Menopause is a natural stage in women's lives, typically occurring between the ages of 45 and 55. It marks the end of the reproductive period and the start of the aging process. Menopausal Syndrome (MPS) refers to a series of physical and psychological symptoms triggered by fluctuating or declining sex hormone levels due to ovarian dysfunction during this phase. With the acceleration of global aging, the number of postmenopausal women worldwide is expected to reach 1.1 billion by 2025, including 280 million in China. Meanwhile, iatrogenic menopause has become an increasingly prominent issue. Current international guidelines are mainly developed for European and American women, while Chinese women have insufficient awareness of menopausal health. They struggle to accurately identify their own symptoms and lack scientific self-management awareness. This consensus aims to provide women with scientific and practical knowledge on menopausal self-management. Menopause is a new starting point in women's life journey. By learning more relevant knowledge, women can navigate menopause more smoothly and healthily.
I. Symptoms of Menopausal Syndrome
01 Physical Symptoms
(1) Muscle and joint pain: Over 70% of menopausal women develop osteoporosis and osteoarthritis due to decreased estrogen levels, leading to muscle and joint pain. Among them, 25% experience severe functional impairment [1]. Common manifestations include morning stiffness, joint swelling, and limited mobility, especially in weight-bearing joints such as the knees and hips.
(2) Hot flashes and night sweats: Hot flashes are one of the most common menopausal symptoms. They typically present as a sudden feeling of heat spreading from the chest to the face and entire body, often accompanied by sweating and palpitations. Night sweats refer to sweating during sleep, usually associated with poor sleep quality. Over 50% of menopausal women experience these symptoms, with an average duration of 2.6 years [2].
(3) Palpitations: Due to fluctuating estrogen levels during menopause, some women may experience palpitations, characterized by irregular heart rhythms or tachycardia. Women with a lower body mass index (BMI) have a lower risk of palpitations, while the proportion is significantly higher among women with insomnia or depression [3].
(4) Urogenital symptoms: Genitourinary syndrome affects 50% to 70% of postmenopausal women, usually worsening with age. Symptoms include vaginal dryness, frequent urination, and urinary incontinence. Vaginal dryness can cause discomfort during sexual activity, while frequent urination and urinary incontinence impact daily quality of life.
(5) Breast pain: Some women may experience breast pain and increased sensitivity during menopause, which is usually related to hormonal fluctuations.
02 Psychological Symptoms
(1) Insomnia: Sleep disorders often manifest as difficulty falling asleep, easy awakening, and early awakening. If not relieved, they can develop into insomnia. Insomnia is defined as persistent sleep disturbances despite adequate sleep opportunities and environment, accompanied by daytime functional impairment, occurring more than 3 times a week for over 3 months [4]. Analysis shows that 50.8% of menopausal women have poor sleep quality [5], and the incidence of sleep disorders in women over 40 is about 4 times that of young women [6]. For Chinese women, the prevalence of insomnia symptoms begins to increase after 44 years of age and peaks at 52 [7].
(2) Mood swings: Initial manifestations include low mood and even helplessness, which may be associated with decreased estrogen levels. In addition, genetic and environmental factors, as well as comorbid chronic diseases, have a significant impact on mood. The incidence of depression during menopause is 3 times higher than before menopause. Women with a history of depression are nearly 5 times more likely to develop severe depression during menopause than before, especially those exposed to relevant risk factors [8-9]. However, for women with no prior history, emotions such as tension and anxiety tend to gradually ease with age [6].
(3) Memory loss and poor concentration: Some women experience memory loss and poor concentration during menopause, which are related to poor sleep quality and mood swings [10].
The above physical and psychological symptoms are common among most menopausal women. Some may have only one symptom, while others may experience several simultaneously. Self-management is required when any of the above symptoms appear, and professional medical help should be sought if necessary.
II. Self-Management of Menopausal Syndrome
01 Lifestyle Adjustments
(1) Quit smoking and limit alcohol: Smoking and excessive alcohol consumption increase the risk of cardiovascular diseases and osteoporosis and should be avoided as much as possible. Quitting smoking and limiting alcohol intake (adult women should consume no more than 15g of alcohol per day) also help alleviate menopausal symptoms.
