The hormonal changes in menopause do not happen suddenly, but they 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 stage of change, 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 than of 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.
The climacteric, on the other hand, 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.
- Post menopause: is the period after the declared menopause.
Menopause and hormonal changes
The hormonal changes in menopause are commanded by the decrease in the production of estrogens and progesterone. The lower amount of both hormones in the body is to blame for the symptoms.
In normal menstrual cycles, an ovulation 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, there is no menstruation. In short, that 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
- They affect lipid metabolism
- They participate in the synthesis of collagen
- Determine the storage location for body fat
- 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:
- Menstrual cycles do not have a defined rhythm and alternate with months without ovulation.
- Temperature dysregulations appear, with hot flashes and heats.
- Sweating of the skin is disturbed, 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 increased risk of other diseases, they should be used with caution.
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 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.
It is very important that you consult a trusted doctor about your symptoms. The best first approach is to evacuate all the doubts that hormonal changes generate in order 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.