Don’t Fear Menopause Fear Early Menopause That Will Catch You Unprepared.

1-Why should we not be afraid of menopause, but pay attention to early menopause.

Menopause is a process in which 99% of all women in their average age of 50 (44-56) can prepare themselves emotionally, socially and physically for these natural processes, and we, as physicians, are quite prepared for the medical, social and psychological support that should be given during and after menopause. However, early menopause often catches people off guard. Women and even young women come across them as they mature in their own lives, complete their education and try to overcome some of their daily worries. It can often take away the chance to have a sudden and most dreamed child.
Thus, in modern city and metropolitan life, young women avoid marriage before completing their career, especially in societies with vertical social mobility such as our country, while making long-term education, finding a job, and making career plans, and looking for a wife with social, economic and cultural development in parallel with their own development. delay the age of marriage and childbearing.
Precisely in this pursuit of perfection, early menopause, which can be seen in 1% of women, mostly affects this group of women. Therefore, it is vital to suspect, diagnose and provide early counseling to this group of patients.
2-Who do we define with early menopause and what is the frequency?

The classic definition of early menopause is to stop menstruating under the age of 35, but it does not have much effect on menopausal complaints and possible effects of menopause, other than being caught early. The main thing is to enter menopause under the age of 40, that is, before the productive age is completed. The rate of menopause under 40 is 1% of all women. and women may suddenly lose their reproductive abilities in their own world while looking for career plans and a suitable partner (except to get pregnant with someone else’s egg, which is not legal in our country today).

3-Who is particularly at risk?

The most important risk factors are;
a- Those who have early menopause in their family (especially mother, sister),
b- Ovarian reserves should be investigated in women who have frequent and irregular menstruation.
Moreover;
Those who will or have undergone chemotherapy and radiotherapy
-Smokers (does not cause early menopause, but these women enter menopause 1-1.5 years earlier on average).
4-What should patients who are at high risk for early menopause and women who are afraid of possible early menopause do?

The best thing to do is to apply to a gynecologist and get support in this regard. With the developing technology in recent years, it was possible to determine whether women were only in menopause or in the transition period to menopause 5-10 years ago. We can offer a perspective. In fact, many successful studies have been conducted to determine the average age of women at menopause using maternal age and AMH, and the ages at which possible menopause is expected have begun to be estimated.
Could you give some more information about 5-AMH?
It’s a hormone test and a new test that, like other hormones, takes blood from your arm and can get results in a very short time, and is done all over the country. With this test, we can obtain very accurate information about the ovarian reserves of women and provide information about their capacity to have children and the imminence of menopause. Since it is a new test, as the studies increase over time, our ideas and the sensitivity of the test may change, albeit small. However, in general, today it can give us strong, easy and inexpensive data about ovarian capacity and possible menopause probability.

6-Is there any similarity between the symptoms of classical menopause and the symptoms of the depletion of the ovarian reserve and the restriction of the capacity to have children, which are the main fears?

Classical menopause; Absence of menstruation, hot flushes, insomnia, irritability and similar findings are mostly not caused by early depletion of ovarian reserves. The only possible warning sign is irregular menstruation or even a menstrual cycle that is more than 22 days old. These reasons are mostly detected by the tests performed in everyone and in patients who apply to the physician for menstrual irregularities that seem innocent.
7-What kind of reactions do you encounter in patients with early menopause or its near probability?

In fact, all reactions are related to having or not having children. While women with children are only asking how to manage this situation now, women who have never had children face a very deep anxiety and worry. It is often necessary to provide not only medical but also psychological support to this group of women. In addition, cultural factors are very related to being affected by this situation. Although the destruction is very evident in small cities and rural areas due to possible cultural and economic factors, the number of people affected is less because they marry and have children at an early age. However, women who are worried about life in metropolises, who make career plans, and who come to an advanced age to get married and have children while doing these, are more likely to be affected because they do not have children yet.
8-What is your advice to all women during the menopause week to cope with this situation?
First of all, they should not delay their annual gynecological controls, if they have not had a child yet and they care about it, they should definitely get counseling about their reproductive capacity. Especially those with early menopause in the family and those with irregular menstruation should have the AMH test done at regular intervals and be informed about ovarian reserves while planning their lives. Married women with limited reserves should not delay having children or consider methods such as embryo freezing, and those who are single and legally eligible should seek advice on the egg freezing alternative.
Those who have entered early menopause should not neglect to receive medical, psychological and social support for menopause and should not neglect close physician support in order to reduce or eliminate possible osteoporosis and similar devastating menopausal effects.

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