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Mustafa Çelik
Mustafa Çelik Liv Hospital Content Team
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Can Lowering Estrogen Set Back the Time? Surprising Facts
Can Lowering Estrogen Set Back the Time? Surprising Facts 4

Can lowering estrogen set back the time? This ultimate guide reveals the surprising, critical facts about anti-aging and hormones. Menopause is a big change for women, affecting their mental health. Women usually go through menopause around 51-52 years old. This time brings a stop to menstrual cycles and a drop in estrogen and progesterone levels. This leads to many symptoms.

Medical Expert, “Hormonal changes can play a big role in your mental health. Anxiety or depression can happen during menopause because of the ups and downs in estrogen and progesterone.” It’s important to know how these changes affect mood. This helps figure out when to seek help.

At Liv Hospital, we focus on both the body and mind during menopause. We make sure women get all the support they need during this big change.

Key Takeaways

  • Menopause is a big change for women, affecting their mental health.
  • Hormonal changes during menopause can lead to depression and anxiety.
  • Understanding the relationship between hormonal fluctuations and mood changes is key.
  • Professional support is available for women experiencing mental health challenges during menopause.
  • Liv Hospital offers complete, patient-centered care for menopause symptoms.

The Menopause Transition: What Happens to Your Body

Can Lowering Estrogen Set Back the Time? Surprising Facts

The menopause transition is a complex process with many stages and big hormonal changes. It’s important for women to know what happens in their bodies. This knowledge helps manage symptoms and get support.

Defining Perimenopause, Menopause, and Postmenopause

The menopause transition includes perimenopause, menopause, and postmenopause. Perimenopause is the first stage. Women may feel symptoms from hormonal changes, even if they’re not done menstruating yet.

Menopause is when a woman hasn’t had a period for 12 months. It’s when her reproductive years end.

Postmenopause comes after menopause. It lasts for the rest of a woman’s life. Symptoms can stay or get better over time.

Hormonal Fluctuations: Estrogen and Progesterone Decline

During the menopause transition, estrogen and progesterone levels drop a lot. Estrogen is key for many body functions, like reproductive health and bone health.

When estrogen levels go down, women might feel hot flashes, mood swings, and changes in their menstrual cycles.

Average Timeline: What to Expect at Ages 45-55

The menopause transition usually starts in a woman’s mid-to-late 40s. It can last 4 to 8 years, but it varies.

Stage

Average Age

Characteristics

Perimenopause

45-50

Hormonal fluctuations, irregular periods

Menopause

51 (average)

Cessation of menstruation

Postmenopause

After menopause

Symptoms may persist or subside

Knowing the stages of menopause and the hormonal changes helps women deal with this time. By understanding symptoms and what to expect, women can find the right support and ways to manage their health.

The Mental Health Connection: Statistics and Research

Can Lowering Estrogen Set Back the Time? Surprising Facts

Menopause often brings big changes in mental health, like more depression and anxiety. It’s key to know about these changes to help women through this tough time.

Research shows menopause makes women more likely to feel depressed and anxious. About 40% of women going through menopause might feel sad or worried. A 2023 study found that 15% to 50% of women in this stage might also forget things or have trouble sleeping.

Prevalence of Depression During Menopause

Depression is a big worry during menopause. Studies say 15% to 50% of women might feel depressed. This shows how different everyone’s experience can be, and why care needs to be tailored.

Let’s look at some key stats on depression during menopause:

Study

Sample Size

Prevalence of Depression

2023 Study

1,000 women

15% to 50%

2019 Research

500 women

30% to 40%

Anxiety Symptoms and Their Frequency

Anxiety is also common during menopause. Symptoms can be mild or severe, like feeling worried or restless. Many women experience these symptoms during this time.

Research Evidence: Is There a Causal Relationship?

There’s a big question: does menopause cause depression and anxiety? Research says yes, hormonal changes play a big role. But how exactly, is a bit more complicated.

Studies show that dropping estrogen levels can mess with mood-regulating chemicals in the brain. This is thought to be a main reason for depression and anxiety in menopause.

Can Lowering Estrogen Set Back the Time? Hormonal Mechanisms

Menopause brings big changes in hormones that affect a woman’s mind. It’s important to understand how estrogen and mental health are linked. This knowledge helps tackle the mental health issues that come with menopause.

