"压力大"让女性月经紊乱?

　　When Maureen Doherty and her husband got married, she was in her 30s. They were eager to have kids, maybe even a bunch. When she went off the pill at 36 and didn’t get pregnant right away, she didn’t worry much. Her doctor did a few blood tests, just to make sure everything was working fine. But it wasn’t. Doherty got the results in a phone call from a physician’s assistant。

　　莫林·多尔蒂和她的丈夫结婚时已经30多岁了。他们渴望有孩子，甚至可能想生一堆孩子。当她在36 岁停止服用避孕药时，并没能马上怀孕，不过她不是太担心。她的医生为她做了几项血液检查，以确保一切正常。但结果却事与愿违。多尔蒂从医生的助手打来的电话中得知了检测结果。

　　Doherty: I’m sitting at my desk at work one day, and she calls me and she says to me, ‘I have a little bit of bad news. You’re post-menopausal.’

　　多尔蒂：一天我正坐在办公桌前办公，她打来电话告诉我说，“我有一个坏消息要告诉你——你绝经了。”

　　Being past fertility was not news the couple had expected. Doherty says reality hit when she was on her way home that night。

　　这对夫妇没有想到自己会没有了生育能力，多尔蒂说那晚她在回家的路上感受到了现实的打击。

　　Doherty: I can still remember sitting on the bus and thinking, I’m probably not going to have children. And to hear that, you know, four months after you’re married, it was heartbreaking。

　　多尔蒂：我还记得坐在公交车上，心里想着我可能不能有孩子了。你知道，我是在结婚四个月后听到这个消息，真的很伤心。

　　She soon learn she has primary ovarian insufficiency, or POI. One in 100 women develop the condition by the age of 40. Unlike true menopause, which ends periods and ovulation, POI is trickier. It can come and go. A few women get pregnant. But others who may have missed a few periods in a row, and chalk it up to stress, actually have POI and don’t know it. The cause: usually unknown。

　　没过多久她就知道自己得的是原发性卵巢功能不全(POI)。100 个女性中就有一个会在40 岁以前患上这种病。与真正的绝经——月经和排卵停止——不同，原发性卵巢功能不全更加复杂，它会反复发作。一些女性能够怀孕，不过有些女性会以为是压力导致她们连续很长时间没来月经，而实际上她们是得了原发性卵巢功能不全，只是她们不知道。这种病的病因一直不明。

　　Dr. Lawrence Nelson studies and treats young women with POI at the National Institutes of Health. He says his patients are often shocked that irregular periods can be a big deal。

　　劳伦斯·纳尔逊医生在美国国立卫生研究院专门研究和治疗年轻女性的原发性卵巢功能不全。他说他的病人在知道月经不规律会产生大问题时通常都很震惊。

　　Dr. Lawrence Nelson: There’s this disconnect. The menstrual cycle is just seen more of – as a nuisance. But actually, it’s the sign that the ovaries and the whole endocrine system related to the reproductive system is working the way it should。

　　劳伦斯·纳尔逊医生：女性们有这方面知识的缺失。每月来月经更多的是被人们看作一个麻烦事儿，但实际上，它是和生殖系统相关的卵巢以及整个内分泌系统正常“运作”的标志。

　　Looking back, Maureen Doherty realizes there were signs her hormones were off by her early 30s. She had hot flashes now and again。

　　回想起来，莫林·多尔蒂意识到在她30岁出头的时候出现了激素下降的迹象。那时她不时会有热潮红现象。

　　Doherty: A lot of times, I would be out with friends and I would say: Are you guys hot? And they’d say, no, not at all. And I would think: How could they not be hot? Because I am dying here。

　　多尔蒂：许多次，我和朋友出去的时候我会说：“你们不觉得热吗？”他们会说：“不，一点都不热。”我就想：“他们怎么会不热呢？因为我在这里要热死了。”

　　But each surge of heat only lasted a minute or two, so she dismissed it.Around that time, her periods also became a little less predictable。

　　不过每次潮热都只持续一两分钟，所以她就没有在意。大概就是在那个时候，她的月经也变得有点不规律了。

　　Doherty: I’d have one one month, not the other. And so I just – I mentioned this to the doctor, and she just shrugged and immediately gave me a prescription for birth control。

　　多尔蒂：我会有一个月有月经，而另一个月就没有。我把这个情况告诉了医生，她只是耸耸肩，然后立刻给我开了一张避孕的处方。

　　Putting a young woman on the pill to even out her monthly cycles is very common, Nelson says. But doctors should be ruling out underlying problems first。

　　纳尔逊说，让年轻女性服用避孕药来使她的月经规律非常常见，但医生们首先应该消除潜在的问题。

　　Dr. Nelson: It might be reassuring to women – oh, it looks like things are fine now because my periods are coming. But in fact, their ovaries are not supplying the hormones to make that happen, so it’s masking the fact that their ovaries aren’t working normally。

　　纳尔逊医生：这可能会让女性非常安心，噢，现在似乎正常了，因为我的月经来了。但实际上，她们的卵巢并没有分泌产生月经的激素，所以这掩盖了卵巢没有正常排卵的事实。卵

　　Ovaries that aren’t working don’t produce enough estrogen. And when that happens early in life, the damage can go beyond fertility to also affect bones. 

　　巢不排卵就不能产生足够的雌激素，如果在年轻时出现这种情况，那么不仅仅会影响生育，还会损害骨骼。

　　Dr. Nelson: The wake-up call we got was about 10 years ago, where we had twin sisters come to see us in our program, at age 23. They both had bone densities of a 77-year-old woman。

　　纳尔逊医生：这个警钟是在10 年前敲响的。有一对23 岁的双胞胎姐妹参加了我们的研究项目，她们的骨密度相当于一个77 岁老妇的骨密度。

　　Turns out, Nelson says, the twins had menstrual problems during adolescence that were never evaluated. They could’ve grown up with healthy bones, he says, if they’d been prescribed a patch to supply the missing estrogen and progesterone to balance it。

　　纳尔逊说，结果显示这对双胞胎在青春期时有月经问题，但没有被诊断出来。他说如果当初医生为她们开了补药来补充所流失的雌激素和黄体酮以达到平衡，她们的骨骼本应该很健康。

　　For now, there’s still no way to reverse POI’s effect on fertility. But Nelson has new research hinting that most of these women might yet be capable of producing viable eggs。

　　目前还没有办法改变原发性卵巢功能不全对生育的影响。但纳尔逊所进行的一项新研究可能会让大多数有这种问题的女性产生可用的卵子。