-made hormone dehydroepiandrosterone (DHEA) into the vagina. It helps ease vaginal dryness and pain with intercourse.
普雷斯特龙（Intrarosa）。你将这种人造激素脱氢表雄酮（DHEA）放入阴道。它有助于缓解阴道干涩和性交时的疼痛。 - Low-dose medicines to treat depression, called antidepressants. Some antidepressants may ease menopausal hot flashes. These are called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRI). A low-dose antidepressant may help manage hot flashes in people who can't take estrogen for health reasons or for those who need an antidepressant for a mood disorder.
低剂量的药物用于治疗抑郁症，称为抗抑郁药。一些抗抑郁药可能可以缓解更年期潮热。这些被称为选择性血清素再摄取抑制剂（SSRIs）和血清素-去甲肾上腺素再摄取抑制剂（SNRI）。对于因为健康原因不能服用雌激素的人，或者需要抗抑郁药来治疗情绪障碍的人来说，低剂量的抗抑郁药可能有助于管理潮热。 - Gabapentin (Gralise, Neurontin). Gabapentin is approved to treat seizures, but it also has been shown to help reduce hot flashes. This medicine is useful for people who can't use estrogen therapy and for those who also have nighttime hot flashes.
加巴喷丁（Gralise, Neurontin）。加巴喷丁被批准用于治疗癫痫，但它也被证明有助于减少潮热。这种药物对不能使用雌激素疗法的人以及那些夜间也有潮热的人很有用。 - Clonidine (Catapres-TTS-1, Nexiclon XR). This pill or patch most often treats high blood pressure. It might give some relief from hot flashes. It's not often prescribed for hot flashes because of the possible side effects, such as low blood pressure, headache, sleepiness and constipation.
可乐定（Catapres-TTS-1, Nexiclon XR）。这种药片或贴片通常用于治疗高血压。它可能对缓解潮热有一定的帮助。但由于可能出现的副作用，如低血压、头痛、嗜睡和便秘，因此不常将其开处方用于潮热。 - Fezolinetant (Veozah). This medicine is free of hormones. It treats menopause hot flashes by blocking a pathway in the brain that helps manage body temperature. It's FDA approved for managing menopause symptoms. It can cause abdominal pain, liver problems and make sleep problems worse.
Fezolinetant（Veozah）。这种药物不含激素。它通过阻断大脑中帮助调节体温的途径来治疗更年期潮热。它已获得 FDA 批准用于缓解更年期症状。它可能导致腹痛、肝脏问题，并使睡眠问题恶化。 - Oxybutynin (Oxytrol). This medicine treats overactive bladder and urinary urge incontinence. It's also been shown to relieve menopause symptoms. But in older adults, it may be linked to cognitive decline.
奥昔布宁（Oxytrol）。这种药物用于治疗膀胱过度活动症和尿急性失禁。它还被证明可以缓解更年期症状。但在老年人中，它可能与认知能力下降有关。 - Medicines to prevent or treat the bone-thinning condition called osteoporosis. Your healthcare professional might suggest medicine to prevent or treat osteoporosis. Several medicines can help reduce bone loss and risk of fractures. Your healthcare professional also might prescribe vitamin D supplements to help strengthen bones.
用于预防或治疗称为骨质疏松症的骨质变薄状况的药物。您的医疗保健专业人员可能会建议使用药物来预防或治疗骨质疏松症。有几种药物可以帮助减少骨质流失和骨折的风险。您的医疗保健专业人员也可能开具维生素 D 补充剂以帮助强化骨骼。 - Ospemifene (Osphena). Taken by mouth, this selective estrogen receptor modulator (SERM) medicine treats painful intercourse linked to the thinning of vaginal tissue. This medicine isn't for people who have had breast cancer or who are at high risk of breast cancer.
奥斯佩米芬（Osphena）。口服，这种选择性雌激素受体调节剂（SERM）药物用于治疗与阴道组织变薄相关的疼痛性交。这种药物不适用于乳腺癌患者或乳腺癌高风险人群。

