Menopause and your questions about it

MENOPAUSE

Menopause, which is the fearful dream of many women; In fact, although it differs from other periods of life in some issues, when appropriate precautions are taken and life style is determined, it will be a period in which women can live their healthy, conscious and most fulfilling years.

What is menopause? It is generally defined as not having a menstruation (menstruation) for a year.

What is menstrual bleeding? Menstruation (menstrual bleeding) is the swelling and shedding of the inner layer of the uterus at certain intervals.

What is the uterus? female internal reproductive organs; It consists of a pear-sized uterus located at the tip of the vagina, walnut-sized ovaries on both sides, and tubas (channels) extending towards them.

How do reproductive organs work? Under the control of hormones from the brain and pituitary, cysts called follicles form in the ovaries, one month on the right and one month on the left. Usually, only one of these cysts grows up to 2-2.5 cm in diameter, cracks, and although it is the largest cell in the human body, an egg, small from a pinhead, one-fifth of a millimeter in size, comes out and starts to progress in the canal.

How does pregnancy occur? If the egg meets sperms (male germ cells) in the canal, pregnancy can occur. This probability will be one in four for each month under 35 and one in five over 35. After the fertilized egg moves through the canal for 5 days, it burrows into the uterus and pregnancy occurs. If the fertilized egg cannot progress in the canal and grows here, an ectopic pregnancy, which is a serious health problem, occurs.

What hormones are released from the ovaries? Estrogen and progesterone hormones are secreted from the ovaries. The estrogen hormone secreted by the follicle cyst, which develops with the effect of the FSH hormone secreted from the pituitary, begins to relieve the inner layer of the uterus. With the effect of LH hormone, the follicle cracks, sends the egg inside to the tube (fallopian canal), the yellow body formed instead of the follicle secretes progesterone hormone, this hormone changes the swelling effect of estrogen on the inner layer of the uterus (In a sense, it is protective from intrauterine cancer). Progesterone is usually secreted for 14 days and then the inner layer of the uterus is shed (menstrual bleeding). This means that if the egg comes out 14 days before menstruation, lives for 2 days and meets sperms that live for 3 days, the probability of pregnancy will increase in this period.

MENopause is the depletion of the follicles in the ovaries. FOLLICULAR WILL NOT DEVELOP AND CRACK AT MENOPUS, AND NO EGGS WILL GO AND HE WILL BE A CHILD NO LONGER.

THE DEVELOPING FOLLICULAR WILL NOT BE EASTROGEN AND PROGESTERONE HORMONES WILL NOT BE RELEASED AND MENUS BLEEDING WILL NOT OCCUR.

THE Pituitary WILL CONTINUOUSLY secrete FSH AND LH HORMONES TO DEVELOP FOLLICULAR, BECAUSE THE ovaries will not respond to this, what we know as the diagnosis of menopause, will be HIGH FSH AND LH AND LOW ESTROGENIC E2 VALUE IN THE BLOOD.

In menopause, the functions of the ovaries are finished. If the egg does not come, pregnancy will not occur, and if the hormone does not come, there will be no menstruation.

Menopause usually occurs between the ages of 48-52 in women in our country. In the presence of early menopause in the family, in women who smoke, the stressful city life, the effect of thyroid and cortisone hormones may cause menopause at earlier ages. THERE IS NO CONCEPT TO PREVENT OR DELAY MENOPEASE, BECAUSE THE OVACULAR FUNCTION IS DONE. ONLY WE CAN REDUCE SOME OF THE FINDINGS CAUSED BY MISSING HORMONES.

Every woman has different complaints when entering menopause. With the withdrawal of estrogens from her body, some symptoms begin to be seen in women; There are hot flashes that occur only on the upper part of the trunk. (These can last 15-20 seconds, vary from a few times a day to a few times a week), followed by sweat breakouts, palpitations, insomnia, depression, restlessness, and irritability. The windows are opened because it is hot, it is said that there is no taste in life. These complaints will occur at different levels in each person; It will increase with heat, fatigue, sadness and stress and when caffeine (coffee, instant coffee) and alcohol are consumed. It can last from the premenopausal period to years after the menopause.

These findings show only the tip of the iceberg. With the decrease in hormones, some structural changes will occur in the woman. These can be grouped into three main groups;

one. Atherosclerosis and associated coronary heart diseases will increase. Structural changes in the vessels due to estrogen deficiency, decrease in good cholesterol HDL and increase in bad cholesterol LDL, increase in blood lipids and sugar, increase in blood pressure, followed by weight gain are the expected findings of menopause. Overweight, smokers and those who do not do enough sports are in the risk group. Unfortunately, hormone treatments are no longer thought to reduce these findings. Therefore, starting from the pre-menopausal period, women have to make significant changes in their lifestyle. To eat healthy; It should be changed from red meat to white meat (chicken, fish), vegetable proteins, soybean containing phytoestrogen should be consumed, sports (especially walking and swimming) should be emphasized. It should also be taken into account that the risk of heart attack may increase from 10% to 40% in women who smoke.

