加载中…
Place · Level 3
月经停了 12 个月之后的低雌激素长期态· 骨量加速流失 → 骨松窗口 · 心血管风险上行 · GSM 不自愈 · 体成分代谢转变 · MHT 时机假说的诚实复盘 · 该监测什么 · 与医师共同决策
cofactor · 1
The nutritional base for bone is 1000-1200 mg/day of calcium (food first, supplements only for the gap) plus enough vitamin D — D governs whether that calcium is absorbed and laid down, and it is not something high doses buy.
regulates · 5
After menopause estrogen withdraws and the RANKL/OPG balance tips toward resorption, so bone is removed faster than it is built. Menopause matters to bone not as 'getting older' but as a predictable — and treatable — window of accelerated loss.
The post-menopausal rise in cardiovascular risk is real, but it stacks on top of the conventional risk factors — and those you can manage. Blood pressure is the highest-yield and most measurable of them: check it, keep it at target.
With oestrogen gone the lipid profile drifts the wrong way (LDL up, HDL function down), lifting cardiovascular risk on top of existing factors. Monitoring LDL through this period, and discussing a statin where indicated, is baseline care.
Oestrogen kept fat subcutaneous — the pear shape. Once it goes, fat redistributes to the abdomen and viscera, toward the apple. More visceral fat means more insulin resistance, and metabolic syndrome, type 2 diabetes and fatty liver follow.
Eating the same, moving the same, yet heavier with a thicker waist — that part is genuinely endocrine, not willpower. Muscle mass is falling with age at the same time, and the two stack, which is why strength work outranks cardio in this window.
contrast · 1
Two different periods routinely discussed as one: perimenopause is a 4-10 year transition of violent oestrogen swings and fluctuating hot flushes; postmenopause is a stable, lasting low-oestrogen state covering roughly a third of the rest of life. A swinging phase and a plateau call for different responses.