There’s a lot of mystery and confusion surrounding menopause.
围绕更年期有许多谜团和困惑
So I’m gonna take the next few minutes to tell you
所以接下来我要花几分钟告诉你
exactly what’s happening in our bodies when we go through it.
更年期时 我们的身体里到底发生了什么
You can almost think of menopause as puberty in reverse.
你大致可以把更年期看作反向的青春期
[Body Stuff with Dr. Jen Gunter]
和珍·甘特博士一起聊聊身体那些事儿
[Made possible with the support of OURA]
感谢OURA 的大力支持
Hey, it’s your favorite ob-gyn,
嘿 这里是你最爱的妇产科医师
and I’m here today to talk about a subject that I find truly fascinating:
今天我们来聊一个我认为格外有趣的话题：
menopause.
更年期
Chances are you probably don’t find it quite as gripping as I do,
你可能不会像我一样觉得它很吸引人
but I promise that if you can get past the horror stories,
但我保证 如果你能摆脱那些恐怖的描述
you’ll be riveted too.
你也会被吸引
Whether you’re going through it or know someone who is,
不管是你正在经历这一时期 还是你认识的人
you’ll recognize there’s nothing to fear.
你会发现没什么好怕的
So what exactly is menopause?
所以更年期到底是什么？
Technically, “menopause” is diagnosed
严格来说 绝经的一年后
one year after the final period,
会进入“更年期”
but most people use it to refer to
但是大多数人用它来描述
the entire span of time when our menstrual cycle is changing in length,
女性月经周期时长发生改变的一整段时间
a process that lasts several years,
这一过程会持续数年
and then all the time afterwards.
还包括在那之后的所有时间
So it’s best to think of menopause as a continuum,
所以最好把更年期当做一个持续的过程
starting years before,
它开始于数年前
during what is called the menopause transition.
这期间被称为绝经过渡期
Just like puberty, the process happens over many years.
和青春期一样 这个过程会持续很多年
The menopause transition is one bookend of our reproductive cycle,
绝经过渡期是我们生殖周期的一端
opposite puberty.
另一端是青春期
When we’re born,
出生的一刻
we actually have all the eggs we’re ever going to make,
我们能产生的所有卵细胞其实就确定了
about one to two million of them,
大约有一到两百万
unmatured and encased in follicles in the ovaries.
它们尚未成熟且被包裹在卵巢的卵泡中
Around the age of eight to 10,
在八岁到十岁左右
the hypothalamus, a region in your brain,
下丘脑 大脑中的一个区域
starts releasing a hormone
开始释放一种激素
that essentially wakes up those dormant eggs,
它会将休眠的卵子基本唤醒
beginning the monthly cycles of ovulation.
开始每月一次的排卵周期
This is what increases production of a class of hormones
这一过程会产生更多这类激素
you’ve probably heard about — estrogen.
你可能听说过它——雌激素
Estrogen, along with other hormones,
雌激素和其他激素一起
begins a delicate hormonal dance that, once a month,
每月会有一场别致的激素之舞
results in the most mature egg leaving its follicle
结果导致最成熟的卵子离开卵泡
and traveling down a fallopian tube.
沿着输卵管一路前行
The body builds up the lining in the uterus, the endometrium,
子宫内会形成一层膜 即子宫内膜
to house the egg,
来容纳这些卵子
and if the egg isn’t fertilized,
如果卵子没有受精
the lining sheds, and we have our period.
内膜会脱落 我们就会来月经
This cycle repeats over and over and over, for decades.
这个周期会一直循环下去 持续好几十年
On average, sometime in the mid-forties,
平均来说 通常在四十五六岁左右
ovulation starts to get erratic.
排卵过程会开始变得不规律
We just don’t have as many eggs,
我们没有那么多的卵细胞
and the ones that remain may not be as healthy anymore.
而留下来的可能不再那么健康
Estrogen can be lower some cycles,
雌激素在某些周期可能较低
and even higher during others.
而在其它周期却很高
This is the menopause transition
这就是绝经过渡期
hormonal chaos, like puberty,
荷尔蒙紊乱 就像青春期一样
only this time, when estrogen levels stabilize,
只是这一次 当雌激素水平稳定时
they’ll be much lower than they were before.
