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            <div class="desc">我发布了一篇文章</div>
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守护她健康︳女性的围绝经期保健

<div class="creator-platform-content"><p> 女性的一生，根据生理特征和各个发育阶段性激素的不同，分成6个阶段：新生儿期、儿童期、青春期、性成熟期、绝经过渡期和绝经后期。卵巢功能衰退以后，女性进入了围绝经期，雌孕激素水平下降，导致女性卵巢功能紊乱，并带来月经失调等等。最后一次月经来潮以后就叫绝经，此后的人生就进入了绝经后的时期。</p><p><strong>一、围绝经期的定义</strong></p><p> 1994年WHO对围绝经期做出定义，是指女性卵巢功能开始衰退一直到最后一次月经以后一年的一个时间段，就叫围绝经期。</p><p><strong>二、围绝经期的症状</strong></p><p><strong>近期症状：</strong></p><p>○月经失调，绝经前半数以上妇女出现月经紊乱；</p><p>○血管舒缩，主要表现为潮热、盗汗、失眠、心悸等，是围绝经期最常见的症状；</p><p>○精神症状，主要表现为睡眠障碍，易激惹，忧郁等情绪变化。</p><p><strong>远期危害：</strong></p><p>○骨质疏松：骨质丢失速度快于骨质生成，促使骨质丢失变为疏松，易骨折；</p><p>○泌尿生殖道萎缩症状：主要表现为尿失禁，阴道干燥，性交困难等；</p><p>○心脑血管疾病：由于雌激素水平低下，血胆固醇水平升高，各种脂蛋白增加，易发生动脉粥样硬化，心肌缺血，心梗、高血压和脑卒中等心脑血管疾病。</p><p><strong>三、围绝经期的临床问题</strong></p><p>围绝经期在临床上所要解决的一些问题，主要是两方面：</p><p>第一，孕激素缺乏或孕激素合成不足引起的异常子宫出血；</p><p>第二，雌激素波动或减少引起的一系列临床症状；</p><p>第一种需要进行AUB-O处理（异常子宫出血处理）</p><p>第二种需要进行MHT的优化（绝经激素治疗）</p><p><strong>四、绝经激素治疗（MHT）的说明</strong></p><p><strong>适应证：</strong></p><p>▽绝经相关症状：月经紊乱、潮热、多汗、睡眠障碍、疲倦、情绪障碍（如易激动、烦躁、焦虑、紧张、低落）等；</p><p>▽生殖泌尿道萎缩的相关问题（包括GSM）：阴道干涩，外阴阴道疼痛，性交痛，反复发作的萎缩性阴道炎，反复下尿路感染，夜尿、尿频、尿急等；</p><p>▽低骨量及骨质疏松症：存在骨质疏松症的危险因素及绝经后骨质疏松症，MHT可作为预防年龄＜60岁及绝经10年内女性骨质疏松性骨折的一线方案选择；</p><p>▽过早的低雌激素状态：如POI、下丘脑垂体性闭经、手术绝经等，更早出现雌激素下降，风险更大。</p><p><strong>禁忌证：</strong></p><p>▽已知或可疑妊娠；</p><p>▽原因不明的阴道流血；</p><p>▽已知或可疑患有乳腺癌；</p><p>▽已知或可疑患有性激素依赖性恶性肿瘤；</p><p>▽最近6个月内患有活动性静脉或动脉血栓栓塞性疾病；</p><p>▽严重肝肾功能不全。</p><p><strong>用药时机：</strong></p><p>▽月经开始紊乱，出现更年期症状时；</p><p>▽绝经10年内或年龄＜60岁： 60岁后 MHT组的血管事件风险高于安慰剂组；最好避免65岁以上绝经后女性使用MHT。</p><p><strong>用药原则、获益与风险：</strong></p><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549482045448.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p></p><p><strong>MHT个性化方案：</strong></p><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549484365192.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p></p><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549485266952.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549486349512.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p><strong>五、围绝经期健康管理</strong></p><p>○定期普查：定期进行妇科病及肿瘤的普查，门诊随访</p><p>○健康宣教：科普妇科疾病相关的预防知识、对相关疾病树立正确认识、家庭支持……</p><p>○药物指导：必要时MHT，避免长期服用广谱抗生素</p><p>○生活方式：合理膳食、规律运动、增加社交脑力活动、戒烟限酒、重视个人卫生、充足睡眠、保持心情舒畅……</p><p><strong>六、合理膳食</strong></p><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549487438660.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p></p><p><strong>七、规律运动</strong></p><p></p><img src="https://mc-gxlmmz-public.8531.cn/11549488638148.png?x-oss-process=image/watermark,g_se,x_0,y_0,image_MTE1NDk0OTA0MDg0NTYucG5nP3gtb3NzLXByb2Nlc3M9aW1hZ2UvcmVzaXplLFBfNTA"><p></p><p><strong>八、围绝经期的健康保健</strong></p><p>总目标：提高妇女生活质量、减少疾病、促进健康。</p><p>○合理安排工作生活，保持心情愉快和适量的运动</p><p>○饮食方面一定要注意营养搭配，足够的能量以及维生素、蛋白质、微量元素的摄入</p><p>○要定期体格检查，尤其是关注为绝经期的异常子宫出血和绝经后的出血，防治绝经综合症、骨质疏松和心血管的问题</p><p>&nbsp;</p><p><strong>结语：</strong>女性一生的每一个阶段，都是非常美好的，脆弱的围绝经期更应该得到关注和呵护。这里我们也期待和希望围绝经期的广大女性姐妹们人人都能够度过一个舒适、愉快、安全的特殊生命历程。愿人人健康无忧，谢谢！</p></div>