(2) Regular daily routine:① Maintaining a regular schedule helps regulate the biological clock, improve sleep quality, and promote physical recovery and emotional stability.② Create a good sleep environment: Keep the bedroom quiet, dark, and at a suitable temperature during sleep to promote deep sleep and reduce nighttime awakenings.③ Pre-sleep relaxation activities: Engage in relaxing activities such as reading, listening to light music, or meditation to calm the mind and facilitate falling asleep.
(3) Reduce caffeine intake, especially in the afternoon and evening. Caffeine stimulates the nervous system, leading to difficulty falling asleep and anxiety.
02 Healthy Diet
(1) Balanced diet:① Eat more vegetables, low-sugar fruits, whole grains, and low-fat protein; reduce intake of sugar and saturated fats. A balanced diet not only provides essential nutrients but also helps maintain weight and reduce the risk of diabetes and cardiovascular diseases.② Diversify the diet: Include grains, vegetables, fruits, protein, and dairy products to avoid a single dietary pattern and ensure nutritional balance.③ Reduce high-sugar and high-fat foods: Limit saturated fatty acid intake to less than 7% of total calories, avoid trans fats and fried foods, and reduce animal fats.④ Eat more high-fiber foods such as whole grains, vegetables, and fruits to improve digestive function and prevent constipation.
(2) Supplement calcium and vitamin D: Calcium and vitamin D are crucial for bone health. Vitamin D supplements can only reduce the risk of fractures when combined with calcium, and the anti-fracture benefits are most significant in the elderly.① Calcium should first be supplemented through diet. Calcium-rich foods include dairy products, soy products, and dark green vegetables. The recommended daily calcium intake is 800mg for adults aged 18-49, and 1000mg for women over 50.② Vitamin D can be obtained through sun exposure and foods such as fish and egg yolks [11]. If insufficient, exogenous supplements are recommended. Menopausal women are advised to take 1000IU of vitamin D and 1000-1200mg of calcium supplements daily [12]. Professional medical guidance should be sought based on individual conditions if necessary.
(3) Maintain adequate hydration: Drinking 1500-1700ml of water per day supports various metabolic activities of the body. Special attention should be paid to avoiding dehydration after exercise and in hot weather.
03 Moderate Exercise
It is recommended to exercise 3-5 times a week for at least 30 minutes each time. Exercise intensity and duration can be increased gradually. A 5-10 minute warm-up should be performed before exercise, followed by 5-10 minutes of stretching for major muscle groups after exercise.
(1) Aerobic exercise: Menopausal women should maintain at least 150 minutes of moderate-intensity aerobic exercise per week [13], which helps improve cardiopulmonary function, enhance immunity, and alleviate anxiety and depression.
(2) Strength training (anaerobic exercise): Perform strength training at least twice a week to enhance muscle strength and maintain bone health. Strength training includes exercises using dumbbells, resistance bands, and body weight, helping to prevent muscle loss and osteoporosis.
(3) Flexibility and balance training: Activities such as yoga and tai chi improve flexibility and balance, relieve muscle tension, reduce the risk of falls and injuries, and enhance quality of life.
(4) Diversified exercise forms: Diversification avoids fatigue and burnout from a single exercise type. Regular outdoor activities increase sun exposure, helping the body synthesize vitamin D and promote bone health.
III. Regular Monitoring of Physical Changes
Physical fitness is an indicator of physical quality, mainly including: (1) Body shape (e.g., height, weight, and BMI); (2) Physical function (e.g., cardiopulmonary function, blood pressure); (3) Physical fitness (e.g., strength, endurance, flexibility). Regular assessment of physical changes helps understand whether health status and physical fitness are normal, enabling targeted interventions and seeking medical help if necessary.
00001.
BMI = weight (kg) / height (m)², the most practical indicator for judging obesity. The normal range is 18.5-24 kg/m². BMI < 18.5 kg/m² is underweight, 24.0-27.9 kg/m² is overweight, and BMI ≥ 28.0 kg/m² is obese.
00002.
00003.
Waist-to-hip ratio (WHR): The ratio of waist circumference (horizontal circumference at the umbilical center) to hip circumference (horizontal circumference at the most prominent part of the buttocks). The normal WHR for women is < 0.8; WHR > 0.8 indicates central obesity.
00004.
IV. Psychological Adjustment
Awareness of poor mental health during menopause needs to be improved. Not all mental health symptoms should be automatically attributed to menopause, as this assumption reinforces stereotypes about menopause.
