Patient's question:
This year, I am 43 years old, and I have been postmenopausal for three years. A year ago, I started experiencing insomnia. Later, I began to be suspicious, irritable, prone to getting angry, and constantly overthinking, to the point where I couldn't control myself. My mind was filled with thoughts that I couldn't get rid of. I would like to ask the experts, what is this condition, how should it be treated, and what medication should be used?Doctor's answer:
Hello, when women reach around the age of 45, their ovarian function gradually declines, leading to menstrual irregularities, such as infrequency or cessation. During this period, due to the body temporarily not adapting well, a series of symptoms and signs appear, known as menopausal syndrome. Menopause is a stage that every woman must go through, but not every woman will experience menopausal syndrome. Only some women, due to poor psychological and physiological adaptability, may develop symptoms of menopausal syndrome, such as restlessness, depression, fatigue, palpitations, headaches, insomnia, difficulty concentrating, and others. This period typically lasts for about six months to three years.The human body needs a self-regulating adaptation phase during menopause. During this time, it is important to maintain a well-structured lifestyle, ensure adequate sleep, and correctly address the physical changes that occur during menopause, without overly worrying about the discomforts of menopause. Generally, special treatment is not required. If the symptoms are more pronounced, such as headaches, dizziness, insomnia, or emotional instability, symptomatic treatment with sedatives or hypnotic drugs may be used. For example, diazepam at a dose of 2.5–5 mg, taken three times daily, or 5–10 mg taken once before bedtime. Gamma-oryzanol has a regulatory effect on the function of the autonomic nervous system and is commonly used at a dose of 10–30 mg, taken three times daily. Vitamin B6, vitamin E, and compound vitamin B can also be used as appropriate. Alternatively, oral traditional Chinese medicine such as Menopausal Comfort Tablets (3 tablets per dose, three times daily) or Schisandra Syrup or Modified Xiaoyao Pills can also be effective in alleviating symptoms.
If the symptoms of menopausal syndrome are severe and do not improve with the above treatments, or if vaginal infections and sexual dysfunction occur due to declining estrogen levels, estrogen supplementation may be appropriately administered to alleviate some menopausal symptoms. However, long-term estrogen use can stimulate endometrial growth and increase the risk of cancer, so it should be used with caution.