The increase in life expectancy has led to women spending 1/3 of their lives after menopause. This situation drew attention to the physical and psychological changes of menopause and post-menopause, and this issue has become an important health problem. With important observational studies, the use of hormone drugs in women during this period was described as very beneficial.
The publication titled WHI (Women's Health Initiative), published in 2002, is both related to the subject. on the medical community, but perhaps more surprisingly, it had already hit the press as “breaking news”. As a result of this research conducted on more than 16 thousand (161,808) post-menopausal women in the United States, hormone therapy was declared "AFAROZ". Physicians who have been dealing with this field for many years were amazed by the results and examined the results of this study. First of all, the most important issue that was criticized was considered to be age. Indeed, the average age of the women in the study group was 50-79 (average 64). 12% of the cases were postmenopausal for more than 20 years. In this sense, the main target of criticism was the idea of giving hormone medication to a 73-year-old woman who had no complaints and had been in menopause for 22 years. Moreover, the information that there was a group of women with complaints in this study group, which was said to be randomly selected, and that some of them had diseases related to cardiovascular health, such as high blood pressure, led to serious criticism, especially in the last 5 years, after this study was published in 2002. Prof Robert Langer, who was part of the team that conducted this study, said the following at the 2016 International Menopause Society (IMS)meeting held in Prague: “The process of conducting a clinical study is very complicated. Human metabolism and physiology – its functioning – is complex and full of surprises. We are never as smart in the end as we were in the beginning”. His speech almost meant that we admitted that there were inaccuracies in this study. So, where is "menopause" today? What awaits us at menopause? What about mon treatment? Here are the answers to these questions in the question-answer style below: “Menopause; I will convey it to you from scratch. This is an issue that the Board of Directors of the Turkish Menopause and Osteoporosis Association, of which I am a member, met and studied for a long time and a report was prepared. Let me start with the questions and answers in the light of this report and current data abroad:
- What is menopause?
Menopause literally depends on the termination of the work of the ovaries. It is the name given to "last menstrual bleeding". As it turns out, the diagnosis can be made retroactively.
- What kind of complaints occur during the menopausal process?
Starting before menopause and continuing with old age. The period that lasts until senility, that is, the climacteric period, is the period in which complaints are most common. In fact, during this period, hot flashes (vasomotor symptoms) are most common in perimenopause. In this period, hot flashes (vasomotor symptoms) are observed in 75% of the cases. In fact, in30%of women, these hot flashes are moderate to severe and have a very negative impact on the quality of life. Hot flashes cause sleeplessness at night, which affects the next day/days and brings about problems such as fatigue, loss of concentration, loss of work efficiency, and depressive mood. Joint and muscle pain may occur.
As time passes after menopause, problems such as vaginal dryness, burning, and pain in intercourse begin to occur. p>Actually, all these complaints are like the tip of the iceberg; Heart and bone health, above all else, begins to be negatively affected by the decrease in hormones.
- Is there weight gain during menopause?
We all know that there is an increase in weight starting from middle age, which is approximately 0.5 kg per year. However, this weight gain seen in middle age cannot be attributed to menopause. However, it has been shown that there is an increase in the total amount of fat and a change in fat distribution during menopause. In women, there is an increase in fat, especially in the waist area. This situation is a negative sign for health and requires careful nutrition and exercise. Fat accumulation, especially in the waist area, should be prevented. Research has shown that this negative fat distribution tends to improve, especially in women receiving estrogen therapy, and the risk of diabetes (Type II diabetes) decreases.
- Am I in menopause?
In women who do not menstruate, the menopausal process is diagnosed as a result of a physician's examination and the tests requested. It would be appropriate to leave the interpretation of the FSH test, which is among the tests, to the physician. As information from the book, FSHvalues of 40 IU/Land above, checked at least twice at different times, indicate that the ovaries are not functioning, and menopause can be diagnosed as a result of FSH alone.
- What is Early Menopause?
If the diagnosis of menopause is made before the age of 40, it is called early menopause.
<Most of the time, no specific cause can be found. Sometimes it may be caused by genetic disorders (monosomy X, FMRI, etc.), congenital enzyme deficiencies or some problems with the immune system
- Is it possible to delay menopause?
