Menopause Follow-up and Treatment

Meno means bleeding, Pause means interruption. Menopause means stopping of bleeding. There is no such period as a menopause period. Menopause is a point in a long period between sexual maturity and old age. So, there is a before and a after. Therefore, we say there is a pre-menopausal period and a post-menopausal period.

What is the average age of menopause in Turkey

The age of entering menopause is 47 in Turkey, but it can be extended up to 51 years, while the pre-menopausal period starts from the 40s.

There are three types of menopause.

Natural menopause; normal, spontaneous menopause.

Surgical menopause; For any reason, at any age, even if the uterus is present, the woman who has lost her ovary enters menopause

Early menopause; Entering menopause before age 40

Symptoms of Menopause

Menopause is a physical event. So it is not a disease. The prolongation of human life causes us to experience the effects of the absence of estrogen hormone, which is the cause of menopause, for a longer period of time.

(Average life expectancy in Turkey is 70 years old. In the US life expectancy was about 80 years old)

All women have menopause complaints that last for 3-5 years just before and right after menopause.

First complaints: Hot flashes, sudden sweating, irritability, irritability, crying spells, forgetfulness, insomnia. This psychological depressive state is observed in 75% of women. In other words, it creates a psychologically depressive state in women, these are seen in 75% of women. It is mild in 25 percent. It continues for 3-5 years, then disappears. At 10 percent it prolongs up to 10 years. After that, late symptoms begin. The most important is the risk of infarction with skin disorders and heart attack. Infarction increases 10 times during menopause. Normally, infarction is a common male disease, but it becomes a female disease during this period. The causes of death due to heart attack in the world today are almost twice all deaths, including cancers. There is also osteoporosis, which starts with menopause and is characterized by insidious bone loss. The biggest negativity is also fractures. Hip fractures, vertebral fractures are very important. At the same time, humping occurs. As a result of compression fractures in the vertebrae, paralysis may occur.

Early Menopause Detection and Treatment

Early menopause occurs before the age of 40. Findings can be easily diagnosed with a blood hormone test. If the woman is having normal menstruation, she will not have any complaints of menopause, but if there is a menstrual disorder, the risk of early menopause can be determined very easily by a simple blood hormone analysis.

Which Tests Are Performed During Menopause?

What should be done in Menopause Treatment?

In Menopause Treatment, the woman should first go to the gynecologist. The period when uterine and cervical cancer is most common has begun, so gynecological examination and smear test should be performed. Vaginal ultrasonography is very important for the diagnosis of ovarian cancers and intrauterine cancers and is one of the best diagnostic methods showing pathologies and disorders. Breast cancer takes the second place after lung cancer among the cancers seen in women. Due to this increase in breast cancer, women should definitely have mammography and breast ultrasonography from the age of 40 (it is 35 in mammography). Apart from this, blood fats should be checked and bone measurement should be done if there is a family history.

Hormone Replacement Therapy

There are two types of treatment in hormone replacement therapy, which is defined as the replacement therapy for estrogen hormone that can no longer be produced during menopause.

To menstruate

Not to menstruate

Hormone replacement therapy can be given orally, in the form of adhesion to the skin, with creams applied to the skin or in the form of nasal sprays. There are also ovules, creams and intrauterine devices containing progesterone hormone placed in the vagina. Estrogen hormone is added to these. Today, it is the most commonly used method of use through the transfermal and oral routes, and also through the vagina. When hormone replacement therapy is given, success is over 90%. The early symptoms of mennopause, which we have just mentioned, are disappearing. Late symptoms and osteoporosis are also prevented. Today’s concept is to start the treatment as soon as the woman enters menopause, when the deficiency is felt, and continue for 5-10 years. Anyway, the message given to all women is to use it for a long time.

RISKS OF HORMONE THERAPY

How common is breast cancer? This is very wrongly known among the people. According to the latest data of the USA, which is one of the countries where it is seen most, breast cancer is seen in 300 out of 100 thousand women, meaning 3 out of 1000 women between the ages of 55-59 (this study was conducted between the ages of 55-59). Already, the probability of breast cancer seen before the age of 40 is 25%. 75% is seen after the age of 40. With each increasing year, it is in an increasing trend, whether taking hormones or not. Just as there is a risk of prostate cancer in men, 1 out of 9 women over the age of 80 carries the risk of developing breast cancer. The later it is caught, the better the chance of survival.