Estrogen’s Critical Role in Brain Function

Estrogen is key to how our brains work. It affects neurotransmitters and brain paths. Studies show estrogen receptors are all over the brain, in areas that control mood.

When estrogen levels fall during menopause, these brain areas can change. This might lead to mood swings and emotional shifts.

How Fluctuating Hormones Affect Mood Stability

Changes in estrogen and progesterone during menopause mess with mood. As estrogen drops, neurotransmitters like serotonin and dopamine get out of balance. This can cause mood swings, irritability, and a higher risk of depression and anxiety.

These hormone changes also cause hot flashes and night sweats. These symptoms can disrupt sleep and make mood problems worse.

Research says, “The drop in estrogen levels can also lead to hot flashes that disturb sleep, which can then lead to a host of different problems, including depression.” This shows how hormones, physical symptoms, and mental health are all connected during menopause.

The Estrogen Withdrawal Theory of Depression

The estrogen withdrawal theory says a quick drop in estrogen can cause depression in some women. Studies show estrogen therapy can help with depression in menopausal women. It suggests it’s the sudden drop in estrogen, not just the levels, that causes depression.

To show how estrogen and depression are linked, here’s a table:

Hormonal Change

Effect on Mood

Potential Outcome

Rapid decline in estrogen

Increased risk of mood swings

Depression or anxiety

Fluctuating estrogen levels

Mood instability

Irritability, emotional distress

Estrogen withdrawal

Depressive symptoms

Clinical depression

Knowing how hormones affect mental health in menopause helps doctors find better treatments. By understanding estrogen’s role in brain function and mood, we can tackle menopause-related mental health issues better.

Neurotransmitter Disruption During Menopause

Menopause brings a drop in estrogen, which can mess with brain chemicals. These chemicals, or neurotransmitters, help control mood, hunger, and sleep. When they get out of balance, it can cause feelings of sadness and worry.

Serotonin Levels and Depression Risk

Changes in estrogen can lower serotonin, a key mood controller. Studies show that less estrogen means less serotonin, raising the chance of feeling down. This can make it hard to enjoy things and feel happy.

Research backs up the serotonin-depression link. It shows that medicines that boost serotonin can help with depression symptoms.

GABA Function and Anxiety Symptoms

GABA is another brain chemical affected by menopause. It helps us feel calm and less anxious. Changes in estrogen can mess with GABA, making women feel more on edge and irritable.

  • Increased anxiety symptoms
  • Restlessness and irritability
  • Feelings of overwhelm and worry

The Hormonal-Neurochemical Interaction

Menopause’s hormonal shifts affect brain chemicals in complex ways. Estrogen impacts serotonin and GABA, and other chemicals too. This mix can cause mood swings and mental health issues. It’s key to understand this to find the right treatments.

Knowing how neurotransmitters change in menopause helps doctors. They can then use specific treatments to ease depression and anxiety. This improves life for women going through this big change.

Physical Symptoms That Affect Mental Health

Women going through menopause often face physical symptoms that impact their mental health. These symptoms are not just about hormonal changes. They also include physical discomfort.

Hot Flashes and Night Sweats

Hot flashes and night sweats are common in menopause, affecting 40% to 69% of women. These symptoms can disrupt daily life. When they happen at night, they can lead to sleep problems, making mental health worse. Medical Expert, “If hot flashes and night sweats at bedtime are keeping you up, there are treatments available.”

Sleep Disturbances and Their Impact on Mood

Sleep problems are a big issue during menopause. Night sweats and hot flashes can wake you up often, causing sleep loss. This lack of sleep can make you feel irritable, anxious, and depressed. Poor sleep can lead to mental health issues, and mental health problems can also disrupt sleep.

The Vicious Cycle: Physical Discomfort and Emotional Distress

Menopause symptoms can create a cycle of discomfort and emotional distress. For example, hot flashes can cause anxiety, which can make hot flashes worse. It’s important to break this cycle to manage both physical and mental health during menopause. Understanding this connection helps in finding effective treatments for both symptoms.

Identifying Depression and Anxiety During Menopause

Women going through menopause need to know the difference between normal mood swings and serious mental health issues. Hormonal changes can cause physical and emotional symptoms. It’s hard to tell when these symptoms become clinical depression or anxiety.

