“... I am Mother and the Daughter
I am in the Arms of my Mother
I am barren, and my children are many
I am Married and the Spinster
I am a woman who gives birth and she who never procreated….”
From the Hymn to Isis
The life journey of a woman is both unique and beautiful—a confluence of the opposing forces of creation and destruction repeating themselves in an eternal cycle. In the biological sense, the seeds of creation lie in the menstrual cycle for women.
Many women have a lot of confusion during the menopause period. They often find themselves in the dark, unable to decipher the signals their body is trying to convey.
In this blog, we discuss the role of hormones during menopause and the various hormonal changes you may experience during menopause.
Menopause occurs when you go 12 consecutive months without a menstrual cycle. It’s confirmed when blood tests reveal that ovaries are no longer responsive to the hormonal messages from the pituitary gland in the brain. This results at the end of ovulation and the menstrual cycle. Hence, menopause marks a significant portion of your life: the end of your reproductive period.
The age of menopause generally ranges from 45 to 55 years, 50 on average. The average age of menopause for women in the US is 52. For women in the UK, the average age for menopause is 51.
Menopause is a natural part of ageing and can last for an average of 7 years. Natural menopause, i.e., not caused by surgery or any other treatment or medication occurs in stages. They are
Perimenopause (or menopause transition) - This usually occurs 8–10 years before menopause and usually starts in your 40s. During this phase, your ovaries produce fewer amounts of estrogen (one of the primary hormones for the female reproductive system).
This usually accelerates in the last 1–2 years of menopause. This is also when the symptoms of menopause, such as hot flashes, mood changes, itchy skin, etc., usually show up. However, the menstrual cycles are not at a complete stop, and you can get pregnant during this time.
The period during which a woman shifts from a reproductive to a non-reproductive stage is called climacteric. It usually lasts 5–10 years and covers the periods before, after, and during menopause.
Ovaries are the key producers of reproductive hormones. So, during the climacteric period, when the ovaries reduce the production of these hormones, it causes hormonal imbalances and fluctuations. This gives rise to symptoms such as hot flashes, vaginal dryness, night sweats, mood swings, etc.
Before moving on to how hormones react specifically during each stage, let’s look at the different hormones at play during menopause.
There are several hormones which are at play during the climacteric period. They have a great physical and psychological impact on women during this period.
The primary hormones are oestrogen, progesterone, and testosterone. There are a few others, such as follicle-stimulating hormone (FSH) and luteinising hormone (LH).
Let’s take a look at them:
Also known as the “feminine hormone”, oestrogen is primarily produced in the ovaries, and also in smaller amounts in the adrenaline glands. It’s one of the two main sex hormones in women, the other being progesterone.
There are usually 4 types found in females:
It’s a key hormone that helps control the menstrual cycle. It is at its peak during the menstrual cycle and lowest during your periods.
As you age, the response from your ovaries reduces. This leads to fluctuations in oestrogen and progesterone levels. This continues until you reach menopause. Oestrogen levels usually fall during menopause. The body may produce less oestrogen when progesterone levels fall when women reach their early 30s to mid-40s. This is when you’ll notice erratic periods or even miss many.
Oestrogen directly relates to bone health. Low oestrogen levels can make your bones weaker and more brittle, increasing the risk of osteoporosis.
Progesterone is one of the quintessential steroidal hormones in the reproductive phase. It has a pivotal role in developing the uterine lining for the nurture and life support of the fertilized egg if implanted.
Progesterone helps prepare your body for pregnancy.
Normally, oestrogen and progesterone complement each other and work in opposite ways to create a balance. During perimenopause, though, the progesterone levels start to fluctuate. Low progesterone levels can cause menstrual bleeds and other symptoms such as vaginal dryness.
During menopause, progesterone starts declining and fails to balance estrogen out. This makes oestrogens dominant before they, too, decline.
Also known as the “male hormone”, testosterone is the primary sex hormone and an anabolic steroid in males. It promotes masculine, secondary sexual developments. However, it is a lesser-known fact that it is secreted in the female body, with a specific and essential role to play.
For women, testosterone is produced in the ovaries and the adrenal gland.
These drop much more gradually than either oestrogen or progesterone. The decline in testosterone can lead to low libido, fluctuations in cognitive capabilities, mood changes, and risk of osteoporosis. In the postmenopause phase, you may also experience acne and growth in facial hair.
It is produced in the pituitary gland and helps control the menstrual cycle. Post 2 weeks during your cycle, the LH increases, causing the ovaries to release eggs during ovulation.