Before deciding on any form of treatment, talk with your healthcare professional about your choices and the risks and benefits of each. Review your choices yearly. Your needs and the treatment choices may change.
在决定任何治疗方式之前，与你的医疗保健专业人士讨论你的选择以及每种选择的风险和益处。每年重新审视你的选择。你的需求和治疗选择可能会改变。

More Information 更多信息¶

Clinical trials 临床试验¶

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
探索梅奥诊所测试新治疗方法、干预措施和检测方法的研究，以此作为预防、检测、治疗或管理该疾病的方法。

Lifestyle and home remedies¶

生活方式和家庭疗法

Many of the symptoms menopause causes go away on their own in time. In the meantime, the following might help:
许多更年期引起的症状会随着时间的推移自然消失。在此期间，以下方法可能会有所帮助：

Cool hot flashes. Dress in layers, wear sleeveless tops and wear fabrics that breathe, such as cotton. Lower room temperatures and use hand or room fans. Put cold packs under your pillow and turn the pillow often so your head is on the cool side.
凉热潮涌。穿着多层衣物，穿无袖上衣，选择透气的面料，如棉质材料。降低房间温度，使用手持风扇或房间风扇。在枕头下放冰袋，并经常翻动枕头，使头部放在较凉的一侧。

It might also help to avoid triggers such as caffeine, alcohol and spicy foods.
这可能也有助于避免触发因素，如咖啡因、酒精和辛辣食物。 - Ease vaginal pain. Try a water-based vaginal lubricant (Astroglide, Sliquid, others) or a silicone-based lubricant or moisturizer (Replens, K-Y Liquibeads, others). You can get these without a prescription.
缓解阴道疼痛。尝试使用水基润滑剂（如 Astroglide、Sliquid 等）或硅基润滑剂或保湿剂（如 Replens、K-Y Liquibeads 等）。这些产品无需处方即可获得。

Stay sexually active by yourself or with a partner. This also can ease vaginal discomfort by increasing blood flow to the vagina.
保持自己或与伴侣进行性活动。这还可以通过增加阴道的血流来缓解阴道不适。 - Get enough sleep. Skip caffeine and alcohol, which can make it harder to sleep. Exercise during the day, but not right before bedtime. If hot flashes disturb your sleep, find a way to help manage them so you can get better rest.
获得足够的睡眠。避免咖啡因和酒精，因为它们会让人更难入睡。白天锻炼，但睡前不要进行。如果潮热影响你的睡眠，找到方法来帮助管理它们，以便你能更好地休息。 - Find ways to relax. There's little proof that deep breathing, guided imagery, massage and muscle relaxation can ease menopausal symptoms. But finding ways to relax is good for overall health and may help you cope with menopausal symptoms. You can learn how through books and websites.
寻找放松的方法。几乎没有证据表明深呼吸、指导性想象、按摩和肌肉放松可以缓解更年期症状。但是找到放松的方法对整体健康有益，可能有助于你应对更年期症状。你可以通过书籍和网站学习如何做到这一点。 - Strengthen your pelvic floor. Pelvic floor muscle exercises, called Kegel exercises, can improve some forms of urinary incontinence.
加强你的盆底肌。称为凯格尔运动的盆底肌肉锻炼可以改善某些形式的尿失禁。 - Eat a balanced diet. Include a variety of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars. Ask your healthcare professional if you need calcium or vitamin D supplements.
吃均衡的饮食。包括各种水果、蔬菜和全谷物。限制饱和脂肪、油和糖的摄入。如果你需要钙或维生素 D 补充剂，请咨询你的医疗保健专业人士。 - Manage weight. Studies show that being obese is linked to having more and worse hot flashes. Losing weight and keeping it off may help ease them. Talk with your healthcare professional if you need help losing weight.
管理体重。研究表明，肥胖与更频繁和严重的潮热有关。减轻体重并保持下去可能有助于缓解潮热。如果您需要帮助减轻体重，请与您的医疗保健专业人士讨论。 - Don't smoke. Smoking increases your risk of heart disease, stroke, osteoporosis, cancer and a range of other health problems. It also may increase hot flashes and bring on earlier menopause.
不要吸烟。吸烟会增加你患心脏病、中风、骨质疏松症、癌症以及一系列其他健康问题的风险。它还可能增加潮热并导致更年期提前到来。 - Exercise regularly. Get regular physical activity or exercise on most days to help protect against heart disease, diabetes, osteoporosis and other conditions associated with aging.
定期锻炼。大多数日子都要进行规律的体力活动或锻炼，以帮助预防心脏病、糖尿病、骨质疏松症和其他与年龄有关的疾病。

