What can change during menopause?
Changes in estrogen levels can affect sleep, mood, the genitourinary system, bone turnover, and body composition, as well as cause vasomotor symptoms such as hot flashes and night sweats. Not every woman experiences the same symptoms; complaints remain mild in some individuals, while in others they can significantly affect daily life and sleep.
What conditions are assessed?
- Hot flashes and night sweats
- Difficulty sleeping and fatigue
- Vaginal dryness, painful intercourse, or recurrent urinary complaints
- Weight gain or fat accumulation, especially around the abdomen
- Risk of decreased muscle mass and bone density
- Mood changes and cognitive complaints
- Changes in libido and sexual health
- Reassessment of cardiovascular and metabolic risks
How is hormone therapy assessed?
Menopausal hormone therapy is one of the most effective options, particularly for bothersome hot flashes and night sweats. Suitability is determined by assessing age, time since menopause, personal and family history, thrombosis and cardiovascular risks, breast and endometrial history, and the individual’s preferences together. In generally healthy, appropriately selected women near menopause, the benefit-risk balance may often be more favorable. However, hormone therapy is not a “rejuvenation” or anti-aging treatment automatically recommended for everyone.
For vaginal dryness and genitourinary complaints, options such as low-dose local vaginal estrogen are assessed differently from systemic therapy. Treatment selection should be based on individual needs.
Nonhormonal options
Various nonhormonal treatment options are available for individuals who do not want to use hormones or are not suitable candidates for hormone therapy. Some prescription medications can reduce vasomotor symptoms. Approaches such as cognitive behavioral therapy may also be helpful for some women in coping with hot flashes and improving sleep quality. Although studies on acupuncture, herbal products, omega-3, and other complementary approaches exist, results vary by method and study; these options should be considered by assessing individual benefit, safety, and drug interactions together.
Menopause and weight management
Weight gain during menopause cannot be explained by hormonal changes alone. Age-related decreases in muscle mass, sleep disturbances, physical activity, dietary patterns, stress, and changes in insulin sensitivity may all play a role together. Therefore, addressing body composition, resistance exercise, adequate protein, sleep, and metabolic risks together is more meaningful than calorie restriction alone. We discuss this approach in detail on the Weight Management and Metabolic Health page.
Bone and muscle health
Bone loss may accelerate after menopause. A bone mineral density assessment may be needed depending on age, fracture risk, and clinical history. Resistance exercise, adequate protein, appropriate calcium and vitamin D intake, and reducing the risk of falls are important parts of a healthy aging plan. For information on muscle strength and sarcopenia, you can consult the Sarcopenia and Muscle Strength guide.
Sleep and cognitive complaints
Night sweats and interrupted sleep can increase daytime fatigue, difficulty concentrating, and a feeling of “brain fog.” However, snoring, obstructive sleep apnea, depression, thyroid disorders, iron deficiency, and certain medications can also contribute to similar complaints. Rather than attributing symptoms solely to menopause, these possibilities are also assessed when necessary.
Sexual health
Vaginal dryness, painful intercourse, low libido, and changes in sexual response can be common during menopause. Local treatments, lubricant/moisturizer options, and hormone therapies in suitable individuals may be considered for genitourinary syndrome. Libido problems, in turn, should be addressed together with sleep, relationships, stress, medications, pain, depression, and hormonal factors. For details, you can visit the Sexual Health and Healthy Aging page.
Our approach at our Bodrum clinic
We do not reduce menopause to a single hormone value or a single treatment method. Our priority is to assess the individual’s most bothersome complaints, sleep and energy status, cardiometabolic risk, bone and muscle health, weight changes, and sexual health goals together. Hormone therapy, nonhormonal options, and lifestyle modifications are considered within the individual’s benefit-risk balance.
Frequently asked questions
Does everyone need hormone therapy during menopause?
No. While it can provide significant benefits for some women, it may not be necessary or appropriate for others. The decision is made by considering symptoms, risk profile, and personal preferences together.
Is weight gain during menopause inevitable?
It is not inevitable. Since age, muscle mass, sleep, activity, and metabolic factors all play a role, body composition can be managed with a personalized and sustainable plan.
Does menopause treatment stop aging?
The purpose of menopause treatment is not to stop aging. The goal is to reduce symptoms, support quality of life, and develop appropriate, individualized preventive strategies in specific areas of health, such as bone health.
References
- The Menopause Society – Position Statements
- The Menopause Society – Hormone Therapy Statement
- The Menopause Society – 2025 hormone therapy update
For a broader framework of the healthy aging approach, you can review the Healthy Aging and Longevity guide.
Written and medically reviewed by: Dr. Kerem Çağlayan
Last medical review: 10 September 2026
Notice: This page provides general health information. An individual assessment is conducted with consideration of age, symptoms, current treatments, and individual goals.
