What really happens to your body during menopause | Body Stuff with Dr. Jen Gunter

Transcriber:

There's a lot of mystery and confusion surrounding menopause,

譯者: Jessica Teng 審譯者: Zoe Walmsley

大家對更年期有許多迷思和困惑，

so I'm going to take the next few minutes

所以讓我花幾分鐘時間說明，

to tell you exactly what's happening in our bodies when we go through it.

我們的身體在更年期時 究竟產生了什麼轉變。

You can almost think of menopause as puberty in reverse.

你差不多可以將更年期 視為青春期的逆轉。

（音樂聲）

[Body Stuff with Dr. Jen Gunter]

《認識你的身體—珍·岡特醫師》

（音樂聲）

Hey, it's your favorite ob-gyn,

嗨！妳最喜歡的婦產科醫師又來了，

and I'm here today to talk about a subject that I find truly fascinating: menopause.

今天我想談一個我覺得 極有趣的話題：更年期。

Chances are you probably don't find it quite as gripping as I do,

妳很可能不覺得更年期有趣，

but I promise that if you can get past the horror stories,

但我保證，只要妳 不聽信一些恐怖說法，

you'll be riveted too.

妳也會發現它很有意思。

Whether you're going through it or know someone who is,

無論妳自己還是認識的人 正在經歷更年期，

you'll recognize there's nothing to fear.

妳就會知道其實沒有什麼好怕的。

So what exactly is menopause?

那究竟更年期是怎麼一回事？

Technically, "menopause" is diagnosed one year after the final period,

技術上而言，「更年期」是 最後一個經期結束後的一年，

but most people use it to refer to the entire span of time

但多數人用它來表示更長的一段時間，

when our menstrual cycle is changing in length,

從月經週期的長短開始變化，

a process that lasts several years,

這個階段可持續好多年，

and then all the time afterwards.

及這階段之後所有的時間。

So it's best to think of menopause as a continuum, starting years before,

所以最好把更年期想成 一個持續不斷的過程，

從歷時數年的「停經過渡期」開始。

during what is called the menopause transition.

Just like puberty, the process happens over many years.

跟青春期一樣， 這整個過程歷時許多年。

The menopause transition is one bookend of our reproductive cycle,

就像書架上的書檔， 停經過渡期與青春期

opposite puberty.

分踞生殖週期的兩端。

When we're born, we actually have all the eggs we're ever going to make,

我們出生時，一生中 會製造的卵子已經在體內，

about one to two million of them,

大約一到兩百萬顆，

unmatured and encased in follicles in the ovaries.

未成熟的卵子包覆在卵巢的濾泡中。

Around the age of eight to 10, the hypothalamus, a region in your brain,

在八到十歲左右，大腦中的下視丘

開始釋放一種激素，

starts releasing a hormone

that essentially wakes up those dormant eggs,

體內沉睡的卵子一旦被這激素喚醒，

beginning the monthly cycles of ovulation.

就展開了每月固定的排卵週期。

This is what increases production of a class of hormones

同時促成某種激素的分泌──

you've probably heard about -- estrogen.

你可能聽過的── 雌激素。

Estrogen, along with other hormones,

雌激素與其他激素

begins a delicate hormonal dance that, once a month,

聯合展開一場微妙的激素舞蹈，

導致每個月， 最成熟的一顆卵子脫離濾泡，

results in the most mature egg leaving its follicle

and traveling down a fallopian tube.

沿著輸卵管進入子宮。

The body builds up the lining in the uterus, the endometrium,

子宮內壁的黏膜 ── 子宮內膜隨之增生變厚，

to house the egg,

準備卵子發育所需之環境，

and if the egg isn't fertilized,

如果卵子沒有受精，

the lining sheds, and we have our period.

內膜脫落月經來潮。

This cycle repeats over and over and over, for decades.

這個週期就如此一遍、 一遍地循環，重複幾十年。

On average, sometime in the mid-forties, ovulation starts to get erratic.

平均而言，排卵期在 四、五十歲之間開始不規律。

We just don't have as many eggs,

純粹就是卵子剩下無多，

and the ones that remain may not be as healthy anymore.

或者剩下的卵子不是那麼健康了。

Estrogen can be lower some cycles,

某些週期的雌激素可能偏低，

and even higher during others.

某些週期則可能偏高。

This is the menopause transition --

這就是停經過渡期 ──

hormonal chaos, like puberty,

激素紊亂，就像青春期一樣，

only this time, when estrogen levels stabilize,

只是這次當雌激素的分泌穩定下來時，

they'll be much lower than they were before.