(1) Maintain a positive attitude to cope with life changes. Pursue hobbies and seek social support to alleviate anxiety and depression, and enhance self-confidence and adaptability.
(2) Relaxation techniques: Yoga, meditation, and deep breathing exercises help relieve stress and improve sleep quality. Mindfulness interventions have been shown to improve vasomotor, neuropsychiatric, and genitourinary symptoms, as well as quality of life and overall well-being in menopausal women [14].
(3) Seek professional help: Consult psychologists or counselors for emotional management, self-psychological adjustment, and stress reduction to relieve pressure and prevent depression and anxiety [15].
V. Medical Management of Menopausal Syndrome
Menopause causes various related symptoms and increases the risk of metabolic diseases in women. The goal of medical management is to relieve symptoms while "preventing diseases before they occur," preventing chronic diseases in middle and old age, maintaining and promoting health, and improving quality of life [13].
01 Multidisciplinary Systematic Health Management
The essence of menopause is aging and ovarian dysfunction, leading to fluctuating and declining estrogen levels, which in turn cause systemic health problems.
(1) Cardiovascular health: Cardiovascular diseases are the leading health issue affecting menopausal women. The American Heart Association emphasized in 2020 that menopause is a major risk factor for cardiovascular diseases, and maintaining a healthy diet and moderate exercise is essential. Regular cardiovascular-related examinations such as blood pressure, blood lipid, and blood glucose tests, including vascular imaging, should be performed.
(2) Bone health: Decreased estrogen levels in menopausal women alter bone metabolism, leading to accelerated bone loss compared to men and an increased risk of osteoporosis. Bone mineral density decreases by about 1% per year after the age of 50. Regular bone density testing is recommended to take timely preventive and therapeutic measures, such as supplementing calcium and vitamin D, engaging in moderate weight-bearing exercises (muscle-building exercises), and conducting regular monitoring of bone metabolism indicators and bone density.
(3) Breast health: The risk of breast cancer increases in menopausal women. Annual breast examinations are recommended, including self-examinations and professional imaging tests such as breast ultrasound and mammography.
(4) Reproductive health: Menopause is associated with a series of reproductive health issues such as irregular menstruation and vaginal discomfort. There is still a risk of unintended pregnancy due to irregular ovulation. Timely medical consultation is required when such symptoms occur to rule out organic diseases and pregnancy, and receive prompt treatment. Contraception remains an important part of menopausal self-care, with barrier methods and progestin-releasing intrauterine systems recommended as the first choice [13]. Sexual health is also a key health issue. Harmonious sexual life is beneficial to physical and mental health, enhances marital relationships, and promotes family harmony. Women with vaginal dryness and decreased libido are advised to seek professional medical guidance [16].
02 Western Medicine Treatment
(1) Menopausal Hormone Therapy (MHT): MHT is the most effective drug treatment for menopausal health issues, including supplementation of estrogen, progestin, and tibolone. Rational use can effectively improve menopausal symptoms and have positive effects on bone loss and abnormal lipid metabolism caused by decreased estrogen levels [17]. The benefit-risk assessment, specific application forms, and long-term management plans of MHT must be conducted under the guidance of professional doctors [13]. The one-day menopausal clinic greatly simplifies the diagnosis and treatment process: patients visit the hospital in the morning to complete menopausal-related laboratory tests (including blood routine, blood biochemistry, sex hormones, gynecological ultrasound, breast ultrasound, and bone density), and in the afternoon, a systematic physical assessment is conducted based on test results to determine whether to initiate MHT [18].
(2) Principles of MHT use:① Consult a professional doctor: Relevant laboratory tests should be completed first, and a personalized MHT plan must be formulated by a doctor.② Understand risks and benefits: MHT may carry certain risks such as breast cancer and thrombosis. Menopausal women with a history or family history of thromboembolism, malignant tumors, obesity, antiphospholipid syndrome, autoimmune diseases, etc., should fully understand the benefits and risks of MHT under the interpretation and guidance of professional physicians to make an informed decision.③ Long-term management: Long-term management of MHT is necessary to monitor benefit-risk profiles, with regular follow-up to adjust treatment plans.
