With the onset of puberty in females, two hormones released from the pituitary gland, which is the central regulator of the endocrine system, activate hormone cells. These hormones are FSH (follicle-stimulating hormone) and LH (luteinizing hormone). After the regulated release of FSH and LH, ovarian cells start to form.
After this, two other hormones come into play: estrogen and progesterone. Following the formation of these two hormones, the egg cells mature completely depending on the balance between them. These hormones are released into the uterus during the middle of the menstrual cycle. If fertilization does not occur, the changes in hormone levels lead to shedding of the tissues in the uterus, resulting in menstruation.
A decrease in estrogen hormone in the body leads to the cessation of menstruation, which in other words means the end of fertility. Generally, menstruation stops for women between the ages of 45-55. To be able to say that a woman has reached menopause, she must not have had a menstrual period for at least one year. Menopause occurring before the age of 45 is called early menopause, while menopause occurring after the age of 55 is called late menopause. Menopause is not a sudden event; it is a slow and natural physiological process.
What are the symptoms of menopause?
– Irregular menstrual cycles are one of the most important signs.
– Vaginal dryness, pain, itching, or burning during sexual intercourse.
– Decreased sexual desire.
– Hot flashes, night sweats, palpitations.
– Dizziness, headaches, fatigue.
– Frequent urination or urinary incontinence.
– Increased facial and body hair growth.
– Sleep disturbances, difficulty falling asleep, and shortened total sleep time.
– Mood swings, depression, crying spells, irritability.
– Thinning of the skin and nails.
How is menopause diagnosed?
If menstruation is absent for 12 months, one of the first conditions that come to mind is menopause. There is a period called “perimenopause” where menstrual cycles are irregular, and ovulation may not occur. To determine if a woman has entered menopause, a blood test will be requested to measure FSH hormone levels. If the FSH hormone level is above 40 mIU/mL and the estrogen hormone level is below 20 pg/mL, a diagnosis of menopause can be made.
Menopause cannot be diagnosed using ultrasound.
The main goal of treatment during menopause is to alleviate symptoms, especially for vaginal atrophy prevention and halting bone loss associated with menopause. Hormone therapy may be used in such cases.
An important point to consider in hormone therapy is the choice of drugs. If a woman has had a hysterectomy (removal of the uterus) and is receiving hormone therapy, only estrogen-containing pills are preferred. In women who still have a uterus, consideration of the endometrial tissue is important, and therefore, pills containing both estrogen and progesterone should be used.