Highlights in this issue:
◎ Why 40+ is a critical turning point in women’s health
◎ What typical health threats will women over 40 encounter?
◎ How 40+ women can protect their health at this stage
40+, a critical period for inheriting the past and forging ahead with the future
Due to factors such as body aging and hormonal changes, at the age of 40+, health problems from various aspects such as skin, bones, breasts, urinary system, etc. often “involuntarily” flock to female friends.
▪ Statistical analysis data from iKang’s “2021 Chinese Women’s Breast Health Pink Report” show that among the 3,253,870 adult women who participated in breast examinations, the detection rate of breast abnormalities (abnormalities discovered through breast color ultrasound examination) was 32.21%, of which 40 The detection rate of breast abnormalities among women between the ages of 49 and 49 is the highest, reaching 39.95%.
▪ Epidemiological surveys conducted in some areas of my country show that the incidence rate of urinary incontinence is 18% to 53%, and the incidence rate of stress urinary incontinence (SUI) among 45-year-old women who have given birth is as high as 40%.
▪ Data from “The Prevalence of Osteoporosis in China: A Community-Based Osteoporosis Cohort Study” show that among middle-aged and elderly women aged over 45 years and men over 50 years old, the markers of osteoporosis are The prevalence rate is 33.49%, of which 20.73% is in men; 38.05% is in women, and the prevalence rate in women is significantly higher than that in men.
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The paper “Determining a multimodal aging clock in a cohort of Chinese women” published in the Med magazine, a subsidiary of “Cell”, shows that women have obvious differences at the two time points of 30 and 50 years old. Dynamics of intensified changes in aging.
Among them, aging changes around the age of 30 are mainly manifested by lipid accumulation and steroid reduction at the metabolic level. By around the age of 50, women’s aging process has undergone dramatic changes at multiple levels such as organs, cells, and molecules, including steep increases or decreases in a variety of age-related indicators.
Around the age of 40, as the “watershed” between the above two key nodes, it plays an important role in connecting the past and the future. This stage will reveal one by one the health problems caused by women’s fertility and lifestyle habits. It will also be a critical stage for women to lay the foundation for postmenopausal health. With good care during this period, women may face fewer health problems in the next few decades.
Crisis faced by women over 40
| Urinary problems |
| 【The main symptoms】Frequent urination, urgency, urine leakage, urinary incontinence, urinary tract infection 【Common causes of disease】Female urinary problems begin to manifest in the 40+ stage. On the one hand, the strength of the female pelvic floor muscles and bladder detrusor muscles is greatly reduced at this stage; on the other hand, due to bad habits such as sitting for a long time or decline in physical functions, etc., when the bladder, urethra, etc. When microcirculation disorders occur in the detrusors and sphincter muscles of the urinary system, the blood supply to the corresponding muscles will be blocked, the supply of nutrients and oxygen will be insufficient, and metabolites will be blocked, resulting in muscle relaxation or edema, impaired function, and the blocked toxins will stimulate compression. Nerves, leading to muscle dysfunction, resulting in symptoms such as frequent urination, urgency, incontinence, leakage, and nocturia. |
| Menstrual problems |
| 【The main symptoms】Irregular menstruation, abnormal menstrual flow, etc. 【Common causes of disease】On the one hand, due to normal aging, women begin to experience a decline in ovarian function after the age of forty, leading to a decrease in the secretion of estrogen and progesterone, causing irregular menstruation, prolonged menstrual cycles, decreased menstrual flow, and other symptoms; on the other hand, similarly Due to factors such as bad habits or aging, when microcirculation disorders occur in the endometrium and myometrium, or when the ovaries are blocked, it will lead to abnormal uterine and ovarian function, often manifested as menstrual disorders, such as menstrual cycles and menstruaperiods. , abnormal menstrual flow. Blockage aggravates the ovarian dysfunction caused by aging. |
| Breast Problems |
| 【The main symptoms】Swelling and pain in the breast and surrounding areas, breast lumps, nipple discharge, etc. 【Reason for occurrence】It is also affected by factors such as the huge changes in hormones during this stage, and the breast glands are particularly susceptible to emotional effects. Women over 40 are often going through a period of career decline, and the children of most pregnant women are going through critical periods such as high school entrance exams and college entrance examinations. , women at this stage may often be in a state of high tension and anxiety, which will have a greater negative impact on the breasts. Coupled with the accumulation of bad living habits and other factors, as shown in the data mentioned above, starting from the age of 40, women’s Breast problems such as breast nodules and breast cancer have become increasingly common.。 |
| Female menopausal syndrome |
