Stating that the average age of menopause in Turkey is 47, Gynecology and Obstetrics Specialist Dr. Sevgi Selen pointed out that the symptoms differ from person to person and that hormone therapy to reduce the negative effects should be planned individually.
Acıbadem Eskişehir Hospital Gynecology and Obstetrics Specialist Dr. Sevgi Selen stated that the word menopause means the last menstrual bleeding and that menopause can be diagnosed if there is no menstrual bleeding for 1 year. Stating that menopause is a physiological process, Dr. Selen said, “It occurs when the ovaries lose their function, fertility ends, and estrogen and progesterone hormones are not released. This physiological process starts with the perimenopausal period when symptoms begin, and progresses with menopause and the 12-month period following menopause and the postmenopausal period that follows. It can be classified as early menopause, natural menopause and surgical menopause.”
“The first symptoms are menstrual irregularity and hot flashes”
Stating that the average age of menopause is 51 in the world and 47 in Turkey, Dr. Selen said that when this process occurs between the ages of 45-55 without any factors, it is called natural menopause, when it develops before the age of 40, it is called early menopause, and when it develops by removing the ovaries during any surgical intervention, it is called surgical menopause. She said that the age of menopause is mostly determined by genetics, but race, nutrition, number of births, smoking and drug use can also be effective. Stating that the perimenopausal period, in which the first signs of menopause are seen, continues for an average of 2 to 8 years, Dr. Selen said that the process starts with menstrual irregularities, hot flashes, vaginal dryness, night sweats, insomnia, irritability, depression and sexual reluctance. She also added that the frequency and duration of these symptoms vary from person to person.
“Pregnancy should not be ignored in the complaint of not menstruating for a long time”
More than 21 days more frequent bleeding, intermittent spotting or prolonged periods of menstrual periods, Dr. Selen emphasized that a gynecological examination should be performed first, “Pregnancy should not be ignored in the complaint of not menstruating for a long time. At the same time, especially if there is no menstrual bleeding for 1 year and any bleeding that develops in the following period, an obstetric examination should be performed.”
“Hormone therapy should be planned individually”
Pointing out that hot flashes are one of the most common complaints in menopause, Dr. Selen continued as follows:
“Hot flashes are not harmful to health. Hot flashes at night can affect sleep patterns, but other than that, they are medically harmless and do not always require treatment. However, when it affects the social life of the person, treatment should be planned individually. Since hot flashes are particularly associated with a decrease in hormone levels, hormone treatments can reduce the feeling of hot flashes. The health status of the person should be started by considering the medical history. If there is a risk of cardiovascular diseases, existing cancer history, a treatment plan should be made for it.”
“Exercise, calcium, vitamin D support can be preventive”
Pointing out that the estrogen hormone is effective in preserving bone mass, Dr. Selen stated that the decrease in this hormone with menopause may cause bone resorption and that a measurement method called bone densitometry, which gives an idea about bone structure, is used to monitor this situation. Emphasizing that hormone therapy is the most effective method to prevent osteoporosis, Dr. Selen said, “However, hormone therapy can be started individually and by considering the health status. Apart from that, exercise, calcium, vitamin D support can be preventive. If severe osteoporosis and fractures develop, treatment can be initiated.”
“Continue to protect against pregnancy”
Referring to the possibility of pregnancy in the perimenopausal period, Dr. Selen recommended continuing contraception methods in the pre-menopausal period. She explained that birth control pills, barrier methods, monthly injections, subcutaneous implants and intrauterine device systems can be used, taking into account the health status of the person. Stating that sexual life can continue without any contraceptive measures after menopause and the 1-year period without menstruation, Dr. Selen said, “In the postmenopausal period, that is, in the postmenopausal period, there may be a decrease in sexual desire due to vaginal atrophy (ie vaginal tissue thinning due to insufficient estrogen) and skin changes due to complaints of pain and dryness in intercourse. In this case, support can be obtained from vaginal local treatments. Psychosocial changes after menopause, sleep disorders, medications due to metabolic diseases may also negatively affect this process. However, the source of the situation can be identified and support can be given in that direction.”
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