會比以前低很多。

This very normal decrease in estrogen and other hormonal changes

雌激素的分泌正常下降， 加上其他內分泌的變化，

does come with medical concerns,

的確能引發一些健康上的隱憂，

such as osteoporosis, heart disease,

例如：骨質疏鬆症、心臟病、

diabetes and vaginal dryness.

糖尿病和陰道乾燥症。

Some of us are lucky and we will have no or mild symptoms.

有些比較幸運的可能 完全沒有症狀或症狀輕微。

Others will experience trouble sleeping, irritability,

有些則可能會有失眠、躁鬱、

depression or decreased sex drive.

憂鬱、性慾衰退等問題。

And then there's the most classic symptom, hot flushes.

當然還有最經典的症狀──熱潮紅。

They're a wave of heat

熱潮紅是一波燥熱感，

that makes it feel like the furnace just got cranked up on the inside.

好像體內有個熊熊燃燒的火爐。

Scientists aren't completely sure why this happens,

雖然科學家們尚不清楚原因，

but the resulting heat makes you feel sweaty and off-kilter.

但熱潮紅帶來的熱感除了出汗 還會讓妳覺得身體失調。

Some women even have symptoms that overlap with anxiety,

此外，有些女性甚至出現焦慮症狀，

like nausea and palpitations.

例如：噁心和心悸。

But for me, it feels as if I've had too much to drink.

我個人的症狀則像是酒喝多了的感覺。

Those are some of the negatives,

前面說的這些是比較負面的，

but there are positives too.

當然也有一些正面的。

After menopause, you don't have to worry about periods or cramps,

例如，更年期後， 妳不必再擔心經期和經痛，

and people who partner with men who make sperm

即使與仍在製造精子的男性伴侶一起，

don't have to be concerned about unintended pregnancy.

也不必擔心無預期懷孕。

You're through all that.

那都結束了。

To me, menopause is something we go through, like puberty.

對我來說，更年期是個必經歷程， 就像青春期一樣。

And like puberty, there's a range of experiences.

也如同青春期，充滿各式各樣的經驗。

We continue to make vital contributions to society after menopause.

更年期後我們還是能繼續貢獻社會。

It's not your dotage.

進入更年期不代表老而無用。

Your worth has nothing to do with your ovaries.

妳的價值跟卵巢無關。

So let's say you're in the menopause transition.

假設妳正處於停經過渡期。

What are the best things you can do?

最好的應對方式有哪些呢？

If you're suffering, there's almost always some kind of help.

無論妳受哪些症狀所苦， 幾乎差不多都有解方。

If you smoke, definitely try to quit.

如果妳吸菸，一定要嘗試戒菸。

It will reduce your risk of heart disease,

不僅降低罹患心臟病的風險，

it might also reduce some symptoms of menopause.

也可能減少某些更年期的症狀。

Reducing stress and getting enough sleep is also good.

減輕壓力和睡眠充足也很有幫助。

Focus on eating a healthy, balanced diet

多吃健康、均衡、

rich in calcium and vitamin D for healthy bones,

富含鈣及維生素Ｄ的飲食 保持骨骼健康，

and try to get at least 150 minutes of moderate physical activity a week,

每週盡量進行至少 150 分鐘中等強度的運動，

especially if it's weight-bearing exercises,

尤其是負重運動，

like hiking, dancing or jogging.

如：登山健行、跳舞或慢跑。

If you're losing sleep or having hot flushes,

如果妳有失眠或熱潮紅，

or experiencing other symptoms that affect your quality of life,

還是其他影響生活品質的症狀，

talk to your doctor.

請跟妳的醫生諮詢。

Don't rely on wearable magnets or so-called compounded hormones.

不要倚賴可穿戴磁石， 或所謂的合成類賀爾蒙，

These are unproven and have risks.

那些是未經證實且具風險的療法。

There are a variety of proven options,

現在有多種確證有效的選擇，

from cognitive behavioral therapy to FDA-approved estrogen,

從認知行為療法到聯邦 藥物管理局認可的雌激素，

and some nonhormonal medications that can be very helpful.

以及一些非常有用的非激素藥物。

There are so many permutations and combinations of options

有這麼多療法可以排列組合，

that safe therapy can be customized for almost every woman.

差不多每個女性都能有 一套量身打造的安全療法。

One more idea, have a mantra ready.

還有，準備一小段話。

When I get a hot flush, sometimes I tell myself

每次熱潮紅時，我就告訴自己：

I'm feeling this because women have evolved

「我現在感受到的是女性的進化，

是推動人類發展前進的動力。

to drive humanity forward.

This is a sign of my strength.

熱潮紅是我個人力量的象徵。」

And then, I can make it until it goes away.

如此一來，我就能撐到它退散。