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📚 | Japan's first "menopausal book" that you want to read from your 40s


Japan's first "menopausal book" that you want to read from your 40s

If you write the contents roughly
This book is a book that you should definitely read from your 40s when you are worried about "menopause" and "menopause".

"The more female hormones you have, the better!" "The more soy you eat, the more female hormones you have!" ... ... → Continue reading

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Menopause(Konenki Shogai,British: Menopause, postmenopausal syndrome, PMS) is a syndrome caused by a decrease in gonadotropin, which mainly means a syndrome in women.For womenOvaryDue to functional deteriorationestrogenDeficiency, especiallyEstradiolBased on deficiency ofhormoneCaused by imbalancesyndrome[1][2]..Even for men due to agingMale hormoneIs a type oftestosteroneMay occur with a sharp decrease in menopause.For menLOH syndromeCalled.

This page describes women's menopause.For treatment, see "Menopause #TreatmentSee.


A wide variety of symptoms that do not depend on the organic causes seen in women's menopause are called menopause, and among them, those that interfere with life are defined as menopause.[1][2]..Menopause is in JapanmenopauseRefers to a total of 5 years, 10 years before and after[1][Annotation 1][Annotation 2].


Due to age-related decline in ovarian endocrine functionestrogenIt is said that the decrease in concentration and changes in the domestic and social environment associated with menopause are interrelated and cause various indefinite complaints.[1][2].


So-calledIndefinite complaintThere are many symptoms belonging to, and the strength and weakness are related to the mental factor.At this timeEmpty nest syndromeIt is also said that it is easy to have stress due to problems in the workplace, family care, etc. It is classified into three categories: "vasomotor symptoms", "psychiatric symptoms" and "other symptoms".[1]..Estrogen is involved in many symptoms, but is said to have a particularly strong effect on "vasomotor symptoms"[3]..Many of the symptoms of menopause are said to be natural[2].

Symptoms of menopause[1][2]
Vasomotor symptomsBurning face, hot flashes, abnormal sweating, palpitation, dizziness,high blood pressure[4]
Psychiatric symptomsEmotional anxiety, frustration, anxiety, depression, insomnia, heavy head
Other symptoms
  • Locomotor symptoms-backache, joint pain, etc.
  • Gastrointestinal symptoms-nausea, loss of appetite, etc.
  • Mucocutaneous symptoms-dry skin, itching, etc.
  • Genitourinary symptoms-dysuria, pollakiuria, sexual intercourse, vulvar discomfort, etc.

There are racial differences in the frequency of onset of symptoms, and it is said that Japanese people have many symptoms of stiff shoulders, easy fatigue, headache, fatigue, low back pain, and abnormal sweating.[1].


The Kupperman Menopause Index, which scores patients' own symptoms, was used worldwide to evaluate menopause.[1], There is a problem with the scoring method[1], As of 2014, it is no longer used[Annotation 3]..The Japan Society of Obstetrics and Gynecology has created a simple evaluation table that answers 21 questions with yes / no.[1]..Measuring serum FSH and serum estradiol levels can also help with diagnosis[3]..Menopause is judged after 12 months of amenorrhea, but even if it is less than 12 months, it can be judged to be menopausal if the blood FSH concentration is 40 mlU or more and the blood estradiol concentration (E2) is 20 pg / ml or less.If estradiol levels are well maintained and menstruation is good, even symptoms similar to menopause should be excluded.[3].


Hormone replacement therapy is effective as a fundamental treatment[3]..As a symptomatic treatmentHerbal medicine,Placenta,Psychotropic drugsEtc. used[1]..In particular, hormone replacement therapy is basically selected for symptoms directly related to estrogen deficiency such as autonomic neuropathy. Hormone replacement therapy, such as HRT, is highly effective for vasomotor symptoms but may not be effective for psychiatric symptoms.[Annotation 4], Anxiolytics and antidepressants are used[3]..On the other hand, dialogue therapy that listens to problems such as family problems and incompatibility with the surrounding environment also has an effect of improving symptoms.[3].

Hormone replacement therapy

Female hormones (estrogens) that have been deficient in the body before and after menopause can be taken as oral medicines or patches (oral preparations).Patch) To replenishHormone replacement therapy(HRT) is performed.It is highly effective for vasomotor symptoms, but it may also be effective for neuropsychiatric symptoms such as depression.[1]..Evaluation has not been determined for the effect on depression that develops with menopause[1]..It has a track record of more than 30 years in Europe and the United States, and it has been used for more than XNUMX years in Japan to improve menopause.Quality of lifeIt is evaluated and utilized as an effective and appropriate therapy to improve and spend daily life comfortably.[5], Patients with menstruation or patients with retained blood estrogen are not indicated.

It is also speculated that there is a secondary effect of becoming more careful about exercise, diet, and medical examinations while continuing to receive HRT.[5]..Estrogen alone or estrogen, depending on the presence or absence of menstruation and the type of symptomsProgesteroneCombination agents etc. are used[6]..Estrogen alone is given to patients whose uterus has been removed due to uterine fibroids, etc.[2].. HRTosteoporosisImprovement effect, skin beautification effect, anti-aging effect, lipid metabolism improvement effect[1]However, depending on the administration method, gynecologic malignancies such as breast cancer, endometrial cancer, and ovarian cancer may increase slightly, and blood coagulation diseases such as lower limb thrombosis may increase.However, for endometrial cancer, the risk of endometrial cancer can be reduced to zero by co-administering progesterone.[2].. The standard treatment period for HRT is about 5 years, and continuous administration beyond that is on a case-by-case basis.[2].

