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What are the Hormonal changes in menopause?

Depressed because of menopause, the woman with headache hand holding her head on the bed

Hormonal changes in menopause do not happen suddenly but are established little by little. Menopause is not a specific moment but a process. We explain here what to expect from this stage when estrogens start to drop.

Going through the hormonal changes in menopause is not easy for almost any woman. Like any evolution stage, new issues and problems appear that are a challenge for the body and the mind.

We must understand that it is not the same to speak of menopause as climacteric. In menopause, we are focusing on menstrual cycles. It is understood that a woman is menopausal when twelve consecutive months have passed without menstruation.

On the other hand, the climacteric is the cessation of the menstrual cycle plus all the other elements that accompany the process. As menopause is gradual, we can speak of three stages within it :

  • Perimenopause: these are the months or years prior to the definitive loss of menstruation. The ovaries have fewer eggs, and hormonal production drops sharply.
  • Menopause proper: it is the twelve consecutive months without menstruating.
  • Postmenopause: is the period after the declared menopause.

Menopause and hormonal changes

The hormonal changes in menopause are commanded by the decrease in estrogens and progesterone production. The lower amount of both hormones in the body is to blame for the symptoms.

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In normal menstrual cycles, anovulation happens in the middle of the phase. This ovulation, that is, the exit of an ovum to the fallopian tubes to prepare for fertilization, is possible because the female body has estrogens and progesterone.

Both hormones are synthesized in the ovaries. When these organs stop production, there is no ovulation and therefore no menstruation. In short, this is the direct cause of the menopausal period.

Because estrogens and progesterone serve various functions in the human body, and not only direct ovulation, menopause has many symptoms. Mainly, the substance that causes the most hormonal changes in menopause is estrogen.

The estrogen problem

Hormonal changes in menopause can be attributed, for the most part, to estrogens. These are sex hormones that are made in the ovaries and adrenal glands. When the woman is pregnant, the placenta also produces.

Estrogens turn genes on and off in cells to do their job. Thus, they can give the order that certain proteins in the body are produced or not. And not only do they promote ovulation, but they also:

  • They change the mucus of the urinary and reproductive systems
  • They grow pubic hair in a characteristic way
  • Affect lipid metabolism
  • They participate in the synthesis of collagen
  • Determine where body fat is stored
  • They support the menstrual rhythm
  • They intervene in bone metabolism

Symptoms related to hormonal changes

Based on all the functions of estrogens that we mentioned, we must imagine that the symptoms of hormonal changes in menopause are derived from alterations in those functions. When estrogens decrease, it happens that:

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  • Menstrual cycles do not have a defined rhythm and alternate with months without ovulation.
  • Temperature dysregulations appear, with hot flashes and heats.
  • The sweating of the skin is altered, leading to a profuse loss of fluids during the night.
  • The mucous membranes dry out, especially in the vagina, which causes pain when practicing sexual intercourse – dyspareunia.
  • The bone loses more calcium than it absorbs and fills with pores, in a situation that is clinically known as osteoporosis.

Replacement therapy for hormonal changes in menopause

To counteract the hormonal changes in menopause, doctors may prescribe hormone replacement therapy. It can be done systemically or locally for specific symptoms.

This therapy consists of adding to the body the estrogen that is lacking due to the decrease in production. This artificial and external estrogen would supplant the deficiencies and control the symptoms.

The systemic way of using hormone replacement therapy is estrogen pills or patches. Because some scientific studies have associated some of these therapies with an increased risk of other diseases, they should be used with caution.

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Doctors assess whether the benefit of therapy actually outweighs the possible risk . You should also assess how much discomfort in quality of life means a hot flash or vaginal dryness. For osteoporosis you can choose other treatments that support the bones without using hormones.

An interesting option is a local estrogen, which does not penetrate the entire body. There are vaginal preparations with very small doses of estrogens that improve, for example, vaginal dryness. There the aforementioned risks do not apply.

You must consult a trusted doctor about your symptoms. The best first approach is to evacuate all the doubts that hormonal changes generate to make a wise therapeutic decision. If we understand that menopause is an inevitable change, then we will face it in the most natural way possible.

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Notes

    • Torres Jiménez, Ana Paola, and José María Torres Rincón. “Climacteric and menopause.” Journal of the Faculty of Medicine (Mexico) 61.2 (2018): 51-58.
    • Lugones Botell, Miguel, Tania Y. Quintana Riverón, and Yolanda Cruz Oviedo. “Climacteric and menopause: importance of your care at the primary level.” Cuban Journal of Comprehensive General Medicine 13.5 (1997): 494-503.
    • Martínez, Silvia Sanz, et al. “Prevention of menopause in women.” Developmental Health and Care (2017): 239.

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