Menopause is a natural physiological stage in every woman’s life. However, experiencing hot flashes, insomnia, palpitations, anxiety, and a significant decline in quality of life should not be considered “normal” or something to be endured without support. 

Today, menopause is no longer viewed as an unavoidable fate. It is a condition that can be medically evaluated, monitored, and treated when necessary. 

At the center of this process is regular gynecologic care. 

What Is the Main Problem in Menopause? 

During menopause, the ovaries significantly reduce their production of estrogen. Estrogen deficiency affects multiple systems in the body: 

● The brain’s temperature regulation center → hot flashes 

● Sleep regulation → insomnia 

● Bone tissue → loss of bone density 

● Cardiovascular system → increased risk 

● Skin and connective tissue → loss of elasticity 

● Mood and emotional balance → anxiety and depressive symptoms 

Therefore, menopause is not simply the end of menstruation. It is a systemic hormonal condition affecting the entire body. 

Why Is Gynecologic Follow-Up Important During Menopause? 

Many women believe that after menopause they no longer need gynecologic care. This is a misconception. 

During menopause, a gynecologist plays a key role in: 

● Screening for breast and gynecologic cancers 

● Assessing osteoporosis risk 

● Evaluating cardiovascular health 

● Monitoring genital and urinary health 

● Determining suitability for hormone therapy 

● Creating an individualized treatment plan 

Menopause is not the time to stop seeing a gynecologist. It is the time when medical follow-up becomes even more important. 

Hormone Therapy: Not for Everyone, but for the Right Patient 

The purpose of hormone replacement therapy (HRT) is to replace the estrogen that the body no longer produces sufficiently. 

However, HRT should not be started automatically in every woman. The decision is based on: 

● Age 

● Time since menopause 

● Severity of symptoms 

● History of breast cancer 

● Risk of thrombosis or cardiovascular disease 

● Presence or absence of the uterus 

Hormone therapy is a medical decision, not a lifestyle choice, and it must be tailored to the individual patient. 

The Importance of Transdermal Estrogen Therapy 

Estrogen can be administered in different forms during menopause. One of the most commonly preferred methods today is: 

transdermal estrogen therapy, applied through the skin as a gel, spray, or patch. 

Transdermal estrogen has several important advantages: 

● It bypasses the gastrointestinal system 

● It avoids first-pass metabolism in the liver 

● It provides more stable blood hormone levels 

● It carries a lower risk of blood clot formation compared with oral estrogen 

● It effectively reduces hot flashes and night sweats 

● It improves sleep quality 

● It may reduce palpitations and nervousness 

For these reasons, transdermal estrogen is often preferred in women with: 

● Migraine 

● Liver disease 

● Increased risk of thrombosis 

● A need for a more physiological hormone replacement approach 

Psychological and Emotional Effects of Menopause 

Common symptoms such as: 

● irritability 

● emotional instability 

● memory and concentration difficulties 

● anxiety 

are not signs of personal weakness. They reflect the effect of estrogen deficiency on the central nervous system. 

With appropriate hormone therapy, not only physical symptoms but also emotional well-being and daily functioning can significantly improve. 

Menopause Is a Manageable Life Stage 

Menopause is: ❌ not the end of womanhood ❌ not something that must be endured in silence 

Menopause is: ✅ manageable ✅ treatable ✅ medically monitorable 

The goals of treatment are not only to reduce hot flashes, but also to: 

🎯 protect bone health 🎯 support cardiovascular health 🎯 preserve sexual health 🎯 improve overall quality of life 

DR.TÜLAY ÇAĞLAR, OBGYN 
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Gynist IVF Clinic in Turkiye-İstanbul

Vali Konağı Caddesi.129 Milas Apartmanı Kat 5 Daire 13, 34363 Şişli/İstanbul

gynistivfclinic.com
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+90 537 615 36 10
info@tulaycaglar.com