Menopause and Hormone Therapy: Options Available in Turkey
Menopause — the natural cessation of menstruation marking the end of reproductive life — affects every woman, typically between the ages of 45 and 55. The hormonal changes of the menopausal transition produce a range of symptoms that significantly affect quality of life for many women: hot flushes, night sweats, sleep disturbance, mood changes, vaginal dryness, cognitive changes and increased cardiovascular and bone health risks.
Turkey’s gynaecological and endocrinological specialists offer comprehensive menopause management, including modern hormone replacement therapy (HRT) and non-hormonal alternatives, as part of women’s health packages for international patients.
Modern HRT: Reassessing the Evidence
Hormone replacement therapy suffered a dramatic fall from favour following the 2002 Women’s Health Initiative study, which reported increased risks of breast cancer, cardiovascular disease and stroke. Subsequent analysis has substantially revised this picture. The risks identified in the WHI were largely attributable to the specific formulations used (oral conjugated equine oestrogens and medroxyprogesterone acetate) in an older population. Modern HRT using body-identical hormones — micronised progesterone and transdermal oestradiol — carries a very different risk profile.
Current evidence supports that transdermal oestradiol does not carry the thromboembolism risk associated with oral oestrogens. Micronised progesterone (Utrogestan) has a more favourable breast safety profile than synthetic progestogens. For women under 60 or within ten years of menopause, the benefits of HRT in terms of symptom relief, cardiovascular protection, bone protection and quality of life generally outweigh the risks.
Non-Hormonal Options
For women who cannot or choose not to use HRT, several non-hormonal options have evidence for specific symptoms. SSRIs and SNRIs reduce hot flush frequency. Gabapentin has evidence for night sweats. Oxybutynin is effective for flushes. For vaginal dryness, local vaginal oestrogen (which has minimal systemic absorption) is safe even for women who cannot use systemic HRT.
Menopause and Bone Health
Oestrogen deficiency accelerates bone loss during the menopausal transition, increasing fracture risk. DEXA scanning — a low-radiation bone density assessment — is part of comprehensive menopause assessment. Turkey’s health screening packages include DEXA as an add-on assessment for appropriate patients.
Menopause Consultations in Turkey
Turkey’s leading gynaecological and endocrine specialists offer comprehensive menopause consultations for international patients, providing evidence-based assessment and personalised treatment recommendations. Find a menopause specialist through Dr.Visor at drvisor.com.