Menopause Care

Menopause is the stage of life at which ovarian function naturally ends and menstrual periods stop permanently. This page provides general information on follow-up and treatment options during this period.

What is menopause and when does it begin?

Menopause is defined as 12 consecutive months without a menstrual period. The average age of menopause in Türkiye is 47–50 years. The transition period before menopause (perimenopause) may last several years and bring changes in the menstrual pattern and symptoms related to hormone fluctuation. Loss of ovarian function before the age of 40 is termed premature ovarian insufficiency and requires separate assessment.

Common symptoms

• Hot flushes and night sweats (vasomotor symptoms)
• Sleep disturbance, fatigue
• Mood changes, forgetfulness, difficulty concentrating
• Vaginal dryness, pain during intercourse, urinary frequency (genitourinary syndrome of menopause)
• Joint aches, changes in skin and hair

Severity varies widely; some women pass through this period without significant complaints.

Follow-up during menopause

Menopause itself is not a disease; however, the fall in oestrogen may have long-term effects on bone density and cardiovascular health. Annual gynaecological examination, cervical screening (smear/HPV), breast screening (mammography), bone density measurement (DEXA) and assessment of blood pressure, lipids and blood glucose are therefore recommended. Screening intervals are set by the physician according to age and individual risk factors.

Menopausal hormone therapy (MHT)

For symptoms that clearly affect quality of life, and in women without medical contraindications, menopausal hormone therapy is one of the available options. The decision takes into account age, time since menopause, history of breast cancer or thrombosis, cardiovascular risk factors and personal preference, and is made together with the physician. Therapy is used at the lowest effective dose with regular review; it is not suitable for every woman.

About bioidentical hormones

“Bioidentical” describes molecules such as oestradiol and micronised progesterone that are chemically identical to the hormones produced by the body. Licensed, standard-dose pharmaceutical forms of these molecules exist and may be used in menopausal hormone therapy. By contrast, custom-compounded, non-standardised mixtures have limited efficacy and safety data, and international menopause societies do not recommend their routine use. Which preparation is appropriate can only be determined by medical assessment.

Non-hormonal approaches

Where hormone therapy is unsuitable or not preferred, regular physical activity, adequate calcium and vitamin D intake, smoking cessation, sleep hygiene and, where necessary, non-hormonal medications may be considered. Vaginal moisturisers and low-dose local treatments are available for vaginal dryness.