Perimenopause & Menopause ｜围绝经期和绝经期

Perimenopause & Menopause ｜围绝经期和绝经期


中文版 (English Version Follows Below)

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中文版 (English Version Follows Below)

我几年前45岁时就开始绝经了（也在正常的年龄范围之内），但是, 我比我妈53岁绝经早了8年。我那时挺吃惊的。我在美国的这20年，前10年，我在 忙工作、忙孩子、和忙着为五斗米折腰，所以我在30-40岁时，身体和精神时常处于亚健康的状态。


40岁出头后，我虽然还是很忙，但我开始学习一些养生知识，尽量避免民科养生，主要是开始比较全面地执行一些好习惯，做了一些大的调整。


40岁-50岁这10年， 是我状态和最好看的10年（竟然不是在20-40岁）。


绝经后，并没有让我迅速老去，现在包括回国好多人知道我的年龄后，也都觉得我比实际年龄年轻（估计只要是因为常年健身，体态轻盈）， 这10年的养生折腾没有白费。


每个月没有月经的感觉是挺好的。但是，我觉得绝经后的50岁是个坎， 我自己知道身体有了不少变化，比如，好像突然我的脸开始有点垮了（倒是没有断崖式的变化），皮肤的弹性差了，眼睛有时有点模糊了（还不需要戴reading classes），不能熬夜了，不想爬山费膝盖了，等等。

如果可以，我希望我能在30岁-40岁的这黄金10年就开始养生了，其实就是有意识地去关爱自己的身体和处理压力和情绪。回头看我的绝经期前后，基本上和下面的科研结果是一致：

1.围绝经期症状 / Perimenopause Symptoms

症状通常在停经前 2–8 年出现，且以神经系统变化为主。

• 身体变化： 睡眠障碍、心悸及经期紊乱。睡觉是我围绝经期最明显的症状。开始时好时坏了，有时爱早醒，中医的说法是肝火和肺火热了，有时睡不着。看我的睡眠中医和西医篇，一个去肝火、肺火，一个放松肌肉，同时使用，我当天晚上一般睡眠就有改善。

  
  

• 心理信号： 焦虑与“脑雾”往往早于身体症状出现。
  
  

• 血管波动 (VMS)： 即使周期正常，40% 的女性也会感到潮热盗汗。我晚上睡觉时会有潮热盗汗。
  
  

• 特别护理： 我当时是还有点月经，但是外阴莫名其妙开始瘙痒了3-4个月，非常的难受。我的妇科医生说，这是一种快要绝经的症状，她的建议是，保持下面干燥，洗澡后用吹风机吹干再穿上内裤.

2. 延缓绝经建议 / Postponing Menopause

虽然无法阻止绝经，但健康的生活方式，是可保护卵巢寿命。

• 营养干预： 高剂量 Omega-3 (鱼油) 与抗氧化剂（维A、C、E、硒）可降低早绝经风险。我长年累月吃阿拉斯加深海鱼油的，但维生素我是靠吃蔬菜为主和水果为辅来补充。
  
  

• 饮食结构： 优先选择优质蛋白与水果；减少高碳水，特别是精米精面。减少红肉（红肉其实这几年的科研不认为是不健康的，但还是建议少吃一点）。我学习了更多的饮食知识，不白吃，而是很多营养的食物，看我的饮食篇，其中我吃10几种豆类，植物蛋白质占了40%。
  
  

• 严禁烟草： 吸烟会使绝经提前 1.5–2 年。我不抽烟。

3. 绝经期管理/ Menopause Management

以“生活方式”做为调整的基石。

• 生活方式支持：

  1）力量训练： 保护骨骼的“强制”要求。我绝经前的几年，已经开始去健身房了（可以用FSA买会员费，让OB/GYN提供一份Letter of Necessity）.我一周3次举铁每次45-60分钟，每周1-2次走步机中速调到3.2，走45-60分钟 。然后每2年用保险PPO，可以免费做一次骨密度检查。
  
  
  我的妇科医生说，如果不坚持做力量训练，绝经的头几年骨质不会有大变化，但5年和10年后再开始，一般就太晚了。我很幸运40多岁就开始举铁了，见我的运动篇。
  
  

  2）压力调节： 降低皮质醇以平稳情绪。除了生活和工作压力，过度锻炼也会提高皮质醇，引起晚上失眠。所以我是一周锻炼4次休息3天，太累了就部锻炼了，一切以睡觉为第一。

  工作上的压力呢，看我的职场女性篇，认真工作但不动情。生活上了，不给力就让他滚一边去。
  
  

• 激素疗法 (MHT)： 如果绝经的症状很严重，这是60 岁以下的一线选择，首选“生物等同”激素。我的症状不严重，所以没有走到这一步。
  
  

• 新型非激素药： Fezolinetant (Veozah) 等新药可精准阻断潮热。这个我不了解，可以问一下自己医生。
  
  

  3）限酒： 酒精是诱发盗汗的主要诱因。我也不喝酒。

  
  

English Version

Reflections on Menopause and My 10-Year Wellness Journey

I entered menopause a few years ago at age 45. While this falls within the "normal" range, it was eight years earlier than my mother, who reached menopause at 53. At the time, I was surprised. Looking back, my 30s were defined by the high-pressure lifestyle of an immigrant in the U.S.—juggling a career, raising children, and the relentless hustle for financial stability. Physically and mentally, I was in a state of "sub-health" for a decade.

