10 Questions About Menopause and Menopause Treatment

Anadolu Medical Center’s Obstetrics and Gynecology Specialists state that menopause is a natural process that women experience as their ovarian function ends. Due to decreased hormone levels, this period can lead to important issues affecting many systems. They clarify that "Menopause is not a disease, but due to the absence of estrogen’s protective effect, the risk of heart disease, osteoporosis, and other health problems is higher. Therefore, it is essential to be prepared for this special period and reduce the challenging effects it may cause. Along with medical support during menopause, it is crucial for women to consciously prepare for this natural process." They answered the 10 most important questions about menopause.

If Menopause is Not a Disease, Why Is Medical Support Important?

Although menopause is a natural part of life, the hormonal decline causes symptoms such as hot flashes, irritability, insomnia, and tingling in the hands and feet, which reduce the quality of life. Long-term consequences include increased risk of osteoporosis, heart and vascular diseases, breast and gynecological cancers, urinary tract problems, and skin issues like wrinkles and sagging. Medical support at this stage improves a woman’s quality of life. Additionally, menstrual irregularities or bleeding should not be considered normal as one approaches menopause, and a gynecological examination is necessary to rule out potential gynecological cancers. Regular yearly check-ups are essential.

How Can the Negative Effects of Menopause Be Treated?

There is no one-size-fits-all menopause treatment, as each woman has unique needs. For instance, if a woman is actively working and suffering from night sweats that disrupt her sleep, this could negatively affect her work life. If another woman has a family history of early bone fractures, her menopause management may need to address this risk. If a woman has dense, fibrocystic breast tissue or a family history of breast cancer, these factors should be taken into account during treatment. All these factors should be thoroughly evaluated, and routine check-ups should be conducted to identify potential health problems that may arise after menopause.

Does Sexuality End After Menopause?

Three significant changes occur in the sexual health of women after menopause. The first is a decrease in vaginal lubrication, the second is the thinning of the mucous membrane that forms the vaginal surface, and the third is a loss of elasticity in the vaginal muscles. These changes can lead to painful intercourse (a condition known as dyspareunia), which is the most common cause in this age group. Without treatment, women may experience dryness, tightness, burning, and irritation during intercourse. Vaginal medications can help women regain a healthy vagina and maintain sexual activity. These medications have also been shown to prevent urinary tract infections and reduce complaints of urinary incontinence, which are common in this age group.

Does the Risk of Gynecological Cancers Increase During Menopause?

Certain types of cancer see an increased risk as women age, especially during menopause. A decrease in progesterone levels and a relative increase in estrogen levels lead to changes in the uterus. In this period, either a decrease in progesterone or the administration of external estrogen can increase the risk of uterine cancer. Therefore, hormone replacement therapy (HRT) is used during menopause to balance both estrogen and progesterone levels, thus reducing the risk of uterine cancer. Cervical cancer can be caught early with smear tests, and if detected early, treatments and surgeries are less invasive and don’t significantly affect quality of life. Regular check-ups are vital in fighting these tumors.

Is Hormone Replacement Therapy (HRT) Risky?

HRT, used to replace the hormones lost during menopause, is no longer as freely recommended as it once was. Concerns about its potential to increase the risk of breast cancer and cardiovascular issues have led to more cautious use. However, the risk is not so high that hormone therapy should be avoided for all women. A careful evaluation of the benefit/risk balance can help doctors determine whether HRT is appropriate for a particular patient.

What Is the Average Age for Menopause?

In Turkey, women typically enter menopause at an average age of 47, while the average age in Europe is 51. The age of menopause onset is genetically determined and is not influenced by factors like the age at first menstruation, breastfeeding, birth control use, race, education, height, or the age of the last pregnancy. However, smoking accelerates the death of egg cells, and women who smoke 20 or more cigarettes per day may experience menopause 1-2 years earlier.

What Is Early Menopause?

Early menopause occurs when ovarian reserve ends before the age of 40. It affects about 1 in 1000 women between the ages of 15-29 and 1 in 100 women between the ages of 30-39. Early menopause is easily diagnosed with careful analysis, and symptoms like psychological changes, insomnia, sudden sweating, difficulty concentrating, or aggressive behavior are prominent. Genetic factors play a major role in early menopause, but lifestyle factors such as diet, smoking, and stress can also affect the age of menopause onset. It’s important for women with a family history of early menopause to ensure they undergo necessary medical check-ups.

How Is Early Menopause Treated?

The most effective treatment for early menopause is estrogen therapy. If the woman has had a hysterectomy, estrogen alone is used; otherwise, progesterone is added. Treatment can be continuous or sequential and may be administered orally or through skin patches. Studies show that women receiving estrogen therapy for menopause have a lower incidence of Alzheimer's disease, colon cancer, carpal tunnel syndrome, rheumatoid arthritis, and fibromyalgia. While there have been discussions about estrogen increasing breast cancer risk, studies indicate this risk is very low. Additionally, women on estrogen therapy are monitored with regular check-ups, ensuring early diagnosis and treatment of any potential health issues.

Can Natural Supplements Be Used Instead of Hormone Therapy?

There is growing interest in phytoestrogens, natural plant-based estrogens. These phytoestrogens have molecular structures that are similar to estrogen, allowing the body to recognize them as its own estrogen. Isoflavones, which are a type of phytoestrogen, are chemically similar to estrogens but have milder effects. One of the most significant sources of phytoestrogens is soy. Another popular product is black cohosh, a plant extract with mild estrogenic effects. Other herbs that may help alleviate menopausal symptoms include ginseng, green tea, and valerian (catnip). While doctors have reported positive results with these natural products, more research is needed to confirm their effectiveness.

What Can Women Do During Menopause?

The two most important factors during menopause are exercise and lifestyle adjustment. Recommendations to protect women from the negative effects of menopause include:

• Engage in regular physical activity, aiming for at least 3 days a week. Prefer stairs over elevators.
• Maintain a healthy body mass index; don’t be underweight or overweight.
• Avoid harmful chemicals.
• Manage stress.
• Don’t smoke and avoid second-hand smoke.
• Consume foods high in antioxidants, such as fish, walnuts, hazelnuts, broccoli, tomatoes, peppers, carrots, grapes, and strawberries.
• Eat calcium-rich foods like milk, yogurt, and ice cream (200 ml daily).
• Spend time in the sun to ensure adequate vitamin D levels.