From Pregnancy to Menopause: Lifestyle in Women’s Health

A topic that touches two generations

In Türkiye the total fertility rate (the average number of children per woman) fell to 1.48 in 2024, the lowest on record, while the average maternal age at first birth was 27.3.

According to the presentation, the causes of maternal death have shifted from bleeding toward cardiovascular disease, stroke and hypertensive (high blood pressure) disorders. Obesity, diabetes and hypertension make pregnancy riskier, so health before pregnancy deserves attention too. In Türkiye, maternal deaths were reported at 11.5 per 100,000 live births (Ministry of Health, 2025).

Preparation that starts before pregnancy

In polycystic ovary syndrome (PCOS), insulin resistance raises free androgens (male-type hormones); infrequent ovulation and irregular bleeding may follow. According to the 2023 international guideline, lifestyle is the first step for every patient, and no particular diet type has been proven superior. A 5–10% weight loss may improve ovulation.

Steps to lower the risk of preeclampsia (a pregnancy condition with high blood pressure) are ideal weight, blood pressure and blood sugar control before pregnancy, salt restriction and regular exercise. Whether a preventive medicine is needed in high-risk pregnancies is a physician’s decision. Because heart disease risk rises after a hypertensive pregnancy, follow-up after birth is essential.

On plant-based eating, the message is balanced: well-planned vegetarian and vegan diets are suitable in every life stage, pregnancy included, but planning and supplementation are essential. Besides B12, folic acid and iodine, iron, vitamin D, calcium and choline should be reviewed; which supplement to use, and how much, is decided with a physician or dietitian. Two to three servings a week of low-mercury fish are suitable; for those who do not eat fish, algae-based DHA (docosahexaenoic acid) is an option.

Movement in pregnancy: brisk, yet able to talk

The presentation’s exercise prescription is clear: at least 150 minutes a week of moderate-intensity activity, spread over most days. The yardstick is simple: you should be able to talk while exercising. Those who exercised vigorously before can continue, and inactive women can start too. Walking, swimming, stationary cycling, yoga and pilates are suitable; sessions should not exceed 45 minutes, and the environment should be cool.

The benefits are wide-ranging: exercise helps reduce excessive weight gain, the risk of gestational diabetes, low back and pelvic pain, fatigue and anxiety. Exercise is reported not to raise the risk of miscarriage, growth restriction or preterm birth. Contact sports, diving, hot yoga and lying on the back for long periods after week 16 are avoided. With vaginal bleeding, painful contractions, chest pain, dizziness or reduced baby movements, stop at once and see a physician; in some heart and lung conditions, clearance for exercise comes from the physician.

Breastfeeding, contraception and infections

Breastfeeding benefits mothers and babies alike. In mothers it is reported to lower the risk of type 2 diabetes, coronary heart disease, and ovarian and endometrial cancer, with a 4.3% drop in breast cancer for every 12 months of breastfeeding. In babies, gastroenteritis, lower respiratory infections and ear infections decrease. In Türkiye only 41% of infants under 6 months are fed on breast milk alone. Hepatitis B and C are not barriers to breastfeeding.

A contraceptive method is chosen according to effectiveness and the person’s health. In Türkiye 70% of married women use a method, but only 49% use a modern one; traditional methods account for 21%. With migraine with aura, a history of clots or liver disease, some hormonal methods may not be suitable; the decision is made with a physician. For sexually transmitted infections, condoms, HPV (human papillomavirus), hepatitis B and A vaccines, and screening come to the fore; hepatitis B (HBsAg) and hepatitis C (anti-HCV) screening is advised in every pregnancy.

Menopause and cancers in women

The average age of natural menopause is 51.4, and for most women it falls between 48 and 55. In the first year after menopause, 67% of women experience hot flashes. Smoking brings menopause forward by 1–2 years. According to the Menopause Society’s 2022 assessment, under age 60 or within 10 years of menopause, without contraindications and with moderate-to-severe symptoms, the benefits of hormone therapy outweigh the risks; the decision is still made individually with a physician.

Non-hormonal options exist too, such as cognitive behavioral therapy and clinical hypnosis; which one is suitable is decided together with a physician. On the lifestyle side, quitting smoking and, if overweight, losing weight stand out. Evidence on soy for hot flashes is inconsistent; the Menopause Society did not recommend it in 2023.

For cancer prevention, there is no safe level of alcohol (International Agency for Research on Cancer, IARC: Group 1); each 10 g/day raises breast cancer risk by roughly 7–10%. Seven or more hours of activity a week is linked to a 16% lower risk. In Türkiye, mammography every two years at ages 40–69 is used for breast screening, and HPV-DNA plus smear every 5 years at ages 30–65 for cervical screening. Ovarian cancer is not screened for; symptoms such as bloating, early fullness and indigestion should be mentioned to a physician.