They are also produced by the pituitary gland. FSH works in tandem with LH to control the menstrual cycle. It also stimulates the formation of eggs during the ovulation period. They reach their peak right before the ovulation stage.
Although hormonal imbalance causes a significant change in a woman’s life and menstrual cycle, not many women are aware of them.
A survey by the American Association of Retired Persons (AARP) finds out that only 18% of women above 35 years of age are well-informed about the hormonal changes that occur during menopause. Moreover, when shown the symptoms, 16% were unaware that the symptoms were related to hormonal decline due to ageing. Finally, only 7% could make the connection that the symptoms were related to hormones.
In this section, we discuss the hormonal changes you feel before, during, and after menopause. Let’s begin.
The hypothalamus and pituitary glands mostly account for a master switch in your body that sets hormonal functions in motion through a cyclic feedback mechanism. When it comes to menopause, the ovarian follicles gradually become resistant to the hormones (gonadotropins) from Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH). This inhibits the formation of new ovarian follicles, reducing oestradiol secretion.
The “hypothalamus-pituitary nexus” generally considers reduced oestrogen levels as a sign to produce more FSH and LH to jump-start the ovaries (obviously not knowing that the terms have changed!). As a result, this is when exactly you start experiencing irregular menstrual activity and early symptoms of imminent perimenopause. Meanwhile, the impairment in the menstrual routine affects the formation of the corpus luteum and hence the hormonal secretion of progesterone.
Ultimately, this leads to a point where no more ovarian follicles exist or reduce to very few that might be gonadotropin resistant by now. Oestradiol is replaced by oestrone as the primary form of oestrogen. However, the higher concentration of LH in the absence of follicles promotes ovarian androgen secretions—mainly testosterone.
Oestrogen, progesterone and testosterone play the lead roles in the cascade of symptoms experienced in menopause.
Fluctuates unevenly Levels
Levels fall down considerably.
Levels remain at less
Levels rise to a range
Drops drastically to as
Levels remain at a
Declines almost by half
Declines slowly as age increases
Levels fall down
Levels rise again
|Luteinizing hormone |
Levels fall down
Levels rise again
Menopause causes a whole lot of symptoms in the body. These vary from woman to woman and can change in severity as well.
Here are the prominent bodily changes you may feel during menopause:
As the name suggests, it is just a pause, not the end. On the contrary sexual life can be more active devoid of pregnancy risk or lesser parental concerns allowing more time and freedom to devote to oneself.
Not exactly. The hormones of our body don’t work by a thumb rule. Menopausal symptoms are reported even from the late thirties to as late as the early 60s.
A big no! It is advised to follow any form of Contraception even during irregular periods. No matter if you are late by a month or two, your hormones are technically active, it is perimenopause, and you have a fair chance of getting pregnant.
There is this widespread misconception equating menopause to depression. Hormonal variations can only cause temporary mood swings or blackouts. Proper counselling, therapy, emotional support and understanding can get things back on track.
You are not the first and definitely not the last to go through this particular phase of life.
In Ayurveda, Menopause or Rajo-nivritthi (Raja means menstrual blood in this context, and nivritthi means cessation) is never considered an ailment but a phase at the threshold of senescence. Ayurveda promotes a healthy lifestyle and food habits over medical interventions in this particular context.
Incorporating yoga, meditation and mild exercises can limit many psychosomatic ailments and body aches, reduce stress and improve focus.
Consider this phase of life as an opportunity or a duty call from your body to restructure your life and reassign your priorities.
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Menopause occurs when you haven’t had a period consecutively for 12 months i.e. when your ovaries stop producing eggs. You can recognise this period since your period stops at this stage. During your reproductive period, your ovaries produce oestrogen and progesterone. However, the oestrogen and progesterone levels fall in menopause.
Hormonal changes in menopause occur due to certain primary and secondary hormones in the body. These are oestrogen, progesterone, testosterone, Luteinizing hormone (LH), and Follicle-stimulating hormone (FSH).
During perimenopause, frequent hormonal changes can cause symptoms such as mood changes, disturbance in sleep, breast tenderness, migraines, and pain.
When the progesterone levels in menopause are lower than estrogen levels, you may experience heavy and painful periods.
When the oestrogen levels in menopause start dropping, you may experience hot flashes and night sweats. These are some of the most common symptoms of menopause. It can also cause brain fog and changes in libido and mood.
In the post-menopause phase, when the oestrogen levels are low, you may experience thinning and drying of menopausal tissues, also known as vaginal atrophy.