它们会比以前低很多
This very normal decrease in estrogen and other hormonal changes
这种十分正常的雌激素减少及其它激素变化
does come with medical concerns,
确实会带来健康问题
such as osteoporosis, heart disease,
比如骨质疏松症 心脏病
diabetes and vaginal dryness.
糖尿病以及阴道干燥
Some of us are lucky and we will have no or mild symptoms.
有些人比较幸运 没有症状或很轻微
Others will experience trouble sleeping, irritability,
另一些人可能会经历睡眠障碍 易怒
depression or decreased sex drive.
情绪低落或者性欲下降
And then there’s the most classic symptom, hot flushes.
此外 最典型的症状是潮热
They’re a wave of heat
就像是一阵热浪
that makes it feel like the furnace just got cranked up on the inside.
仿佛体内有个火炉被点燃
Scientists aren’t completely sure why this happens,
科学家们还不完全确定为什么会发生潮热
but the resulting heat makes you feel sweaty and off-kilter.
但由此产生的热量会让你感到汗湿和不适
Some women even have symptoms that overlap with anxiety,
有些女性甚至会伴随着焦虑的症状
like nausea and palpitations.
比如恶心和心悸
But for me, it feels as if I’ve had too much to drink.
但对我来说 潮热的感觉就像是喝多了
Those are some of the negatives,
以上都是更年期的消极影响
but there are positives too.
但是也有一些积极影响
After menopause, you don’t have to worry about periods or cramps,
绝经后 你不必担心月经或痛经
and people who partner with men who make sperm
伴侣还没绝精的人
don’t have to be concerned about unintended pregnancy.
也不用担心会意外怀孕
You’re through all that.
所有这些不必再担心了
To me, menopause is something we go through,
要我说 更年期是我们必须经历的
like puberty.
就像青春期
And like puberty, there’s a range of experiences.
而且和青春期一样 你也会有一系列的经历
We continue to make vital contributions to society after menopause.
更年期后 我们会继续为社会做出重要贡献
It’s not your dotage.
这并不是你的衰老期
Your worth has nothing to do with your ovaries.
你的价值与你的卵巢无关
So let’s say you’re in the menopause transition.
所以假设你正处于绝经过度期
What are the best things you can do?
你能做的最好的事是什么呢？
If you’re suffering, there’s almost always some kind of help.
如果你正饱受折磨 总会有些东西帮得到你
If you smoke, definitely try to quit.
如果你抽烟 绝对要戒掉
It will reduce your risk of heart disease,
这能降低你得心脏病的风险
it might also reduce some symptoms of menopause.
可能也会减少一些更年期症状
Reducing stress and getting enough sleep is also good.
减少压力以及睡眠充足也有好处
Focus on eating a healthy, balanced diet
专注健康均衡的饮食
rich in calcium and vitamin D for healthy bones,
补钙和维生素D有助于骨骼健康
and try to get at least 150 minutes
每周尽量保证至少150分钟的
of moderate physical activity a week,
适度的体育运动
especially if it’s weight-bearing exercises,
尤其是一些负重运动
like hiking, dancing or jogging.
比如徒步旅行 跳舞或者慢跑
If you’re losing sleep or having hot flushes,
如果你失眠或者正在经历潮热
or experiencing other symptoms that affect your quality of life,
或者有其它影响你生活质量的症状
talk to your doctor.
和你的医生聊聊
Don’t rely on wearable magnets or so-called compounded hormones.
不要依赖可穿戴磁铁或所谓的复合激素
These are unproven and have risks.
这些都是未经证实的 会有风险
There are a variety of proven options,
有很多种经过证实的选择
from cognitive behavioral therapy to FDA-approved estrogen,
比如认知行为疗法到FDA批准的雌激素
and some nonhormonal medications that can be very helpful.
以及一些非激素药物 都能取得很好的效果
There are so many permutations and combinations of options
有很多种组合方案可以选择
that safe therapy can be customized for almost every woman.
几乎可以为每位女性定制安全疗法
One more idea, have a mantra ready.
还有个建议 准备一句自我激励的话
When I get a hot flush, sometimes I tell myself
当我感到潮热 有时候我会告诉自己
I’m feeling this because women have evolved
我之所以有这种感觉是因为
to drive humanity forward.
女性已经进化到可以推动人类前进
This is a sign of my strength.
这是我力量的标志
And then, I can make it until it goes away.
然后 我就能泰然处之直到潮热消失