What on earth is going on with my hormones?
Updated: Mar 24
To understand what’s going on as you go through the menopause you first have to look at the cycle of the female hormones during the years when you regularly have periods - then you will understand what happens as these hormones change as we enter and go through the menopause.
You can think of a hormone acting as a messenger from one part of the body telling another part of the body what to do. The female cycle involves two glands in the brain, the egg cells in the ovaries responding to the hormones and the release of further hormones from the ovaries. To make it simpler we’re just going to be looking at the main female hormones from the ovaries that decline at the menopause:
On the first day of the period, all hormones are at a low level – this sends a message to the hypothalamus in the brain which in turn sends a further message (gonadotrophin) to the pituitary gland (at the base of the brain)
The pituitary gland releases Follicle Stimulating Hormone (‘FSH’)
FSH stimulates the development of follicles (ripening eggs) and by day 5 to 7 usually one follicle is ‘dominant’ which in turn produces high levels of oestrogen - this encourages the womb to become thickened – ready to receive a fertilised egg
At about day 12 to 14 the increasing levels of oestrogen send a message to the pituitary gland to release Luteinising Hormone (‘LH’) and switch off FSH production
The surge of LH causes the follicle to release the egg – ovulation - and the empty follicle starts producing progesterone. This progesterone and the high levels of oestrogen continue to prepare the body for pregnancy
If an egg is not fertilised, the empty follicle ‘collapses’ (about 12 days after ovulation) and the levels of oestrogen and progesterone fall – this drop triggers a ‘period’. (If the egg is fertilised, the empty follicle continues to secrete hormones for the first 90 days of pregnancy until the placenta takes over)
The falling female hormone levels stimulate the hypothalamus to act on the pituitary gland again and so the cycle starts again.
At the pre-menopause stage this cycle occurs monthly as follows:
At the beginning of the cycle (first day of your period) all the female hormones are low – oestrogen and progesterone
Through stimulation from the ‘brain hormones’ – follicle stimulating hormone – FSH – a ripening egg in the ovary is encouraged to develop
As this eggs ripens it produces oestrogen which gets the womb ready in case fertilisation takes place
Mid-month this increasing oestrogen triggers a different ‘brain hormone’ which causes ovulation
The empty egg case produces progesterone – getting the body ready for pregnancy
If the egg not fertilised – egg collapses and all-female hormones reduce and a period starts
At the peri-menopause stage this starts to change:
As you approach the menopause you ovulate less. The ovaries become ‘lazy’, resistant to Follicle Stimulating Hormone (‘FSH’), as your eggs are all used up. To compensate for this your body releases more and more FSH to try and stimulate the egg production – not switched off by the increasing oestrogen levels
Lower levels of oestrogen are produced as the follicles are not stimulated to ripen, which in turn stops ovulation resulting in low levels of progesterone and no monthly bleed – some months the ovary may respond normally – so monthly bleeds become unpredictable. It is the reducing oestrogen particularly, but also the lower levels of progesterone and increasingly higher FSH hormone levels, that are the reason for menopausal symptoms at the peri-menopausal stage
Oestrogen plays a part in almost every tissue in our bodies – in the function of your skin, heart, bones, bladder, vagina, breasts and brain (where it may protect against depression). It is also involved in temperature control which may be a reason for hot flushes as changes in oestrogen levels take place, but also may be due to increasing FSH levels
We continue to produce oestrogen via the adrenal glands and the fat cells in the body – oestrone – this oestrogen is more gentle (than oestradiol) as it has not got the big job of preparing the womb for an embryo every month. It is important not be too stressed (producing adrenaline or noradrenaline), thereby affecting the efficiency of the adrenal glands producing oestrone and also androstenidione, and not too thin so that the fat cells cannot change this chemical into the oestrogen (oestrone) needed for a healthy body
Progesterone levels reduce to very low levels at the menopause as you no longer need this hormone for pregnancy. It is thought by some people that the drop in this hormone may result in the anxiety, irritability, low libido and weight gain experienced at menopause
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