Distinguishing Normal Mood Changes from Clinical Depression

Normal mood swings in menopause might include feeling irritable or sad. But clinical depression is more serious. It involves feeling hopeless, losing interest in activities, and changes in appetite or sleep.

Medical Expert, “If you feel sad or hopeless nearly every day for two weeks or more, you might be depressed.”

Key differences between normal mood changes and clinical depression include:

  • Persistent feelings of sadness or hopelessness
  • Loss of interest in activities once enjoyed
  • Significant changes in appetite or sleep patterns
  • Fatigue or loss of energy

Common Symptoms That Warrant Attention

Women in menopause should watch for these symptoms:

  • Persistent feelings of anxiety or worry
  • Difficulty concentrating or making decisions
  • Memory problems
  • Sleep disturbances

Screening Tools and When to Consult Healthcare Providers

There are tools to help spot depression and anxiety in menopause. Doctors might use the PHQ-9 for depression or the GAD-7 for anxiety. If symptoms affect your daily life, see your doctor.

Screening Tool

Purpose

Score Range

PHQ-9

Assesses depression severity

0-27

GAD-7

Evaluates anxiety severity

0-21

Early treatment of depression and anxiety in menopause can greatly improve life quality. If you’re worried about your mental health, talk to your healthcare provider.

Risk Factors: Who’s Most Vulnerable?

Menopause can be a tough time for women’s mental health. Certain factors make some women more likely to feel depressed or anxious. Knowing these factors can help.

Prior History of Depression or Anxiety

Having depression or anxiety before can make menopause harder. If you’ve had these issues before, you might feel them again during menopause, studies show. It’s key to watch your mental health closely during this time.

Life Circumstances and Stressors

Life changes and stress can also raise the risk of feeling down or anxious during menopause. Big changes, like kids moving out or aging parents, can add to stress. Stress can make menopause symptoms worse, making it hard for women to cope.

Genetic Predisposition and Family History

Genetics and family history also matter. Women with a family history of mental health issues might face a higher risk. Knowing this can help doctors provide better support.

Healthcare providers can help women going through menopause by being proactive. They can watch for signs of depression and anxiety, focusing on those with a history or genetic risk.

Evidence-Based Treatment Approaches

Evidence-based treatments offer new hope for women facing menopause-related mental health issues. They help manage symptoms by understanding treatment options.

Benefits of Hormone Therapy

Hormone therapy boosts hormone levels to ease menopausal symptoms. Studies show estrogen helps perimenopausal women with depression. It’s effective for severe symptoms.

Key Benefits of Hormone Therapy:

  • Relief from hot flashes and night sweats
  • Improvement in mood stability
  • Reduction in risk of osteoporosis

Treatment

Benefits

Considerations

Hormone Therapy

Relieves menopause symptoms, improves mood

Risk of blood clots, stroke

Antidepressant Medications

Effective for depression, anxiety

Side effects, withdrawal symptoms

Psychotherapy (CBT)

Improves coping skills, mood management

Requires commitment, may not be covered by insurance

Effectiveness of Antidepressant Medications

Antidepressant medications are key for managing depression and anxiety in menopause. They work well, mainly for those with a history of these issues.

Considerations for Antidepressant Use:

  • Potential side effects
  • Risk of withdrawal symptoms
  • Interaction with other medications

Psychotherapy Options

Psychotherapy, like Cognitive Behavioral Therapy (CBT), is a valuable option. It helps women cope and improves mental health.

Understanding these treatments helps women make informed choices. They can work with healthcare providers to manage symptoms effectively.

Conclusion: Navigating Mental Health Through Menopause

Menopause is a big change in life that can affect our mental health. It can lead to feelings of sadness and worry. To deal with these feelings, we need to make lifestyle changes, talk to therapists, and use medicine.

Understanding how hormones change and affect our brain can help us manage these feelings. We can help women get the best care possible, no matter where they are in the world. There are many ways to treat these symptoms, like hormone therapy, medicines for depression, and talking therapy.

It’s important to recognize the impact of menopause on our mental health. By getting the right support, women can reduce the risk of feeling sad or anxious. We aim to provide care that meets each woman’s needs, helping them through this big change with confidence and support.

FAQ

Does menopause cause depression and anxiety?

Menopause can lead to depression and anxiety due to hormonal changes. This includes the drop in estrogen levels. But, it’s not the only reason. Life events and past mental health issues also matter.

What are the symptoms of menopause-related depression?

