prof. Dr. Sezai ŞAHMAY
İ.Ü. Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Department of
Reproductive Endocrinology
Menopause , as the word meaning; refers to the last menstrual bleeding. In case of absence of menstruation for a period of one year following a menstrual bleeding, the previous menstrual period is considered as the last menstrual period. However, it is not always easy to pinpoint this last menstrual bleeding.
As can be understood from the recipe, menopause is not a period, but only the last menstrual bleeding. Generally, the term menopause is expressed as a period among the people. Actually, the correct term for the term is “climacterium”. The climacterium period covers a long period of time, in this period there are 3 main periods such as premenopause (premenopausal), menopause and postmenopause (postmenopausal). It is not possible to define the boundaries of these 3 periods precisely.
After briefly explaining the term menopause, to express what it means from a biological point of view, we can briefly say that the activity of the ovaries ends. Now let's talk briefly about the development and function of the ovaries.
As it is known, the development of the ovaries in a girl child takes place in the mother's womb. During ovarian development, one of the most important structural elements of the ovaries is the germ cells, that is, the egg cells that play a role in reproduction. These cells begin to form when a girl is only 2 months old in the mother's womb, continue to increase rapidly, and reach 7 million when she is 5-6 months old. After this period, the biological decrease in egg cells begins. In other words, there is consumption of these egg cells and this number decreases to 2 million in a newborn girl. This physiological event continues and the number of eggs in a girl entering puberty is about 300-400 thousand.
In the following period, while an egg cell develops to the level of normal fertilization, a certain number of egg cells are consumed each month. This consumption lasts until menopause. In a woman approaching the menopause period, the number has decreased and will one day be exhausted. This period of exhaustion is menopause.
The biological goal of egg development is reproduction, that is, reproduction. One of the main events during the development of this egg cell every month is the secretion of hormones. There are two main stages in the development of the egg cell. Estrogen is secreted in the first period of its development, and progesterone is secreted in the second half. In other words, women are under the influence of 2 different hormones in 2 different periods every month.
Since the egg cells are depleted in the postmenopausal period, the hormones mentioned above cannot be secreted. Deficiency of these hormones, especially estrogen hormone, causes known menopausal symptoms seen in women. However, events such as hot flashes, sweating, forgetfulness, insomnia, disconnection from life, and irritability are early findings. Complaints seen in this early period are such that they make women's life difficult. In addition, these postmenopausal complaints affect not only the women who have entered the menopause, but also those around them. In other words, menopause is an important biological period that can cause familial and social problems.
The most important dimension of the problems that occur in the postmenopausal period is the problems seen in the following years. Two important problems that occur in the late period, 10-15 years after menopause, are cardiovascular diseases and weakening of the bones. Among cardiovascular diseases, there are important health problems such as heart attacks and cerebral hemorrhage. As a result of weakening of the bones, serious health problems such as fractures and related disability or death are seen. It is the deficiency of the estrogen hormone that is responsible for these problems.
In other words, estrogen hormone is an important hormone that protects women from serious health problems. However, since there is no estrogen production after menopause, the woman is deprived of this protective effect.
As it can be understood from the explanations above, one of the most important factors causing important postmenopausal health problems is the lack of estrogen hormone.
One of the most important factors that cause the phenomenon of menopause to be extremely current is the prolongation of human life. In the early 1900s, the average human lifespan was approximately 50 years. However, this period has now extended to 80 years. In other words, a woman lives 1/3 of her life after menopause.
For these reasons, important problems seen in the postmenopausal period and studies for their prevention and treatment continue rapidly.
