Menopause and Menopause Treatment in 10 Questions

Anadolu Health Center Gynecology and Obstetrics Specialists stated that in this natural process that women experience with the end of ovulation function, important problems affecting many systems may arise as a result of decreasing hormone levels. “Menopause is not a disease, but since estrogen no longer has the protective effect, heart diseases, osteoporosis and other health problems may occur.” There is a higher risk of facing problems. Therefore, it is necessary to be prepared for this special period and reduce the difficult effects it will create. “In addition to medical support during menopause, it is very important for women to consciously prepare for this natural process,” he said, answering 10 basic questions for women that shed light on the most important issues regarding the menopause period.

If menopause is not a disease, why is medical support important?

Although this period is a normal period of life, due to decreasing hormone levels, effects that reduce the quality of life such as hot flashes, restlessness, insomnia, tingling in the hands and feet, osteoporosis in the later period, increased risk of cardiovascular diseases, breast and gynecological cancer. It brings with it problems such as increased risk, urinary tract problems, wrinkles and sagging of the skin. Medical support at this point will positively affect the woman’s quality of life. In addition, menstrual irregularities or irregular bleeding should not be considered normal with the thought that I am entering menopause. Considering that gynecological cancers are common during this period, a doctor should be consulted and a gynecological examination should be performed once a year.

How are the negative effects of menopause treated?

Since every woman has different needs, it is not possible to talk about a standard menopause treatment. In treatment that needs to be tailored to the individual, for example; If a woman works actively and cannot sleep well due to hot flashes at night, this negatively affects her business life. If early bone fractures are common in another woman’s family, menopause should be addressed accordingly. If the breast tissue is dense, fibrocystic, or there is a family history of breast cancer, this should be taken into consideration in the treatment. All these points should be thoroughly examined individually, and risk factors should be determined by routine checks for health problems that may arise after the patient’s menopause.

Does sexuality end with menopause?

Three important changes regarding sexuality occur in women after menopause. The first of these is the decrease in the amount of fluid secreted in the vagina, the second is the thinning of the tissue called mucosa that forms the surface of the vagina, and the other is the loss of elasticity in the muscles surrounding the vagina. All of these constitute the most common cause of painful sexual intercourse, medically called dyspareunia, in this age group. In untreated women, a feeling of dryness and tightness in the vagina occurs during sexual intercourse, and burning and irritation may occur. Thanks to medications to be used vaginally, women can regain a healthy vagina and remain sexually active. It has been shown that medications that can be used for this purpose also prevent urinary tract infections and reduce complaints of urinary incontinence, which are frequently observed in this age group.

Does the risk of gynecological cancers increase with menopause?

There is an increase in certain types of cancer with age, during menopause. During menopause, changes begin to occur in the uterus due to the low secretion of progesterone hormone and the relative increase in estrogen levels. During this period, uterine cancer occurs as a result of either the decrease in progesterone secretion or the external administration of estrogen hormone. For this reason, both estrogen and progesterone are kept in balance with hormone replacement drugs given to the patient during menopause. Thus, the possibility of uterine cancer is reduced. If cervical cancer can be detected in time with smear tests, its treatments and surgeries are easy and do not reduce the quality of life of patients. At this point, it is of course very important for patients to have regular check-ups in order to combat tumors.

Is hormone replacement therapy (hrt) risky?

HRT, which is administered to replace the missing hormones to eliminate the problems of menopause, is not treated as freely as it was in the past. It can be said that this treatment method is viewed with more suspicion, especially because it increases the risk of breast cancer and its negative effects on the cardiovascular system. However, this risk is no longer high enough to say that no woman should receive hormone therapy. At this point, it can be decided to apply HRT to women by making the benefit/harm equation well.

What is the age of menopause?

Women enter menopause on average at the age of 47 in Turkey and at 51 in Europe. The age of menopause is determined hereditarily and is not affected by variables such as age at first menstrual bleeding, breastfeeding, birth control pills, race, education, height, or age at last pregnancy. However, smoking causes the death of egg cells, and especially in those who smoke 20 or more cigarettes a day, the age of menopause comes 1-2 years earlier.

What is early menopause?

If menopause occurs before the age of 40, which occurs when the ovarian reserve ends, it is called early menopause. Approximately 1 in 1000 women aged 15-29 and 1 in 100 women aged 30-39 experience early menopause. Early menopause can be easily understood with a good analysis; Psychological changes, insomnia, sudden sweating, inability to focus or aggressive attitudes are among the most striking symptoms. Genetic structure is more effective in early menopause, but; Factors such as nutrition, lifestyle, smoking habit or stress can also affect the age of menopause. In this sense, it is important for everyone who has a family history of early menopause to have the necessary medical check-ups without delay.

How is early menopause treated?

The most effective treatment for early menopause is estrogen therapy. If the patient’s uterus has been removed for any reason, it is applied alone, otherwise it is applied with the addition of progesterone. Treatment can be applied sequentially or continuously, orally or in the form of adhesion to the skin. In women treated for menopause with estrogen; There are scientific publications showing that Alzheimer’s disease, colon cancer, carpal-tunnel syndrome, rheumatoid arthritis and fibromyalgia are less common. Although there is controversy about estrogen increasing the risk of breast cancer, studies show that this risk is very low. In addition, since women receiving estrogen therapy undergo a detailed check-up every six months, early diagnosis and treatment of possible diseases is more successful.

Can natural supplements be used other than hormone therapy?

The trend towards natural, plant-based estrogens called phytoestrogens is becoming more widespread. The fact that the molecular structure of herbal estrogens is very similar to the estrogen molecule found in the body allows the human body to perceive this molecule as its own estrogen molecule. Isoflavans, the most prominent among natural phytoestrogens, have chemically similar properties to estrogens, but are milder in effect. One of the most important sources of phytoestrogen is soy. Another popular product in recent years is the plant extract called black cohosh. This plant extract, also called gentian, has a mild estrogen effect. Other herbs recommended to reduce menopausal complaints: Ginseng, green tea, valerian (valerian). Although physicians report good results regarding these herbal products, we must say that more studies are needed.

What can be recommended to women during menopause?

The two most important factors for women during this period are exercising and adjusting their lifestyle. We can list the lifestyle recommendations that protect women from the negative effects of menopause as follows:
• Do plenty of sports. Try to exercise at least 3 days a week. Prefer to use the stairs instead of the elevator during the day.
• Calculate your body mass index. Don’t be too skinny or overweight.
• Stay away from harmful chemicals.
• Avoid stress.
• Do not smoke. Stay away from passive smoking.
• Consume high antioxidant foods such as fish, walnuts, hazelnuts, broccoli, tomatoes, peppers, carrots, grapes and strawberries.
• Consume foods high in calcium. 200 ml per day. Eat milk, yoghurt and ice cream.
• Get plenty of sun exposure and do not miss vitamin D.