Symptoms include feeling sad all the time, losing interest in things, and changes in sleep or appetite. It’s important to tell these apart from normal mood swings during menopause.

How does estrogen affect mood during menopause?

Estrogen affects the brain and mood. When estrogen levels drop during menopause, mood swings can happen. This can increase the risk of depression.

Can hormone therapy help with menopause-related depression?

Hormone therapy, like estrogen, can help some women with depression during menopause. But, it’s not for everyone. Always talk to a doctor before starting hormone therapy.

What other treatments are available for menopause-related depression and anxiety?

Treatments include antidepressants and therapy like cognitive-behavioral therapy (CBT). Making lifestyle changes, like exercising and eating well, can also help.

How long does menopause depression last?

How long menopause depression lasts varies. With the right treatment, symptoms can get better in a few months. But, some women may deal with it longer, so ongoing support is key.

Can menopause cause severe depression?

Yes, menopause can lead to severe depression in some women. If symptoms are severe or affect daily life, seek medical help.

How can I manage anxiety during menopause?

Managing anxiety during menopause involves lifestyle changes and medical treatments. Try relaxation techniques, exercise, and a healthy diet. Antidepressants or hormone therapy might also be needed.

Are there any risk factors that make women more vulnerable to depression and anxiety during menopause?

Yes, risk factors include a history of depression or anxiety, big life stressors, and a family history of mental health issues. Knowing these can help in providing the right support.

What screening tools are used to diagnose depression and anxiety during menopause?

Doctors use questionnaires and clinical assessments to diagnose depression and anxiety during menopause. These tools help identify symptoms and find the right treatment.


References

https://pmc.ncbi.nlm.nih.gov/articles/PMC2984203

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The content on this page is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified healthcare provider regarding any medical conditions.

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Nazlı Topfedaisi Özkan Gynecological Oncology Op. MD. Gökhan Kılıç Liv Hospital Ankara Op. MD. Gökhan Kılıç Obstetrics and Gynecology Op. MD. Zeynep Ataman Yıldırım Liv Hospital Ankara Op. MD. Zeynep Ataman Yıldırım Obstetrics and Gynecology Op. MD. Çetin Arık Liv Hospital Ankara Op. MD. Çetin Arık Obstetrics and Gynecology Op. MD. Özge Şehirli Liv Hospital Ankara Op. MD. Özge Şehirli Obstetrics and Gynecology Op. MD. Özgül Kafadar Liv Hospital Ankara Op. MD. Özgül Kafadar Obstetrics and Gynecology Prof. MD. Mehmet Sinan Beksaç Liv Hospital Ankara Prof. MD. Mehmet Sinan Beksaç Obstetrics and Gynecology Prof. MD. Türkan Gülpınar Liv Hospital Ankara Prof. MD. Türkan Gülpınar Obstetrics and Gynecology Prof. MD. İbrahim Alanbay Liv Hospital Ankara Prof. MD. İbrahim Alanbay Obstetrics and Gynecology Assoc. Prof. MD. Ali Ovayolu Liv Hospital Gaziantep Assoc. Prof. MD. Ali Ovayolu Obstetrics and Gynecology Op. MD. Eda Deniz Atkın Liv Hospital Gaziantep Op. MD. Eda Deniz Atkın Obstetrics and Gynecology Op. MD. Hatice Şahin Bıkmaz Liv Hospital Gaziantep Op. MD. Hatice Şahin Bıkmaz Obstetrics and Gynecology Op. MD. Merve Evrensel Liv Hospital Gaziantep Op. MD. Merve Evrensel Obstetrics and Gynecology Spec. MD. Ayça Bozoklar Nuh Liv Hospital Gaziantep Spec. MD. Ayça Bozoklar Nuh Obstetrics and Gynecology MD. Gamze Keleş Liv Hospital Samsun MD. Gamze Keleş Obstetrics and Gynecology Op. MD. Hilal Mürüvvet Bulut Aydemir Liv Hospital Samsun Op. MD. Hilal Mürüvvet Bulut Aydemir Obstetrics and Gynecology Op. MD. Sami Şahin Liv Hospital Samsun Op. MD. Sami Şahin Obstetrics and Gynecology Op. MD. Seher Sarı Kayalarlı Liv Hospital Samsun Op. MD. Seher Sarı Kayalarlı Obstetrics and Gynecology MD. KAMRAN NAĞIYEV Liv Bona Dea Hospital Bakü MD. KAMRAN NAĞIYEV Obstetrics and Gynecology Spec. MD.  AYNURE HEMIDOVA Liv Bona Dea Hospital Bakü Spec. MD. AYNURE HEMIDOVA Obstetrics and Gynecology Spec. MD. RAMİN QELENDEROV Liv Bona Dea Hospital Bakü Spec. MD. RAMİN QELENDEROV Obstetrics and Gynecology Spec. MD. SEVİNC SERDARLI Liv Bona Dea Hospital Bakü Spec. MD. SEVİNC SERDARLI Obstetrics and Gynecology Spec. MD. İLHAME ELDAROVA Liv Bona Dea Hospital Bakü Spec. MD. İLHAME ELDAROVA Obstetrics and Gynecology Spec. MD. İRANE QORÇİYEVA Liv Bona Dea Hospital Bakü Spec. MD. İRANE QORÇİYEVA Obstetrics and Gynecology Op. MD. Merve Akın Op. MD. Merve Akın Obstetrics and Gynecology Op. MD. Selda Atar Akal Op. MD. Selda Atar Akal Obstetrics and Gynecology Op. MD. Faik Tamer Sözen Liv Hospital Ulus + Liv Hospital Vadistanbul Op. MD. Faik Tamer Sözen Obstetrics and Gynecology Assoc. Prof. MD. Yusuf Başkıran Liv Hospital Bahçeşehir + Liv Hospital Topkapı Assoc. Prof. MD. Yusuf Başkıran Obstetrics and Gynecology
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Assoc. Prof. MD. Miraç Özalp Obstetrics and Gynecology

