Menopause & Hormones

Menopause occurs when a woman's monthly menstrual cycle slows and eventually stops, ending her reproductive years. The entirety of the menstrual cycle is controlled by fluctuating hormones, so it is unsurprising that menopause is initiated by these same hormones slowly changing their cycle.

Hormone Types

• There are four hormones that control a woman's menstrual cycle. Estrogen is essential for a woman's sexual development and maintaining a healthy, working reproductive cycle. Progesterone is needed during gestation to help the baby survive from the time the egg is fertilized. Follicle stimulating hormone (FSH) and the luteinizing hormone (LH) control the production of eggs and levels of both rise before an egg is released.

Hormone Functions

• During the menstrual cycle hormone levels rise and fall. Estrogen normally suppresses FSH, but right before the cycle begins estrogen levels drop. This creates a rise in FSH, and the ovary follicles are stimulated. Now estrogen and progesterone rise, preparing the uterus for the egg. Estrogen causes a surge in LH, and the egg is released. However, if the egg is not fertilized, the uterus rids itself of its preparations, and the woman begins to menstruate. Estrogen levels drop, FSH is released, and the cycle begins again.

Cause of Menopause

• A woman moves into perimenopause when estrogen and progesterone levels drop, while FSH and LH levels rise. More and more frequently ovary follicles do not respond to FSH, which means estrogen is not released. This means that FSH levels continue to increase, and LH levels do not rise and release an egg. With no egg and an estrogen decline, the uterus sheds its lining prematurely, thus leading to shorter cycles.

  When a woman is going through menopause, FSH is at continually higher levels while estrogen and progesterone are at continually lower levels. Menopause concludes when the menstrual cycle stops permanently.

Effects

• The new lack of estrogen in the body causes many body changes: reproductive organs shrink, skin can become thinner and dryer, bone mass decreases sometimes causing osteoporosis, and urinary tract muscles weaken, sometimes contributing to incontinence. Lower estrogen levels also contribute to hot flashes and insomnia and can cause the vaginal walls to dry making intercourse painful.

Treatment

• Many women subscribe to hormone therapy in which they take estrogen to alleviate symptoms. Estrogen alone can treat hot flashes, decrease vaginal dryness and slow or even prevent the progression of osteoporosis, but it can also increase the risk of stroke, blood clots and incontinence. Taking progestin decreases the chance of endometrial cancer, but may raise the levels of bad cholesterol. Combination hormone therapy, a combination of estrogen and progestin, reduces the risk of osteoporosis and colorectal cancer, but can increase the chance of breast cancer and dementia. Remember that in addition to hormone therapy there are natural ways to alleviate symptoms such as regular exercise, proper diet and relaxation techniques.