What Happens to a Woman’s Hormones During Menopause?
Side-Effects of Menopause
Menopause generally describes the period when women permanently stop menstruating. Also called “change of life,” menopause is the culmination of the woman’s siring ability. However, healthcare practitioners use menopause as a reference to a situation where the level of female hormones starts changing/fluctuating. The menopause period is termed complete when a woman stops having menstrual periods for twelve months.
The period just before menopause is called perimenopause, which is characterized by the slow production of mature eggs from the ovaries and irregular ovulation. Similarly, the production of progesterone and estrogen decreases.
When Does Menopause Occur?
While the symptoms of menopause start appearing in women aged 51 years, menopause can occur anytime between 30 years and mid-50s. It may also delay in some women. Generally, underweight women and those who smoke can experience menopause earlier, while it can be delayed for overweight women. Interestingly, women tend to experience menopause at almost the same age as their mothers did.
Apart from natural factors, menopause can occur because of other factors.
- Premature menopause – occurs mostly before 40 years due to ovarian failure. It is highly linked to radiation exposure, smoking, surgeries that affect the blood supply to the ovaries, and chemotherapy drugs.
- Surgical menopause – can occur due to surgical procedures, such as removal of the ovary or pelvic radiation that affects the ovaries. Surgical menopause often has moderate to extreme menopausal symptoms.
Hormonal Changes During Menopause
Most changes associated with menopause occur due to the fluctuation of hormones, primarily estrogen. Below are the two main hormonal changes that occur during menopause:
- Estrogen
Estrogen is the primary female hormone, which promotes the growth and general health of the female reproductive system. It also ensures the vagina is moisturized, well vascularized, and elastic. Estrogen production starts to decline irregularly during perimenopause. In some situations, estrogen levels in the body may surpass previous productions.
Reduced production or low estrogen levels in the body during perimenopause has direct effects on sexual functions, mainly through vaginal dryness, and indirect effects in the form of night sweats and hot flashes. Hot flashes and night sweats deplete energy and undermine sexual desires.
- Progesterone and testosterone
Apart from estrogen, the levels of other ovarian hormones are also affected. Progesterone and testosterone levels also change with midlife changes. Intermittent fluctuation of progesterone primarily affects menstrual periods more than sexual function. However, age-related reduction of testosterone dampens the sex drive or libido of midlife women.
Symptoms of Menopause
While symptoms of menopause vary, below are symptoms typically experienced by most women:
- Hot flashes
Hot flashes are experienced by 75% of women undergoing menopause. This describes a sudden and periodic increase in temperatures. Hot flashes typically start before the last period and last approximately two years. Hot flashes are directly related to declining estrogen levels and vary in intensity and frequency.
Besides increasing skin temperature, hot flashes also increase heart rate, which can lead to perspiration often accompanied by dizziness and palpitations. Hot flashes can turn into night sweats when they occur at night.
- Vaginal atrophy
This describes the thinning and drying of vaginal tissues and the urethra. This leads to dyspareunia, vaginitis, UTI, and cystitis.
- Relaxation of pelvic muscles
Hormonal changes can also cause pelvic muscle relaxation, resulting in urinary incontinence. The bladder, uterus, rectum, and urethra can bulge into the vagina.
How is Menopause Treated?
Symptoms of menopause range from mild and moderate to severe. Once menopause has been diagnosed, usually by the end of menstrual periods for more than 12 months and the occurrence of hot flushes and night sweats, treatment is prescribed for women with severe symptoms. The main types of menopausal treatment include hormone and non-hormonal therapies.
Hormone-replacement therapy primarily involves the replacement of hormones that would otherwise be produced in the ovary. Estrogen is the primary hormone replaced during hormone replacement therapy. Supplements for estrogen hormones are given as patches, creams, injections, or pellets.
Women with gut problems, abnormal lipid profiles, or at risk of thrombolytic diseases, which can occur during menopause, should avoid tablets and instead use topical or implanted hormones. The benefits of hormone replacement therapy for menopausal women outweigh the risks.
On the other hand, non-menopausal treatment includes dietary changes, increasing physical activity, and prescription medications.
The Bottom Line
Menopause is a normal phase in the aging process for women. Once you reach this age bracket, expect some symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness. You should discuss how these symptoms affect your life with your primary healthcare provider for better treatment.