2. OSTEOPOROSIS (BONE REMOVAL); The decrease in estrogen will disrupt the balance between bone formation and destruction, and osteopenia (bone reduction) may occur with the loss of 10% of the body bone mass, and osteoporosis (bone loss) may occur with the loss of 25%. Weak, sedentary women who do not go out to the sun and smoke are in the risk group. Hormone Replacement Therapy (HRT), external supplementation of estrogen and progesterone hormones, which decrease in menopause, can reduce bone resorption by half, especially when used in the first 5 years. At the onset of menopause; In the first five years, the rate of body bone loss will decrease from 4% per year (20% IN FIVE YEARS) to 1% per year after five years. Today, large studies indicate that there is no increase in breast cancer in the first five years in women using hormones. Because; hormone supplementation that begins as soon as you enter menopause and lasts for 5 years; It can be recommended especially for women in the risk group, as it can reduce bone resorption by 50%.

3. ALZHEIMER; This disease, which shows signs of early dementia such as forgetfulness, is more common in those who go through early menopause. If there is a family history, the risk will increase even more in women after menopause. The negative effect of decreased estrogen on the synapses between nerve cells in the brain is significant. Hormone therapy appears to be a good option in reducing the likelihood of Alzheimer’s.

CHANGES IN PERIODIC BLEEDING BEFORE MENOPEASE;

If there is no decrease in the follicle cysts that secrete estrogen, and there is no follicle cracking every month, if the yellow body does not form and progesterone is not secreted, irregular shedding will begin to occur in the inner layer of the uterus. These usually manifest as delayed menstruation, followed by long and excessive bleeding. Some women may experience a decrease in menstrual bleeding. In hormone replacement therapy, when drugs are used regularly, the inner layer of the uterus will swell and shed regularly. Nevertheless, in order to determine the possible increased risk of intrauterine cancer (less than 1%) during the treatment period, the thickness of the inner layer of the uterus should be measured by vaginal ultrasonography every six months.

AT A THICKNESS UNDER 4 MM, THE CHANCE OF DEVELOPING INFLATABLE CANCER FOR THAT YEAR IS NEAR TO ZERO AND THE USE OF HORMONES CAN CONTINUE WITH CONFIDENCE.

Although we continue the use of hormones regularly, without forgetting, in irregular bleeding that occurs, a pathological evaluation may be required by taking a piece from the uterus.

IN A WOMAN WITHOUT ANY TREATMENT, IF THERE IS BLEEDING ONE YEAR AFTER MENopause, 50% INTERNAL CANCER SHOULD BE CONSIDERED AND A BIOPSY SHOULD BE TAKEN INTO THE Womb.

ATROPHY; With the effect of decreasing estrogens after menopause, there will be thinning of the vagina, bladder, muscles that protect the pelvic floor, and skin. In the atrophy of the vaginal tissue; dryness in the vagina will increase, pain and sometimes bleeding may occur during sexual intercourse, and the structure of the discharge will change.

Hygiene is important; cleaning the toilet from front to back, not washing the bowl, drying quickly after bathing, changing underwear frequently). However, locally effective estrogen creams that can be used safely until the age of 80 and do not increase the risk of uterine and breast cancer are a good option in the treatment of atrophy complaints.

Due to the thinning of the bladder adjacent to the vagina; They tend to recur in atrophic cystitis, which manifests itself with burning in the urine, frequent urination and more than one frequent urination at night. We should not forget that local estrogen therapy may be useful for the prevention of these.

In menopause, due to the weakening of the muscles protecting the pelvic floor, complaints of bladder prolapse (increased urinary incontinence due to chronic cough, weight gain, heavy lifting, constipation, etc.) and complaints of uterine prolapse (helmet and lower back pain, pain during sexual intercourse) will progress. To slow them down, pelvic floor exercises may be helpful in the beginning (eg, KEGEL EXERCISE). When the findings progress, surgery may be required.

After all; It should be known that today, a significant part of the problems caused by menopause can be intervened with well-planned, careful and controlled hormone therapy. The benefits of hormone therapy in the treatment of osteoporosis, Alzheimer’s, atrophy-related complaints and bleeding disorders should not be forgotten. It is worth emphasizing that hormone therapy also reduces colon cancer by 20-30%.

Finally, it should be considered that there may be irregular ovulation in the premenopausal period, and an effective contraceptive method should be preferred. The World Health Organization stated that all contraception methods can be used safely in the presence of suitable conditions during this period.

Related Posts

Leave a Reply

Your email address will not be published.