HRT in Japan

In Japan, oral preparations and patches have been used so far, but in 2007, Japan's first "push-type bottle that is slimy to the skin"GelDosage form "Estradiol Topical"Le estrogen'[7]Was newly approved and released[8]..It is characterized by the fact that it does not leave any application marks, causes less skin irritation, is easy to use daily, and can take out a certain amount.

Psychotropic drugs

EtizolamAnxiolytics such as, and strong anxiolytic effectClotiazepamIs used[3]..If you have strong depressive symptomsSSRI (Selective serotonin reuptake inhibitor)SNRI (Serotonin / noradrenaline reuptake inhibitor) is the first choice[3][2].

Herbal medicine

In Kampo, for women's menopausal symptomsKeishibukuryogan-Toki Shakuyakusan-Modified Xiaoyao San-Saiko Karyu Oyster・ Etc. are used[9]..Different Chinese medicines to choose between false and proof[10].

Placenta therapy

In Japan, the Melsmon injection, which is made as a treatment for women's menopause, is covered by insurance. Approved by the Ministry of Health and Welfare in 1956.


With the cooperation of psychiatrists and psychosomatic physiciansCognitive behavioral therapy,Biofeedback therapyEtc. are also done[1].Stress managementAnd environmental adjustments may be made[11]..Female sexual dysfunction, especially sexual dysfunction (female sexual dysfunction; FSD), Although estrogen supplementation is also effective[1], The center of treatment isBehavior therapy,counselingIs[1].

Exclusion diagnosis

Differential diagnosis includes depression, hyperthyroidism, hypothyroidism, malignant tumors, and psychiatric disorders.[1][3]..Symptoms such as "easy fatigue" that are often seen during menopause are non-specific symptoms.[1], A common symptom in these disease groups[1]..Thyroid disease is a common disease during menopause and is often a differential problem.[1]..To distinguish from psychiatric disorders such as neurosis, depression, and schizophrenia, the Cornell medical index (Psychological test)CMI) Health Survey Sheet and Self-rating Depression Scale (SDS) Etc. are used[3], These mental illnesses and menopause may be combined and joint medical care with a psychiatrist is often required.[3].

注 釈

  1. ^ Menopause is defined as a menopausal woman who has been amenorrhea for one year.Also, after hysterectomy, serumFSHSerum with a concentration of 40 mIU / ml or higherEstradiolA definitive diagnosis can also be made if the value is 20 pg / ml or less.
  2. ^ Elevated serum FSH levels are a precursor to menopause, but elevated FSH alone cannot predict the timing of menopause.
  3. ^ An index that evaluates 11 items of symptoms on a 4-point scale to determine the severity of menopause.Although it cannot be used for the definitive diagnosis of menopause, it was used for follow-up of patients who were diagnosed with menopause and for determining the therapeutic effect.A simplified menopausal index was also devised, which was simplified by selecting 10 types of symptoms that are common in Japanese women.
  4. ^ Nevertheless, HRT is said to have a certain effect on depression.


[How to use footnotes]
  1. ^ a b c d e f g h i j k l m n o p q r s t u Obstetrics and Gynecology Practice Guidelines Gynecology Outpatient Edition 2014 Japan Society of Obstetrics and Gynecology
  2. ^ a b c d e f g h i Let's know the disease: Gynecological illness Menopause What is menopause? Japan Society of Obstetrics and Gynecology
  3. ^ a b c d e f g h i j k Nissan Women's Magazine Vol. 61, No. 7 Training Corner E.Diagnosis, treatment and management of gynecological diseases Nissan Women's Magazine Vol. 61, No. 7
  4. ^ Kazuhiro Kobayashi, "[Original] Examination of diagnostic and therapeutic methods for postmenopausal hypertensionSaitama Medical University Magazine 2003 Vol. 30, No. 1, p.51-60, two:10.24689 / sms.30.1_51
  5. ^ a b Yoshie MiwaOthers: "Questionnaire survey report to doctors, medical institutions and patients regarding HRT (hormone replacement therapy) usage status". Japanese Menopausal Medical Association Magazine 12: 282 (2004)
  6. ^ To relieve menopausal symptoms (type of treatment) Otsuka Pharmaceutical
  7. ^ "Le Estrogen 0.06% Patient Guide (PDF)”. Pharmaceuticals and Medical Devices Agency (March 2015). 2016/8/4Browse.
  8. ^ Haruto Takahashi, Seiji Sato,Menopause treatment Le Estrogen 0.06% Pharmacia Vol. 49 (2013) No. 5 p.431-433, two:10.14894 / farauwpsj.49.5_431
  9. ^ Japan Medical Association"ABC of Kampo Treatment (Japan Medical Association Lifelong Education Series)" Japan Medical Association, 1992.ISBN 978-4260175074.
  10. ^ Katsura Miyahara "Handbook of Chinese Medicine Medication" Gensosha, 2013.ISBN 978-4-906668-97-7.
  11. ^ Keiko Miyagami, Nahoko Shirotsuchi, Hisashi Shimohei, Takashi Matsuoka, Akihiko Sekizawa (2017). Management of recent menopauseShowa Gakushikai Magazine, 77, 367-373, two:10.14930 / jshowaunivsoc.77.367

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