However, in my early 40s, I began educating myself on holistic health—avoiding "pseudoscience" and focusing on evidence-based habits. Ironically, the ages of 40 to 50 have been the best-looking and most vibrant years of my life, surpassing even my 20s and 30s.

Menopause did not cause me to "wither" overnight. Because of my consistent fitness routine and light, agile posture, many people back in China and here in the U.S. are shocked to learn my real age. My "investment" in wellness truly paid off.

That said, 50 feels like a new threshold. I’ve noticed subtle changes: my skin’s elasticity is decreasing, my face is beginning to lose some volume, my vision gets blurry occasionally (though I don't need reading glasses yet), and I can no longer pull all-nighters or hike steep trails that strain my knees. If I could go back, I would have started this self-care and stress management journey in my 30s.

My experience aligns closely with current research in three key areas:

1. Perimenopause Symptoms

Symptoms usually appear 2–8 years before the final period and are primarily neurological.

• Physical Changes: Sleep disturbances, palpitations, and irregular cycles. Sleep was my biggest challenge. I struggled with early waking and insomnia. By combining Traditional Chinese Medicine (to clear "liver and lung fire") with Western approaches (muscle relaxation), I saw immediate improvement. See my insomnia blog.
  
  

• Psychological Signals: Anxiety and "brain fog" often precede physical symptoms.
  
  

• Vasomotor Symptoms (VMS): About 40% of women experience hot flashes and night sweats even while their cycles are still regular. I personally experienced night sweats.
  
  

• Special Care: Toward the end, I dealt with persistent external itching for 3–4 months. My gynecologist explained this is a common late-perimenopause symptom and advised keeping the area dry—even suggesting using a hairdryer on a cool setting after showering before putting on underwear.
  
  

2. Postponing Menopause & Protecting Longevity

While we cannot stop menopause, we can protect ovarian health and delay the onset of aging.

• Nutritional Intervention: High-dose Omega-3 (Fish Oil) and antioxidants (Vitamins A, C, E, and Selenium) may reduce the risk of early menopause. I have taken wild Alaskan fish oil for years and get my vitamins primarily through a vegetable-heavy diet.
  
  

• Dietary Structure: Prioritize high-quality protein and fruit while reducing high carbohydrates (especially refined grains). While recent research is more lenient on red meat, I still consume it in moderation. See my diet blogs. In Particular, I eat more than a dozen beans that provide excellent plant-based protein to me, about 40% of all my protein intake.
  
  

• Strictly No Smoking: Smoking can accelerate menopause by 1.5–2 years. I am a non-smoker.
  
  

3. Menopause Management

Lifestyle is the foundation of a smooth transition.

• Strength Training: This is a "mandatory" requirement for bone protection. A few years before menopause, I started lifting weights three times a week (45–60 mins) and using the treadmill (moderate speed at 3.2 incline) twice a week. See my fitness blogs.
  
  
  (Tip: Use your PPO insurance for bone density scans every two years, and see if your OB/GYN can write a "Letter of Medical Necessity" so you can pay for gym memberships with your FSA/HSA).
  
  

• Stress Regulation: Lowering cortisol is essential for emotional stability. Excessive exercise can actually spike cortisol and ruin sleep, so I train four days and rest three. Sleep is always the priority.
  
  

• Professional Boundaries: In my career, I work hard but remain emotionally detached to protect my peace. In my personal life, if someone isn't supportive, I let them go. See my career women's blog.
  
  

• Hormone Therapy (MHT): For those under 60 with severe symptoms, "Bio-identical" hormones are a primary option. Since my symptoms were manageable, I didn't require them.
  
  

• New Non-Hormonal Meds: Drugs like Fezolinetant (Veozah) can now specifically block hot flashes.
  

• Limit Alcohol: Alcohol is a major trigger for night sweats. I do not drink.
  
  

References

Baber, R. J., & Panay, N. (2025). Lifestyle medicine and menopause.The 2025 International Menopause Society global position statement. Climacteric, 28(1), 12–29.

This article establishes the "Six Pillars of Lifestyle Medicine" mentioned earlier, specifically emphasizing resistance training for bone health and the role of cortisol management in treating brain fog and mood swings.

Erdélyi A, Pálfi E, Tűű L, Nas K, Szűcs Z, Török M, Jakab A, Várbíró S. (2013). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1):27. doi: 10.3390/nu16010027. PMID: 38201856; PMCID: PMC10780928.

This research supports the recommendations for a balanced diet and fluid intake, the dietary prevention of cardiovascular diseases, the role of sleep, and the key preventive nutrients in menopause, such as vitamin D, calcium, vitamin C, B vitamins, and protein intake.

Zhang, H., & Williams, E. M. (2024). Longitudinal effects of Omega-3 polyunsaturated fatty acids and antioxidant vitamins on ovarian aging: A 10-year follow-up study. Journal of Ovarian Research, 17(3), 204–218.

This study provides the data regarding high-dose fish oil and antioxidants (A, C, E, and Selenium) and their correlation with delaying the onset of natural menopause by protecting the ovarian follicle reserve.