In the first two installments of “Maybe It’s Menopause,” we took a nerdy look at how hormones function in a woman’s body at all ages and stages. Now it’s time to zero in on “the change.”
Menopause marks the cessation of hormone production by the ovaries and, thus, the end of a woman’s menstrual cycles. A woman technically reaches menopause when she goes a year without a period. While the average age for this shift is 51, the symptoms associated with the decline in estrogen and progesterone can begin several years before a woman’s final period (a time known as perimenopause) and last several years after.
In their early to mid 40s, women experience a hormonal turbulence similar to that of the teen years. “We move into a new hormonal era,” says Roper St. Francis Healthcare OB/GYN Dr. Betty Raney. “When the ovaries run out of eggs, they stop signaling the brain for estrogen. In response, the brain has to work harder to keep the ovaries functioning. The brain pounds the ovaries with follicle-stimulating hormone (FSH) trying to get it to release an egg and thus secrete estrogen.” The strategy works, but only for a few years.
During perimenopause, super high estrogen levels can wreak havoc on a woman’s emotional state. Symptoms of this natural transition include heavier and more frequent menstrual cycles, worsening PMS and mood swings, anxiety, depression, insomnia, weight gain and low sex drive.
When the ovaries finally stop responding to the pituitary’s pumped-up FSH signals, menopause begins. Without estrogen or progesterone production, the body becomes subject to hot flashes, night sweats, vaginal dryness, foggy thinking and memory loss on top of the symptoms that may have begun during perimenopause.
While menopause lasts for the rest of a woman’s life (because ovarian function doesn’t return), its symptoms usually only last three to five years after the final period. In 85 to 90 percent of women, symptoms wane by the late 50s. “Of course, it’s different for everybody. I have a handful of patients in their 80s still getting hot flashes,” says Dr. Raney.
If that idea has you sweating, be sure to catch the next installment of this blog series to find out how hormone replacement therapy can be used to treat menopause symptoms.