Assoc. Prof. MD. Miraç Özalp

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Op. MD. Faik Tamer Sözen Obstetrics and Gynecology

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Prof. MD.  Mustafa Alper Karalök Obstetrics and Gynecology

Prof. MD. Mustafa Alper Karalök

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Prof. MD. Ayhan Sucak Obstetrics and Gynecology

Prof. MD. Ayhan Sucak

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Prof. MD. K. Doğa Seçkin Obstetrics and Gynecology

Prof. MD. K. Doğa Seçkin

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Assoc. Prof. MD. Gönül Özer Obstetrics and Gynecology

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Assoc. Prof. MD. Çağlar Çetin

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Op. MD. Altuğ Semiz Obstetrics and Gynecology

Op. MD. Altuğ Semiz

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Op. MD. Asena Ayar Madenli Obstetrics and Gynecology

Op. MD. Asena Ayar Madenli

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Op. MD. Burak Hazine Obstetrics and Gynecology

Op. MD. Burak Hazine

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Op. MD. Gamze Baykan Özgüç

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Prof. MD. Mehmet Serdar Kütük Obstetrics and Gynecology

Prof. MD. Mehmet Serdar Kütük

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Assoc. Prof. MD.  Müberra Namlı Kalem Obstetrics and Gynecology

Assoc. Prof. MD. Müberra Namlı Kalem

Liv Hospital Bahçeşehir
Assoc. Prof. MD.  Ziya Kalem Obstetrics and Gynecology

Assoc. Prof. MD. Ziya Kalem

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Assoc. Prof. MD. Mine Dağgez Gynecological Oncology

Assoc. Prof. MD. Mine Dağgez

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Assoc. Prof. MD. Yusuf Başkıran Obstetrics and Gynecology

Assoc. Prof. MD. Yusuf Başkıran

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Asst. Prof. MD. Bülent Tekin Obstetrics and Gynecology

Asst. Prof. MD. Bülent Tekin

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Asst. Prof. MD. Kübra Irmak

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Op. MD. Alp Koray Kinter Gynecological Oncology

Op. MD. Alp Koray Kinter

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Op. MD. Ayşe Bilgen Obstetrics and Gynecology

Op. MD. Ayşe Bilgen

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Op. MD. Betül Averbek Obstetrics and Gynecology

Op. MD. Betül Averbek

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Op. MD. Billur Küpelioglu Obstetrics and Gynecology

Op. MD. Billur Küpelioglu

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Op. MD. Cansu Kaya Obstetrics and Gynecology

Op. MD. Cansu Kaya

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Op. MD. Deniz Sarıkaya Kalkan Obstetrics and Gynecology

