How To Know If Your Starting Menopause

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How To Know If Your Starting Menopause

Women go through incredible physical changes throughout their lives. What a woman’s body can do is unique, and how women adapt to change is even more unique. In this series I focus on the changes in the body before, during and after menopause.

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As you know, menopause marks the end of reproduction for a woman. Menopause has different stages and the whole process can take several years. Women usually reach menopause in their 40s or 50s, but the average age in the United States is 51 (1). Stages of a woman’s life are as follows:

Premenopause is the time before any menopausal symptoms appear. Women still have periods, whether regular or irregular. Women are also of reproductive age. Although hormonal changes occur in the body, there are no obvious changes in them. Hormonal changes can start 8-10 years before menopause, usually in a woman’s 40s, but it can also start in her 30s. I like to check the hormones of women over the age of about 35 to make sure they have enough hormones. If it is related to symptoms or illness, I will check as soon as possible.

Perimenopause means “at or after menopause.” During this period, women begin to feel the signs of hormonal changes. The average duration of perimenopause is about four years. For some it may take a few months, for others it may exceed four years. It is still possible to get pregnant during this time.

Menopause occurs when a woman has not had a period for 12 consecutive months. This is when the ovaries stop producing eggs and stop producing most estrogen. As already mentioned, the average age of menopause is 51 years.

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Postmenopause – If more than a year has passed since a woman’s last menstrual cycle, she is in postmenopause. He will be in this stage for the rest of his life.

The symptoms or problems of perimenopause can be very similar to the symptoms or problems of menopause or postmenopause.

Hormones play a big role in menopause. If you remember from biology class, hormones are chemical messengers that are released in the blood or other extracellular fluids. They send messages to specific body parts or target locations to tell those parts what to do. The five main menopausal hormones are follicle-stimulating hormone (FSH), luteinizing hormone (LH), gonadotropin-releasing hormone (GnRH), progesterone, and estrogen. Before we get into the problems associated with hormonal changes, let’s look at the role of these hormones.

Follicle-stimulating hormone (FSH) – FSH plays a major role in controlling the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels fluctuate throughout the menstrual cycle, and FSH reaches its highest level before the egg is released from the ovary.

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Luteinizing hormone (LH) – LH helps control the menstrual cycle and also helps the ovaries release an egg.

Gonadotropin-releasing hormone (GnRH) is released by the hypothalamus to stimulate the release of FSH and LH from the pituitary gland.

Progesterone – Progesterone prepares the endometrium, the lining of the uterus, for possible pregnancy. It signals the lining to thicken to provide an adequate home for the fertilized egg. Progesterone also stops the uterus from contracting, which causes the body to reject the egg. When pregnancy occurs, progesterone levels remain high, preventing ovulation. If pregnancy does not occur, the progesterone level decreases, allowing the menstrual cycle to begin.

Estrogen – Estrogen plays a major role in puberty and beyond. The main source of estrogen comes from the ovaries, but the adrenal glands and adipose tissue also make small amounts of this hormone. Estrogen is responsible for:

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During perimenopause and the onset of menopause, hormone levels may still be somewhat normal. However, when a woman reaches the later stages of menopause, estrogen and progesterone levels are low, and LH and FSH try to stimulate estrogen. FSH and LH remain elevated throughout a woman’s life.

2. Ovaries stop producing eggs – this is a special symptom of menopause. As you approach menopause, your periods and ovulation may become irregular. Ovulation stops completely during menopause.

3. Ovaries stop the production of estrogen and progesterone – estrogen and progesterone are essential for menstrual cycle control and fertility. During menopause, the ovaries stop producing these hormones. Estrogen now comes from the production of the adrenal gland and fat cells. A decrease in estrogen lowers the metabolism in which women use starch and carbohydrates. This can contribute to weight gain in women during menopause.

4. LH and FSH levels rise – because the ovaries stop making estrogen, there is not enough estrogen to turn off the FSH, so these levels rise. Same for LH.

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With these major body changes during menopause, women can experience a variety of issues, from classic hot flashes to mood swings to UTIs. In this article, I provide an overview of these challenges to give patients an idea of ​​what to expect. To learn more about coping with these challenges, see additional articles in my menopause series.

Estrogen can strengthen the urinary tract tissue by increasing the flow of the bladder. During menopause, due to the decrease in estrogen levels, the lining of the urethra and bladder becomes thinner. This thinning allows the folds to expand, which can become pockets for infections, allowing more UTIs to occur during perimenopause, menopause, and postmenopause. Women may experience dysuria or pain/discomfort during urination. However, I have seen many menopausal or postmenopausal women who have no symptoms of UTI, but through the laboratory urinalysis we find a UTI. This continuous UTI gradually weakens the immune system, leaving women more susceptible to inflammation and more infections.

Starting with perimenopause, the drop in estrogen levels can cause the vulvar tissue and the lining of the vagina to become thinner, drier and less elastic. This is called vulvovaginal atrophy. In women, the amount of vaginal secretions decreases and their lubrication decreases. This can cause dryness, itching, burning, irritation and/or vaginal pain. Intercourse may be uncomfortable or painful (3). Some women may experience it at the beginning of perimenopause, while others may not experience it until several years after estrogen levels drop, or not at all. These symptoms can also be associated with a vaginal bacterial or yeast infection (also with increased risk during menopause) or a UTI. I like to use all natural vaginal suppositories with women as we try to regulate hormones and other factors.

Low estrogen levels can also lead to brain problems. All brain cells have estrogen receptors, and a decrease in estrogen levels leads to a decrease in signaling to these brain cells. This can predispose the brain to disease and dysfunction. Research is beginning to show a link between menopause and Alzheimer’s. Menopause can also lead to headaches, mood swings, memory loss, depression and anxiety (4, 5).

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Hot flashes are a sudden feeling of warmth that usually occurs around the face, neck and chest. Women may also experience palpitations, a flushed appearance (perhaps red, blotchy skin), restlessness and/or sweating with hot flashes. They usually last about 5 minutes. As the hot flash passes, a chilly sensation may occur. Frequent nocturnal hot flashes or night sweats can lead to long-term sleep disturbances. Although no one knows why hot flashes occur, it is suspected that a decrease in estrogen levels makes the hypothalamus (your body’s thermostat) more sensitive to slight changes in body temperature. If the hypothalamus thinks your body is too hot, it flashes hot flashes to cool you down (6).

Low estrogen levels in menopausal and postmenopausal women are associated with increased joint pain. You may notice that previous joint injuries start to hurt again and you may experience general joint pain. Although not fully understood, estrogen is believed to reduce inflammation in the body. A lack of estrogen can lead to increased inflammation and joint pain.

Hormonal changes that accompany menopause can lead to weight gain. As I mentioned earlier, the ovaries have stopped producing estrogen and this hormone is now released from the adrenal glands and fat cells, which affects how women process starches and carbohydrates. This hormone shift has a big impact on where women tend to gain weight. Before menopause, women with balanced hormones tend to gain weight around the hips and buttocks in the form of subcutaneous fat. As hormone levels decrease during menopause, they gain visceral fat in the abdomen. Visceral fat does not produce much estrogen and increases inflammation.

Thyroid function can also decrease during this period of life, which can lead to weight gain. Hypothyroidism can share symptoms with menopause, for example

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