No. Unfortunately, there is no medicine or method to delay menopause. However, we need to remember this information here: "Women who smoke experience menopause earlier". Therefore, it would be appropriate to quit smoking or at least eliminate this negative factor.
It is not possible to delay menopause, but regular menstruation in women in this process can be achieved with medications. This does not mean that menopause is delayed.
- I had bleeding after menopause, what should I do?
The majority of post-menopause bleeding is hormonal and These are good reasons. However, uterine cancer is detected in 10-15% of postmenopausal bleeding. Therefore, it is necessary to consult a physician immediately in cases of post-menopausal bleeding.
- I have urinary incontinence after menopause, what should I do?
Lower urinary tract Since it is dependent on the hormone we call "estrogen", it is in these areas after menopause. changes also occur. In the simplest terms, there are basically two types of urinary incontinence: urinary incontinence (stress urinary incontinence), which occurs due to increased intra-abdominal pressure such as coughing, sneezing, laughing, and the type that occurs with a sudden feeling of urgency. (overactive bladder)urinary incontinence. It would be appropriate to consult your physician regarding the treatment of these. Because your need for surgery or medication is determined by examination and some tests. In this sense, menopause treatment is not recommended.
- Which is the most risky disease in the post-menopausal period?
Considering the frequency, it is generally (and in men)the leading cause of death is "heart diseases". Especially after menopause, as the hormone called estrogen decreases, heart protection decreases and the risk of heart diseases increases.
- Which vitamins should I use after menopause?
Although it is not necessary for people who eat regularly to travel with a vitamin bag, it would be appropriate to use vitamins determined by the physician. It should be emphasized that vitamin D is important in this regard: the daily vitamin D requirement is determined as 800-1000 IU in postmenopausal women. Since this amount of vitamin D cannot be taken with food, it is necessary to use vitamin D as recommended by the doctor.
Using calcium supplements is not recommended lately, especially if the doctor does not specifically prescribe it, due to contradictory results such as the risk of heart attack.
- What about breast cancer, which all women fear? Does drug use cause breast cancer?
Breast cancer (if skin cancer is excluded) is the cancer that a woman has the highest risk of encountering in her lifetime. The lifetime probability of occurrence is 1 in 8-10 women. The risk of breast cancer generally increases with age.
- Do menopause medications cause blood clotting?
The most common menopausal hormone treatments. It is noteworthy that although there is a risk of increased blood clotting tendency, this risk is minimized with individually selected medications.
- Using medication after menopause Should I be worried, I'm so confused?
If
1) Hot flushes especially AND
2) If there is no obstacle to use,
Under the age of 60 (or menopause period) (less than 6 years) Menopause medications can be used in women with the recommendation of a physician. These medications are the most effective treatment for menopausal complaints such as hot flashes, insomnia, etc. It can be used safely.
- I want to use medicine, but which medicine should I use and how much?
Everyone has different personal characteristics, severity of complaints, Their expectations from treatment are different for different reasons. Therefore, choosing the right medicine for you depends on your examinations and test results. You can comfortably use the medications prescribed to you in a controlled manner for 5 years. Longer-term use can also be provided by your doctor's general evaluation and discussion with you.
- I have been diagnosed with breast cancer, but I have very severe hot flashes and vaginal complaints. What can I do?
In this case, there are alternative treatments with proven effectiveness that you can use. These can be used with different hormone-free pills or vaginal lubricants and creams.
- I'm avoiding sexual intercourse after menopause, what can I do?
Menopause Afterwards, there is a serious thinning of the vaginal lining due to the decrease in the "estrogen" hormone. This situation causes serious burning and painful complaints in intercourse and is one of the most important reasons for avoiding sexual intercourse in the post-menopausal period. In addition, a decrease in sexual desire (libido) is also seen to be due to hormonal reasons. In this case, it would be appropriate to first thicken the vagina sufficiently with creams or suppositories and then increase libido. In the near future, supplementary drugs that have effects that increase sexual desire will also be on the shelves in our country.
- Which of the herbs sold in herbalists is good for menopause?
NEVER. Although plants are generally found in most medicinal drugs today, the amount of active ingredient in plants purchased from herbalists depends on how much and how often they are used.
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