Op. MD. Deniz Sarıkaya Kalkan

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Op. MD. Selda Akal Obstetrics and Gynecology

Op. MD. Selda Akal

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Spec. MD. Refaettin Şahin Perinatology

Spec. MD. Refaettin Şahin

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Assoc. Prof. MD. Nihal Çallıoğlu Perinatology

Assoc. Prof. MD. Nihal Çallıoğlu

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Assoc. Prof. MD. Semra Yüksel Obstetrics and Gynecology

Assoc. Prof. MD. Semra Yüksel

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Asst. Prof. MD. Serhat Şen Obstetrics and Gynecology

Asst. Prof. MD. Serhat Şen

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Op. MD. Elif Uysal Obstetrics and Gynecology

Op. MD. Elif Uysal

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Op. MD. Haldun Celal Özben Obstetrics and Gynecology

Op. MD. Haldun Celal Özben

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Op. MD. Meltem Özben Obstetrics and Gynecology

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Prof. MD. İsmet Alkış Obstetrics and Gynecology

Prof. MD. İsmet Alkış

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Assoc. Prof. MD.  Ümit Yasemin Sert Dinç Obstetrics and Gynecology

Assoc. Prof. MD. Ümit Yasemin Sert Dinç

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Assoc. Prof. MD. Aytac Jafarzade Obstetrics and Gynecology

Assoc. Prof. MD. Aytac Jafarzade

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Assoc. Prof. MD. Nazlı Topfedaisi Obstetrics and Gynecology

Assoc. Prof. MD. Nazlı Topfedaisi

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Assoc. Prof. MD. Nazlı Topfedaisi Özkan Gynecological Oncology

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Op. MD. Gökhan Kılıç Obstetrics and Gynecology

Op. MD. Gökhan Kılıç

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Op. MD. Zeynep Ataman Yıldırım Obstetrics and Gynecology

Op. MD. Zeynep Ataman Yıldırım

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Op. MD. Çetin Arık Obstetrics and Gynecology

Op. MD. Çetin Arık

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Op. MD. Özge Şehirli Obstetrics and Gynecology

Op. MD. Özge Şehirli

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Op. MD. Özgül Kafadar Obstetrics and Gynecology

Op. MD. Özgül Kafadar

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Prof. MD. Mehmet Sinan Beksaç Obstetrics and Gynecology

Prof. MD. Mehmet Sinan Beksaç

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Prof. MD. Türkan Gülpınar Obstetrics and Gynecology

Prof. MD. Türkan Gülpınar

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Prof. MD. İbrahim Alanbay Obstetrics and Gynecology

Prof. MD. İbrahim Alanbay

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Assoc. Prof. MD. Ali Ovayolu Obstetrics and Gynecology

Assoc. Prof. MD. Ali Ovayolu

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Op. MD. Eda Deniz Atkın Obstetrics and Gynecology

Op. MD. Eda Deniz Atkın

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Op. MD. Hatice Şahin Bıkmaz Obstetrics and Gynecology

Op. MD. Hatice Şahin Bıkmaz

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Op. MD. Merve Evrensel Obstetrics and Gynecology

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Spec. MD. Ayça Bozoklar Nuh Obstetrics and Gynecology

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MD. Gamze Keleş Obstetrics and Gynecology

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Op. MD. Hilal Mürüvvet Bulut Aydemir Obstetrics and Gynecology

Op. MD. Hilal Mürüvvet Bulut Aydemir

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Op. MD. Sami Şahin Obstetrics and Gynecology

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MD. KAMRAN NAĞIYEV Obstetrics and Gynecology

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Liv Bona Dea Hospital Bakü
Spec. MD.  AYNURE HEMIDOVA Obstetrics and Gynecology

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Spec. MD. RAMİN QELENDEROV Obstetrics and Gynecology

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Spec. MD. SEVİNC SERDARLI Obstetrics and Gynecology

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Spec. MD. İLHAME ELDAROVA Obstetrics and Gynecology

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Spec. MD. İRANE QORÇİYEVA Obstetrics and Gynecology

Spec. MD. İRANE QORÇİYEVA

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Op. MD. Merve Akın Obstetrics and Gynecology

Op. MD. Merve Akın

Op. MD. Selda Atar Akal Obstetrics and Gynecology

Op. MD. Selda Atar Akal

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