MESSAGES TO WOMEN APPROACHING THE PERIOD OF MENOPOSIS

In order to improve our quality of life, the woman should definitely receive hormone replacement therapy. Even if you do not take it, you should definitely have control tests with the doctor. It is very important for the prevention of cancers. We should organize our life habits, give importance to our gymnastics, and eat mainly greens and white meat. You have to do your diet very well.

Since breast cancer was thought to have a genetic predisposition, first-degree relatives of such a patient were not given hormone replacement therapy. However, recent studies show that it can also be given to these individuals. These patients can be treated because they are under control and the risk does not increase. There is a minimal increase that can be ignored. However, if breast cancer is not detected in both aunt and aunt, mother and aunt, and every member of the family in the family, there is still a tendency not to give them hormone replacement therapy.

GYNECOLOGICAL EXAMINATION AND ULTRASOUND

Perhaps the most important of the diagnostic methods in Menopause Treatment is the gynecological examination performed after learning the patient’s complaints in detail. Because after this examination, the doctor will consider a series of possible diagnoses about the disease, taking into account the information given by the patient before the examination and will guide the patient accordingly. Although gynecological examination (considering the way it is performed) does not come easily, it is extremely simple, painless, fast and instantly decisive for the diagnosis from the doctor’s point of view. Therefore, it must be done.

There are three main parts of the Menopause Treatment examination:

In the first part, the doctor examines the cervix and takes samples from these tissues or secretions (pap smear, culture, etc.) Afterwards, these samples are analyzed in the laboratory and very important information about the disease is obtained. In fact, a pap smear can warn us (even if the patient does not have a complaint at that time) against the danger of cancer that may be too late in the future. Examination of the vagina is done with an auxiliary device called a speculum and a small amount of lubricant when necessary, without causing pain and discomfort to the patient. (In girls, vaginal examination is not performed, only the external genitalia and hymen can be examined, and if necessary, rectal examination and abdominal ultrasound can be performed.)

Then, the vaginal examination is carried out with the help of hands. The aim here is to get information by feeling the patient’s reproductive organs with fingers. This is done by using a lubricating cream when necessary, without causing pain and discomfort to the patient.

In the third part, unlike the past, there is an ultrasonographic examination made from the vaginal or abdomen, which is almost like the eye of the gynecologist. Ultrasonography is an examination method performed using sound waves at a frequency that the ear cannot hear, and it has no adverse effects on the living or pregnancy proven by comparative clinical studies so far. However, it conveys many problems that we cannot feel by hand (ovarian cyst, fibroids, polyps in the uterus, early pregnancy, baby heartbeat and development, etc.) very objectively and sometimes helps to make an instant diagnosis. At every stage of the gynecological examination, the doctor always uses auxiliary materials such as sterile (germ-free) disposable and discarded gloves. Therefore, it is not possible to pass any microbes from patient to patient or from doctor to patient during this examination. Here, every stage of the examination is very critical and can provide us with valuable information at every moment. For example, while everything may feel normal in a patient’s manual examination, an ovarian cyst can be detected only when ultrasonography is performed. Or, all other examinations of the patient are normal, an infection can only be detected in the vaginal discharge, or a vaginal cyst that cannot be detected by ultrasonography can only be detected by palpation.

In the obstetric (pregnant) examination, unlike this, unless there is a situation that requires vaginal ultrasonography or examination in the following pregnancy months, only the doctor does a vaginal examination and ultrasonography in the early pregnancy period in the first examination, and then follows the pregnancy only with ultrasonography and examination performed from the abdomen. Towards the last weeks of pregnancy, we can understand with the same examination, the internal structure, the position of the baby’s head, whether the cervix is ??suitable for birth or not.

BONE DENSITOMETER

In the case of estrogen deficiency caused by Menopause Treatment or any other reason, we know that osteoporosis is further worsened by low intake of calcium, inactivity, coffee, smoking, alcohol consumption, weakness and some medications.

In the treatment of osteoporosis, it is necessary to adjust the amount of calcium or increase the absorption of calcium, sometimes to use hormone supportive therapies and to support this treatment with exercise.