Alternative medicine 替代医学¶

There are many alternative medicines that claim to help ease the symptoms of menopause. But few of them have been proved in studies. Some complementary and alternative treatments that have been or are being studied include:
有许多替代药物声称可以帮助缓解更年期症状。但其中很少有在研究中得到证实。一些正在研究的补充和替代疗法包括：

Plant estrogens, also called phytoestrogens. There are natural estrogens in certain foods. There are two main types of phytoestrogens, called isoflavones and lignans. Soybeans, lentils, chickpeas and other legumes have isoflavones. Flaxseed, whole grains and some fruits and vegetables have lignans.

It hasn't been proved that the estrogens in these foods can ease hot flashes and other menopausal symptoms. Isoflavones have some weak estrogen-like effects. So if you've had breast cancer, talk with your healthcare provider before taking isoflavone pills. - Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically the same as those the body makes.

The Food and Drug Administration (FDA) has approved some bioidentical hormones. But many are mixed in a pharmacy from a healthcare professional's prescription, called compounded. But the FDA doesn't regulate them, so quality and risks could vary.

Bioidentical hormones have not been shown to work better or be safer than other hormone therapy. - Cognitive behavior therapy. This type of therapy can help you change thoughts, feelings and behaviors that aren't healthy. It's been shown to reduce how much menopause symptoms bother you. - Black cohosh. Black cohosh has been popular among many people with menopause symptoms. But there's little proof that black cohosh works. And it can harm the liver and not be safe for people with a history of breast cancer. - Yoga. Yoga might ease menopause symptoms at least as well as other forms of exercise. And balance exercises such as yoga or tai chi can improve strength and help you move better. That may help prevent falls that could lead to broken bones. - Acupuncture. Acupuncture may help to reduce hot flashes in the short term. But research hasn't shown that it helps a lot. More research is needed. - Hypnosis. This mind-body therapy involves a deeply relaxed state and mental images. Hypnotherapy may lower the number of hot flashes and how bad they are for some menopausal people.

You may have heard of or tried other dietary supplements, such as red clover, kava, dong quai, DHEA, evening primrose oil and wild yam, a natural progesterone cream. There's no scientific proof that they work. Some of these products may be harmful.

Talk with your healthcare professional before taking any herbal or dietary supplements for menopause symptoms. The FDA does not oversee herbal products. Some can be harmful or affect other medicines you take, putting your health at risk.

Preparing for your appointment¶

Your first appointment will likely be with your primary healthcare professional or a gynecologist.

What you can do¶

Before your appointment:

Keep track of your symptoms. For instance, make a list of how many hot flashes you have in a day or week. Note how bad they are.
Make a list of all medicines, herbs and vitamin supplements you take. Include the doses and how often you take them.
Ask a family member or friend to go with you, if possible. Someone with you can help you remember what your healthcare team tells you.
Write down questions to ask your healthcare team. List your most important questions first.

Some basic questions to ask include:

What tests do I need, if any?
What treatments are there to ease my symptoms?
What else can I do to ease my symptoms?
Are there alternative therapies I might try?
Are there any printed materials or brochures I can have?
What websites do you suggest?

Be sure to ask all the questions you have.

What to expect from your doctor¶

Some questions your healthcare team might ask include:

Are you still having periods?
When was your last period?
How often do you have symptoms that bother you?
How bad are your symptoms?
Does anything seem to make your symptoms better?
Does anything make your symptoms worse?

Aug. 07, 2024