Menopause in 5 Steps

1- What is menopause?

Menopause usually begins after the age of 40, and on average, until the age of 55. First, menstrual bleeding becomes irregular. Then, menstrual bleeding stops completely. Menopause literally means “the last menstrual bleeding.” Women spend one-third of their lives in menopause. As human life increases, the period spent in menopause also increases. Menopause is a natural process. If menopause occurs before the age of 40, it is called “early menopause.”

Menopause can manifest itself with various symptoms. However, some women can go through menopause without experiencing these symptoms. Apart from this, the severity and degree of menopause symptoms are related to the genetic and structural characteristics of the woman. Various symptoms and changes that occur during this process can reduce the woman’s quality of life. Menopause is a process that can also cause various diseases. However, precautions can be taken against this situation with the treatment of menopause.

Hormone production in the ovaries decreases with age. As a result of this decrease, irregularities in menstrual bleeding begin to occur. Again, with the decrease in this hormone, there are some changes in body temperature. These changes are reflected in the woman as sweating and hot flashes. Menopause used to be a process that was considered a disease. However, with the advancement of medicine and changing perspectives, it has been understood that menopause is not a disease or a negative situation. The symptoms experienced during menopause can be alleviated with various treatments.

Menopause is not a period when a woman’s life and sexuality end.

Women can enjoy their sexuality comfortably during menopause.

2- Why does menopause occur?

Women enter menopause because of the decrease in estrogen and progesterone hormones, which are considered female hormones, with age. Menstruation stops because of the decrease in these hormones and inadequate production.

3- What are the symptoms of menopause?

How long do menopause symptoms last?

Various symptoms such as hot flashes and sweating usually disappear within 2 years. However, these symptoms may be seen for longer in some women. However, in the long term, osteoporosis, changes in body shape, changes in breasts and genitals are experienced in different degrees in each woman and will continue with increasing age.

Bleeding changes

Some of the symptoms of menopause are changes that indicate that menopause is approaching before the period of menstruation stops. This process is called the premenopausal period. During the premenopausal period, changes occur in the duration and frequency of menstruation. Symptoms usually appear before the menstrual period, between the ages of 40-45. During this period, there may be differences in the duration of menstrual bleeding and bleeding rates.

Hot flashes and sweating

Menstrual periods end with menopause. Most women who enter menopause begin to experience symptoms such as hot flashes, sweating, and palpitations. These symptoms are called vasomotor symptoms. They are seen in 75% of women who enter menopause. The symptom called hot flashes manifests itself with sudden redness on the face, arms, hands, and upper body. It also brings with it sweating, shivering, and feelings of warmth. These women may feel this symptom at night, disrupting their sleep. Hot flashes usually disappear within 3-5 minutes. These symptoms begin in the premenopausal period and can last for 1-5 years until the postmenopausal period.

Psychological symptoms seen in menopause

• Sleep problems
• Depression
• Nervousness and anxiety
• The state of being anxious
• Rapid change of emotional states
• Sentimentality
• Problems with attention, concentration and memory, forgetfulness

Symptoms associated with reproductive organs during menopause

• Vaginal moisture loss and dryness, resulting in pain during sexual intercourse, lack of pleasure, and decreased libido
• Urinary incontinence, a constant need to urinate

Long-term symptoms of menopause

• A state of shrinkage in the breasts: atrophy, loss of fatty tissue and sagging. Shrinkage of the nipples may be observed.
• Shrinkage and atrophy of the vaginal lips and clitoris
• Increased skin dryness and increased wrinkles due to moisture loss
• There is a decrease in hair in the armpits and pubic area, but an increase in arm and leg hair may be noticed.
• Deepening of voice
• Osteoporosis may occur. Depending on the severity of osteoporosis, stooping, shortening of the neck and joint pain may occur.
• The risk of heart disease and cholesterol increases due to hormonal changes in menopause. During menopause, cholesterol, triglycerides and LDL cholesterol increase, while HDL cholesterol decreases.
• Weight gain may occur. During menopause, there is an increase in the amount of fat in a woman’s body. In the pre-menopausal period, fat is mainly observed around the hips, and in the menopausal period, fat is observed around the waist and belly.
• In the postmenopausal period, various disorders occur in carbohydrate (sugar) metabolism. Insulin resistance increases.

4- How is menopause definitively diagnosed?

Menopause is not a disease that occurs all of a sudden. It is a biological and natural process of the body. Changes in the body do not occur all of a sudden and happen gradually. The transition to menopause can take approximately 20 years. Ovulation begins to decrease from the first period in girls. When it decreases to a certain extent, the transition to menopause begins. If menstrual bleeding has not been seen for 1 year, menopause is diagnosed. In addition, various hormone tests are also checked for a definitive diagnosis of menopause. However, not every cessation of menstruation indicates menopause. There may be different problems that can cause this condition. Therefore, it is necessary to see a doctor for a definitive diagnosis.

5- How is menopause treated?

Menopausal symptoms occur due to the decrease in estrogen and progesterone hormones. In the treatment for these symptoms, these female hormones are used. In this way, the decreased hormones are replaced. In this way, menopausal symptoms are eliminated. In this way, the quality of life of women is also increased. Estrogen treatment can be applied in two ways:

• orally or,
• by sticking to the skin method.

Calcium supplements and progesterone can also be added to estrogen therapy. In hormone therapy that is attached to the skin, the patch should be changed every 3 days or once a week. The doctor will decide after how long this patch will be changed and in what doses.

With estrogen therapy

• The risk of Alzheimer’s disease decreases,
• The risk of developing bowel cancer decreases,
• The risk of osteoporosis also decreases,
• The risk of cardiovascular diseases decreases.

There is a belief among society that estrogen causes cancer. However, estrogen does not cause uterine cancer. In fact, problems such as painful sexual intercourse, burning and itching in the vagina are eliminated with estrogen treatment.

However, estrogen is not applied to everyone. Patients who are not given estrogen:

• Patients with active liver disease,
• Patients with uterine or breast cancer,
• Patients with vascular coagulation problems.