This period of the woman, which is physiological just like puberty, is called climacterium. In this period, the reproductive age ends and the ovaries become disabled in terms of reproduction, and a new era begins in which fertility ceases for the woman. We see in books that the "climacterium" symptoms for this period are called climacteric symptoms, menopause syndromes, or simply menopause. It is generally accepted that the cause of its occurrence is the aging of the ovaries. The term menopause refers to an irreversible event for a woman. If a woman has not had a menstrual period for 1 year, she is considered to have entered menopause. The period after this period is called the post-menopausal period, and the period before this period is called the pre-menopausal period. Generally, this period is between the ages of 40-60. Menopause progresses with neurological and psychological symptoms, which we call early symptoms, of varying severity from woman to woman. Vaginal smear, which was a method used in the past for diagnosis, is no longer used due to its low sensitivity and variability from woman to woman during menopause. The most important laboratory findings in women who have entered the postmenopausal period are estrogen levels below 20 and FSH and LH levels above 40 in at least 3 measurements. The levels of FSH and LH reach their maximum level 3 years after menopause and then gradually decrease. Pregnancy should be considered in premenopausal women who do not menstruate, regardless of age.
Symptoms and findings in menopause; Symptoms and signs of estrogen deficiency occur in approximately 70-80% of women. Symptoms due to estrogen deficiency appear immediately in menopause. Despite this, pathologies related to cardiovascular diseases and osteoporosis, which impose significant problems on women in the post-menopausal period, occur in the late period. Hot flashes and sweating are the most common menopausal complaints in women. In addition, women may experience internal distress, restlessness, decreased appetite, loss of memory and concentration, mood swings, and loss of libido. Another important issue is the changes in bone tissue with menopause.
Treatment of Menopause;
We should consider this treatment as the pre-menopausal period and the post-menopausal period. Treatment in the pre-menopausal period; Menopause is caused by the aging of the ovaries It loses its functions. The feature of this period is that FSH and estrogens synthesized from the ovaries begin to lose their old rhythmic oscillations. In this case, it is the patient's complaints that determine the treatment. During this period, two important groups of complaints that push the doctor and the patient to treatment are hot flash symptoms and irregular menstrual bleeding. The treatments to be performed are generally hormonal treatments. However, their dosages are very different from postmenopausal treatment. The aim is to ensure that the patient has menstrual bleeding at certain periods and to relax the patient.
Treatment in the post-menopausal period; The main purpose is to replace the lost estrogen hormone. The most important problem in estrogen treatment is which hormones will be used in which way and for how long. When it comes to preventing hot flash complaints or vaginal thinning, it may be possible to determine the method and duration of treatment appropriate to the individual. When osteoporosis, which is a late problem of menopause, accelerates and the risk of cardiovascular disease increases, it is not possible to adjust the individual treatment dose. For this reason, treatments are tried to be planned within the framework of the results obtained from various studies.
Bone resorption (Osteoporosis);
Deterioration of the microscopic structure of the bone and the resulting decrease in the mineral density of the bone, its fragility and in other words, fracture. is the increased risk.
Treatments for osteoporosis; Since osteoporosis accelerates after menopause, treatment for osteoporosis in the postmenopausal period in women has been discussed for many years. Treatment should primarily aim to eliminate the various factors previously mentioned. Diet and exercise also play an important role in preventing osteoporosis after menopause. The most important factor in the diet is daily calcium intake.
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