Menopause Symptoms and Treatment | Prof. Dr. İkbal Kaygusuz

Menopause: Symptoms, Early Menopause and Treatment Options

Prof. Dr. İkbal Kaygusuz Last reviewed: 25 September 2026 2 min read

In short: Menopause is the permanent end of periods due to loss of ovarian function, defined after 12 months without a period. The average age in Türkiye is around 47-49. Hot flushes, night sweats, sleep and mood changes, vaginal dryness and bone loss are the main effects. Menopause before 40 is considered premature ovarian insufficiency. Lifestyle advice, hormone therapy or non-hormonal treatments are planned according to symptoms.

Stages

Perimenopause: the years before menopause, with irregular periods and emerging symptoms; pregnancy is still possible.
Menopause: 12 months after the last period.
Postmenopause: the years after menopause.

Symptoms

Hot flushes and night sweats
Sleep problems and fatigue
Mood changes and difficulty concentrating
Vaginal dryness, painful sex, recurrent urinary infections (genitourinary syndrome)
Urinary incontinence
Joint pain, skin and hair changes

Long-term health

Falling oestrogen leads to bone loss (osteoporosis) and higher cardiovascular risk. Menopause is a good time to review bone density, cholesterol, blood sugar, blood pressure, and breast and cervical screening.

Early menopause and premature ovarian insufficiency

Loss of ovarian function before 40 is called premature ovarian insufficiency. Causes include genetic factors (fragile X premutation, chromosomal differences), autoimmune disease and chemotherapy or radiotherapy; often no cause is found. Hormone therapy is recommended at least until the natural age of menopause to protect bones and heart unless contraindicated. For women wanting pregnancy, options are discussed after assessing ovarian reserve. Young women with a family history of early menopause benefit from reserve monitoring and information on egg freezing.

Treatment options

Lifestyle: regular exercise, stopping smoking, enough calcium and vitamin D, avoiding triggers such as hot drinks, alcohol and spicy food.
Menopausal hormone therapy: the most effective treatment for hot flushes. For most women starting before 60 or within 10 years of menopause, individualised therapy has benefits outweighing risks. Women with a uterus need progestogen with oestrogen. It is not used after breast cancer or with clotting disorders.
Non-hormonal treatments are available for women who cannot use hormones.
Vaginal treatments: moisturisers and low-dose vaginal oestrogen for dryness and painful sex.

Prof. Dr. İkbal Kaygusuz is a co-author of studies on the effects of menopausal hormone therapy and plant-derived treatments such as genistein on vascular health, platelets and kidney function.

Frequently Asked Questions

Does hormone therapy cause cancer?

Long-term combined oestrogen-progestogen therapy may slightly increase breast cancer risk. Risk varies by individual; the decision is shared and reviewed regularly.

Can I get pregnant around menopause?

Pregnancy is possible in perimenopause. Contraception is advised until 12 months without periods over 50, or 24 months under 50.

Sources

The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause, 2022.
Effects of oral hormone replacement therapy on mean platelet volume in postmenopausal women. Turkish Journal of Medical Sciences, 2014.
Does hormone replacement therapy have beneficial effects on renal functions in menopausal women? Archives of Gynecology and Obstetrics, 2012.
Effect of genistein therapy on plasma levels of asymmetric dimethylarginine in healthy postmenopausal women: a randomized, placebo-controlled study. Fertility and Sterility, 2010.

The information on this website is for general information only and does not replace a medical consultation.

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