(3) Non-hormonal drug treatment: Plant-based drugs such as black cohosh and antidepressants (selective serotonin reuptake inhibitors) can be used to relieve hot flashes and mood swings.
03 Traditional Chinese Medicine (TCM) Treatment
Based on the theory of body-disease correlation, women with biased constitutions are more prone to menopausal syndrome. The integrated TCM and Western medicine approach of "preventing diseases before they occur" can be applied to the prevention and treatment of high-risk groups for menopausal syndrome. TCM and Western medicine can complement each other in menopausal health management.
(1) Chinese herbal medicine: TCM has a long history of treating menopausal symptoms, helping to regulate mood and improve sleep. TCM formulas regulate the body's balance as a whole, relieve discomfort, and have relatively low associated risks, with potential effects comparable to hormone therapy.
(2) Appropriate TCM techniques: Natural TCM therapies such as acupuncture, acupressure, massage, guasha (scraping therapy), and fire dragon cupping can improve qi and blood circulation by stimulating acupoints and meridians, relieve muscle and joint pain, and alleviate hot flashes.
VI. Preventive Management of Menopausal Syndrome
01 Advance Preparation
(1) Health knowledge reserve: Before entering menopause, actively learn about menopausal health knowledge and management methods to prepare for and cope with it calmly. At the same time, eliminate misunderstandings such as "menopause requires no intervention and should be left to nature" (ignoring symptoms may lead to long-term health risks) and "hormone therapy causes cancer" (standardized MHT does not increase the risk of breast cancer when contraindications are excluded).
(2) Improve self-care awareness: Proactively seek and participate in menopausal health education, formulate a self-management plan based on individual conditions, and continuously adjust and update it.
(3) Adjust lifestyle in advance: Adopt a balanced diet, moderate exercise, and quit smoking and limit alcohol to enhance the body's adaptability and prevent the occurrence of menopausal discomfort.
02 Seek Support
(1) Family support:① Understanding and tolerance: Family is an important support system for women. Family members should understand and tolerate the emotional changes and physical discomfort of menopausal women, providing emotional support.② Participate in health management: Family members can participate in women's health management, encouraging them to maintain a healthy lifestyle and improve adherence to health behaviors.
(2) Social support: Social support is a practical and effective strategy for menopausal health management.① Peer support: Exchange experiences and feelings with other menopausal women, form support groups, and face menopausal changes together. This can also reduce loneliness and provide emotional comfort and practical help.② Professional support: Seek professional support from doctors, psychologists, and health educators to obtain scientific health guidance and psychological help. Professionals can provide personalized health advice and psychological counseling, which is more efficient and targeted.
03 Attach Importance to Physical Examinations
(1) Health assessment: Physical examination and health assessment help women monitor their physical condition and detect potential health issues in a timely manner (such as monitoring body fat rate, waist-to-hip ratio, blood pressure, blood glucose, blood lipids, and bone density), enabling proactive prevention.
(2) Disease screening: Conduct screening and follow-up for diseases such as hypertension, thyroid diseases, diabetes, breast diseases, common gynecological diseases, tumors of various systems, and osteoporosis to prevent and control chronic diseases.
04 Early Intervention
(1) Timely identify and pay attention to early menopausal symptoms such as hot flashes, mood swings, and sleep disorders. Early intervention can reduce the severity of symptoms, prevent age-related diseases, and improve quality of life.
(2) When menopausal symptoms appear, consult doctors or health educators in a timely manner to obtain professional health guidance and advice. Health consultations can provide personalized recommendations to help women effectively prevent menopausal symptoms.
VII. Long-Term Management of Menopausal Syndrome
01 Establish a Health Record
(1) Establish a personal health record including menopausal-related content such as menstrual history, obstetric history, family genetic disease history, menopausal symptom scores, gynecological examinations, breast examinations, female hormone tests, and bone density tests. Incorporate family characteristics, living habits, medication use, and dynamic physical examination results to ensure a dynamic and continuous record, which is conducive to long-term health management.
(2) Use electronic health record systems to store, retrieve, and integrate health information, improving the efficiency and accuracy of medical services and providing comprehensive health management services.
02 Individualized Management
Continuously update personal health records.
(1) Update health education: Through continuous health education, continuously update women's health knowledge reserve and self-care capabilities, promote the development of healthy behaviors in different life stages, and help maintain a long-term healthy lifestyle.