Menopause is a natural process that all women undergo as they age. Menopause is the permanent cessation of menstruation. It most often occurs between the ages of 41-58 and is a result of the loss of ovarian activity. When a woman has gone 12 consecutive months of no menses, she has officially entered menopause.
Hormones and Menopause
Menopause is part of the female reproductive cycle that begins between age 10 and 16 with puberty and the beginning of menstruation. Where puberty is the beginning of the fertile period of women, menopause marks the end of this time. However, the transition to menopause is made up of multiple stages including premenopause and perimenopause. Premenopause is the entire period of life from the first menstrual period up until the final one. Perimenopause is the period immediately before menopause. Perimenopause usually begins with changes in the menstrual cycle including lengthening period days and missing periods. This can also be caused by the menopause transition. Various hormones including FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogen and progesterone control the women’s menstrual cycle.
These hormones are integral to the functioning of female reproductive organs but they also have more systemic effects acting on other areas in the body as well. Throughout puberty, these hormones induce menstruation as they rise and interact with each other. During the premenopause stage, they continue to interact with the female reproductive system inducing a menstrual period each month. As a woman enters perimenopause her ovaries begin to decrease in their functioning capacity. This leads to a decreased production of hormones including, estrogen, testosterone and progesterone from the ovaries. This leads to changes in the menstrual period and premenstrual symptoms each month.
These changes in hormone levels not only affect the hormones but they also affect many systems in the body. Other menopausal symptoms that can occur during the perimenopausal period include vaginal dryness, sleep disturbances, mood swings and mood changes, hot flashes, sweating, reddening of the skin, headaches, changes in cognition and memory, fatigue, weight gain, urinary concerns, and low libido. The severity varies amongst women. The perimenopausal period can last between 4 and 10 years.
Menopausal symptoms can be extremely broad and individualized to each person. Some of the most common ones include menstrual changes such as longer time between periods and changes in the amount of flow of menses, vasomotor symptoms such as hot flashes and night sweats, headaches and cognition changes, vaginal dryness, skin dryness, decrease in bone density leading to osteoporosis, mood swings, irritability, depression, loss of sex drive and sleep disturbances.
These symptoms change in intensity can be very debilitating for many women. When these symptoms become too much there is an option to use bioidentical hormones or varying kinds of hormone therapy to supplement the falling hormone levels. As it is the falling levels of estrogen and progesterone that result in the perimenopausal symptoms, adding in some of these hormones endogenously can sometimes help to mediate these symptoms and decrease their intensity short term. Hormone therapy is to help with the symptoms of menopause not to stop menopause. While it can be uncomfortable, menopause and perimenopause is a process that all women need to go through in their lives. Hormone replacement therapy is one to help mediate the symptoms associated with changing hormone levels including both homeopathic and botanical medicines.
The most common form of menopause and perimenopause is natural or spontaneous menopause. This occurs as a woman ages and she leaves the end of her fertile period. In this time her body knows that it is no longer in the premium shape to have children and slowly the ovaries within the reproductive system stop producing the hormones needed to maintain the menstrual cycle and fertility. Natural menopause is a result of the ovaries stopping the production of estrogen and progesterone. While it does produce symptoms that can be intense as the body changes, it is a completely natural process that happens between the ages of 45 and 60.
There are times when menopause can occur earlier than the natural age from other causes. This is known as premature menopause. A premature ovarian failure is a form of menopause that occurs before the age of 40. In this condition, the ovaries fail before a person can reach natural menopause. This results in a loss of the menstrual cycle as well as an increase in the hormone FSH. This is often due to a secondary cause that is resulting in the ovaries not functioning. Temporary menopause results when the normal ovarian function is interrupted temporarily and the menses stops for 12 or more months. Induced menopause occurs when the menses cease after surgical removal of both ovaries (oophorectomy).
Whatever the cause of menopause, the associated symptoms can be similar and equally debilitating. Support may be needed in the form of botanicals, homeopathics, lifestyle changes and hormone replacement therapy may be needed to address the hormonal changes resulting in these symptoms.
Q: Does menopause cause osteoporosis?
A: Menopause does not cause osteoporosis but it does make menopausal women more susceptible to bone loss and the development of osteoporosis. This is because of the effect that the hormone estrogen has on the bones. Typically estrogen prevents bone resorption. This means that it prevents bones from being destroyed and stops bone loss. Our bones are constantly being reshaped during our lives - osteoblasts build bone and osteoclasts break down bones. Estrogen helps control osteoclasts so that they don't destroy or resorp too much bone. When estrogen levels begin to drop in menopause this bone regulatory mechanism is lost. This gives osteoclasts more freedom to the resorp bone causing bone loss. This makes menopause a risk factor for osteoporosis. There are many other factors beyond menopause and falling estrogen levels that lead to an osteoporotic state in menopausal and perimenopausal women.
Q: How long does menopause last?
A: Menopause happens when a woman does not menstruate for 12 straight months. Perimenopause preceded menopause and this is when the hormones begin falling and what is referred to as menopausal symptoms start appearing. Perimenopause can last between 4 and 10 years before menopause is official. Together this is called the menopausal transition. Once menopause is reached symptoms may begin to decrease or they can continue for any number of years after. This makes it very challenging to know how long menopausal symptoms will last. In most cases, symptoms will decrease a few years following menopause.
Q: What kinds of symptoms does menopause cause?
A: Menopause symptoms are the result of the ovaries stopping the production of major sex hormones including estrogen, progesterone and testosterone. The falling levels of these hormones cause symptoms including night sweats, hot flushes, a decrease in sex drive, weight gain, irregular periods, a decrease in ovulation, vaginal dryness, skin dryness, changes in cognition including hazy memory, headaches and many more. Menopause symptoms can be quite varied in their characteristicness and in their intensity. Menopause is complete when a woman does not menstruate for at least 12 straight months.