| 【The main symptoms】Palpitations, hot flashes and sweating, irritability, edema, decreased menstruation, joint pain, etc. 【Reason for occurrence】Female menopausal syndrome refers to a series of symptoms mainly caused by autonomic nerve dysfunction and metabolic disorders due to the gradual decline or loss of ovarian function and the drop in estrogen levels in womenduring or after menopause. Menopausal syndrome usually occurs between theages of 45 and 55. Generally, these symptoms have begun to appear during the menopausal period when menstrual disorders occur, and can last until 2 to 3 years after menopause (a few people experience 5 to 10 years).This disease is unavoidable and can only be postponed and slowed down as much as possible through reasonable maintenance. Blockage may lead to early replacement. |
| Bone health issues |
| 【The main symptoms】Joint pain (stiffness), bone hyperplasia, easy fractures, limited mobility, etc. 【Reason for occurrence】Because estrogen is significantly reduced, menopause and other changes cause abnormal calcium metabolism, women at this stage are prone to osteoporosis. In addition, changes in menopausal physique can easily cause fatigue. If there is a lack of exercise, fat metabolism is slow and weight gain. Being older and less active will greatly increase the risk of osteoporosis.For women who have given birth, bone loss due to hormonal changes duringpregnancy, coupled with changes in bone morphology, the effects of these problems accumulate until after the age of 40, they will begin to show variousbone health symptoms, the most typical one is joint pain. |
| Skin Problems |
| 【The main symptoms】Spots and acne, dehydration and dryness, inflammation and sensitivity, etc. 【Reason for occurrence】 Due to hormonal changes, endocrine disorders, as well as the accumulation of damage from factors such as sun exposure, environmental damage, improper care, and long-term use of certain drugs, many women begin to develop visible spots around the age of 40. In addition, due to the huge changes in menstruation, side effects of drugs, fluid retention caused by excessive salty diet, and damage to the skin barrier, women’s skin may also suffer from severe dehydration and dryness at this stage, and the skin caused by these reasons Deep-seated dehydration and the inability to lock in moisture often cannot be improved through skin care products. As we age, if blockage remains unclear for a long time, it will affect endocrine on the one hand, and cause clogging of pores on the other, making the skin prone to acne and inflammation. |
40+ Women’s Must-Collect Health Care List
In view of the characteristics of women’s physical conditions at this stage, Dianhetang has listed a highly referenced “40+ Women’s Health Improvement Suggestions List”. Female friends who have reached or are about to reach 40 years old can use this as a basis and combine it with their own conditions. Help yourself or your mother develop a corresponding health adjustment plan.
| orrect view of gynecological health issues |
| Before making any changes, women should first adjust their understanding ofsome gynecological health issues, and neither ignore nor overly worry about them. For example:▪ Cervical erosion“Cervical erosion” [1] is mostly a purely physiological phenomenon. Do not over-treat. Please go to a regular hospital to rule out other possible causes. Please follow your doctor’s advice regarding “whether treatment is needed” and “how to treat”;▪ Menstrual problemsIrregular menstruation in women aged 40+ is mostly caused by normal changes in hormones and may not necessarily require treatment. However, if problems such as premature menstruation, irregular bleeding, or frequent dysmenorrhea occur, you can go to the hospital to rule out other possible causes. If there are no special circumstances, you can increase the intensity of daily decontamination.▪ Face the problem squarely and adjust expectationsFor all kinds of gynecological problems encountered, women should adopt the attitude of “prevention that can be prevented, treatment that can be cured, and measures that cannot be avoided or completely treated to delay their occurrence, or to keep them under good control without affecting their daily lives”. |
| Pay attention to daily removal of stasis and prevent/improve various gynecological and other problems |
| As mentioned above, gynecological problems such as irregular menstruation and dysmenorrhea, including early menstruation due to affected ovarian function, are often caused by “blockage”. Depending on the degree of blockage, itmay lead to uncomfortable symptoms or related disease. Therefore, women at this stage should pay more attention to daily desilting. Of course, for women who are less than 40 years old, it will be better to start daily desilting as early as possible to prevent various female problems.In addition to preventing and alleviating many gynecological problems, desilting and blockage can also prevent many discomforts and diseases caused by blockage, such as urinary problems such as leakage, frequent urination and urgency, urinary incontinence, as well as cysts, stones, gout, and skin problems. |
| Eat a light/balanced diet, and supplement calcium, vitamins, etc. appropriately |
| ▪ DietIn addition to reducing the intake of irritating, high-fat, high-salt and high-sugar foods, women can appropriately supplement soy products containing phytoestrogens [2] to regulate the sharp decline in estrogen during this stage; they also need to pay attention to maintaining a healthy weight.▪ Dietary SupplementsOn the basis of clearing the stasis (clear the stasis first and then replenish nutrients, otherwise it will not be replenished), you could add more food or health products that regulate qi and blood, such as jujubes, donkey-hide gelatin, etc.▪ TonicRegarding calcium tablets, vitamin supplements, etc., it is best for women to go to the hospital for routine blood tests, isotope testing and other tests to determine the lack ofrelevant trace elements. Based on the actual situation, follow the doctor’s instructions for targeted scientific supplements. |
| Proper exercise increases metabolism and improves bone density |
