Menopause is a naturally occurring aspect of the female* life process. Hormones play a major role in the healthy function of the female body so when levels begin to fluctuate during perimenopause/menopause the effects can be dramatic.
The word “Menopause” comes from the Greek words: “men” meaning month and “pausis” meaning to pause or cease.
Most women understand they will go through Menopause at some stage in their lives but, when asked why and what causes it, many will be unable to answer beyond the cessation of their periods. This article will try to uncover the mystery behind this life-changing series of events.
Throughout her life a woman will experience five stages in her reproductive life: Infancy; Puberty/adolescence; sexual maturation, (reproductive years) peri-menopause and menopause.
Infancy; (Birth: 8 - 13 years) – During this period the female reproductive organs develop. These include Uterus/womb; 2 ovaries; 2 Fallopian Tubes; Cervix and Vagina. Women are born with a finite number of eggs which are stored in the ovaries until Puberty.
Puberty; (8-13 years to 45-55 years) – This is the phase when periods start and the body develops in preparation for future pregnancy. Each month an egg will mature in one of the ovaries, (or both in the case of non-identical twins) and be released to travel along the fallopian tube where it waits to be fertilised before continuing on to the Uterus. If it is not fertilised the egg is expelled from the body. Prior to the release of the egg, the lining of the womb begins to thicken to allow for a fertilised egg to implant and pregnancy to occur. If no egg implants the womb begins to contract, shedding the lining causing a period. This occurs once a month.
Perimenopause; (45-55 years to average age: 51) - “The months or years before the periods stop”, (Abernathy, 2018). During this time the periods may become erratic and change, which is normal for the individual. The length of time between periods may shorten or lengthen, they may become lighter or heavier. Women may begin to experience Menopausal symptoms such as hot flushes; night sweats; mood changes, etc. Pregnancy is still possible during this time but eggs will be in short supply and their condition, poor quality so the chances are low.
Menopause; (Average age in UK – 51) - It is defined as: “when a woman has had no periods for one year or more”. (British Menopause Society, (2022.) The age of Menopause varies and blood tests are not a good indicator of the transition, therefore the diagnosis of Menopause is solely dependent on the occurrence of the last natural period. However, this can be difficult in women who use some forms of contraception that suppress periods or cause a monthly, breakthrough “bleed”, women with certain conditions such as Poly-Cystic Ovary Syndrome, etc or any woman whose periods are naturally sporadic, therefore, diagnosis is often made on symptoms and age alone.
The Menstrual Cycle and the Hormones
Contrary to popular belief the menstrual cycle, although described as monthly, does not run as per calendar months. In reality, it is, on average, every 28 days. (Some women may get a period after 21 days, others may be 33, but usually somewhere between.) The cycle is governed by hormones, specifically: Oestrogen, Progesterone, Follicle-Stimulating Hormone, (FSH) Luteinising Hormone, (LH) and Testosterone.
Day 1: (Menses Phase)The womb starts to shed its lining causing a period; this lasts, on average, for 5 days.
Day 6-14: (The follicular phase) During this time Oestrogen levels begin to rise causing the womb lining to begin to thicken. FSH is released to allow the eggs to mature within the ovary. Around day 14 a surge of LH causes the egg to be released into the fallopian tube.
Day 15-28: (The Luteal Phase) The level of Progesterone increases as the egg travels along the Fallopian Tube. The hormone allows the lining of the womb to prepare for implantation of a fertilised egg. If the egg is not fertilised and/or does not implant, the levels of Oestrogen and Progesterone drop to allow the womb lining to shed and the cycle to begin again.
From Puberty to PeriMenopause/Menopause the hormones continue to perform this "roller coaster" of rising and falling as the reproductive system requires. As life progresses and the number and quality of eggs available lessens, the body's production of hormones begins to fluctuate and eventually stop causing a wide variety of symptoms.
Symptoms are wide ranging and can vary from one person to another due to how the body utilises Oestrogen during the reproductive phase of life. The female body has widespread "Oestrogen Receptors". Receptors are like tiny, individual "parking spaces" for every different hormone. Oestrogen travels around the body and when it locates its specific receptor it "parks" in it and allows its effect to work.
The Ovaries have the most receptors and dictate the levels during the menstrual cycle, but Oestrogen receptors are also located in the brain, cardiovascular system, urinary tract, bones, breast tissue, skin, and hair, amongst others. When levels of Oestrogen drop in the Menopause all of these areas, not just the reproductive system, are affected causing symptoms that can include: Brain fog/Memory issues; mood swings/anxiety/depression; heart palpitations; dry skin; brittle nails; recurrent urine infections/vaginal dryness, the list goes on.
Anyone experiencing issues they feel may be Menopause related should speak to a healthcare professional for support and advice. It is important to rule out other causes, such as thyroid function problems; anaemia; etc but often the strange menagerie of symptoms can be attributed directly to the drop in Oestrogen experienced in perimenopause and menopause.
Hormones play a major role in the healthy function of the female body so when levels begin to fluctuate the effects can be dramatic and debilitating and whilst Menopause is a natural phase in life individuals should not have to struggle and suffer alone when help and support is available to assist a smoother transition to a happy, enjoyable post-menopausal life.
*Throughout this article the use of the words: "female", "woman/en" are used to refer to any individual who may experience Menopause whether they identify this way or other.
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