| Proper exercise can not only improve metabolism, which decreases year by year dueto age, and prevent blockage and other problems, but also help maintain a healthy weight, maintain muscle content, improve endocrine disorders, promote calcium absorption in bones, and prevent osteoporosis. However, you need to pay attention to correct posture, reasonably plan exercise intensity, pay attention to the combination of aerobic and anaerobic exercise, and warm up and stretch before and after exercise. |
| 40+, these examinations for women should be done regularly |
| In addition to basic physical examination items, women over the age of 40 should also add the following examination items: |
| These parts need warmth the most |
| Women’s limbs, lower abdomen, joints, head, and shoulders all need to be kept warm, especially when metabolism inevitably decreases with age. In addition to exercise, you can also add clothes, soak your feet, heat compresses, moxibustion, etc. Keep these areas warm at all times to avoid blockage (exacerbation) caused by poor circulation. |
| A stable mood is the best skin care product |
| Joy, anger, sorrow, and joy are normal human emotions. No emotion is an absolute “bad emotion.” Bad emotions actually refer to excessive, suppressed, and sudden changes in emotions. Bad emotions can directly affect blood flowrate, or lead to abnormal secretion of adrenaline, estrogen, thyroxine, cortisol, catecholamines and other substances, and female hormones are obviously affected by emotions. On the one hand, bad emotional state will directly affect the production of various hormones. Regulating physiological phenomena such as menstruation, on the other hand, the toxins produced due to bad emotions will circulate throughout the body with the blood, accumulating over time and forming stasis, which can cause many problems. Therefore, in terms of emotions, female friends should stay as calm as possible and try to avoid things and situations that make them emotional. Create an environment that makes you emotionally comfortable and cultivate interestand hobbies that cultivate your sentiments |
References
[1]《2021 Pink Report on Chinese Women’s Breast Health》
[2]Li J, Xiong M, Fu XH, et al. Determining a multimodal aging clock in a cohort of Chinese women. Med. 2023;S2666-6340(23)00197-6. doi:10.1016/j.medj.2023.06.010
[3 ]《Prevalence of osteoporosis in China, a community-based osteoporosis cohort study》 （the prevalence of osteoporosis in china, a community based cohort study of osteoporosis）
Expand knowledge
- Cervical erosion: Before 2008, the “Obstetrics and Gynecology” textbook for Chinese medical students regarded cervical erosion as a standard disease symptom with complete clinical manifestations, diagnosis and treatment methods; and in the 2008 new edition of “Gynecology and Obstetrics” In the “Obstetrics” textbook, the disease name “cervical erosion” was clearly canceled and replaced by the physiological phenomenon of “cervical columnar epithelial ectopia”. Cervical erosion is a normal physiological phenomenon, which is caused by the migration of cervical columnar epithelium due to changes in hormone levels. The second is the manifestation of gynecological inflammation, the causes include physical, chemical, and biological factors. These two so-called “cervical erosion”-like appearances, whether physiological or so-called pathological, require prophylactic treatment as long as there are symptoms such as excessive leucorrhea, low back pain, and bleeding after intercourse. If there are symptoms, even physiological changes, sometimes treatment can be considered. The third is the manifestations of cervical precancerous lesions or early cervical cancer, which need to be diagnosed in combination with cervical cytology examination, HPV virus examination, etc. Therefore, cervical erosion can neither be exaggerated nor ignored.
- Phytoestrogens: Phytoestrogens are compounds in plants that have weak estrogenic effects. It exerts weak estrogen-like effects by binding with low affinity to steroidal estrogen receptors. The molecular structure of phytoestrogens is similar to that of mammalian estrogens. They are a type of plant components with similar biological activities to animal estrogens. They have a wide range of effects on hormone-related diseases. Although called phytoestrogens, they are not hormones themselves. Plants containing phytoestrogens mainly include: soybeans (soy isoflavones), kudzu root, flax seeds, etc.
- TCT examination: TCT examination is a reproductive tract cytology examination. It uses a special small brush to brush the uterine collar cells. After the specimen is taken out, it is immediately washed into a bottle with cell preservation solution and filtered through a high-precision filter membrane to separate the impurities in the specimen. And the filtered epithelial cells are evenly distributed in a single layer on the glass slide, and then observed under a microscope for preliminary screening of cervical precancerous lesions and cervical cancer.
[4] HPV test: HPV is the abbreviation of human papillomavirus. It is a small DNA virus that has many types and can cause a variety of benign papillomas or warts on human skin and mucous membranes. Certain types of HPV The infection is also potentially carcinogenic. HPV examination mainly detects whether a person carries the HPV virus. Whether a person is infected with HPV can be checked through stain microscopy, HPV DNA detection or serology test. HPV infection in the female reproductive tract is a common sexually transmitted disease. Up to 50% of sexually active women may be infected with at least one type of HPV. Since human papillomavirus infection is the cause of cervical cancer, attention must be paid to this infection and HPV testing.
