Menopause: Learn More

Hormonal Imbalance and Menopause

Although the ovaries decrease their output of estrogen significantly at menopause, they still may produce a small amount.   In addition, some estrogen is also produced in fat cells with help from the adrenal glands.

Progesterone, the other female hormone, works during the second half of the menstrual cycle to create a lining in the uterus as a viable home for an egg, and to shed the lining if the egg is not fertilized. If you skip a period, it generally means that your body is not making enough progesterone to break down the uterine lining because your estrogen levels were not high enough to cause the LH (leutenizing hormone) surge to rupture the follicle, release the egg and create the corpus luteum. Since menses ceases at menopause, your progesterone levels decline sharply.

At menopause, hormone levels don't always decline uniformly . They alternately rise and fall again.

These fluctuating levels of ovarian hormone levels affect the other glands in the body, which together make up the endocrine system. The endocrine system controls growth, metabolism, and reproduction. This system must constantly readjust itself to work effectively. Ovarian hormones also affect all other tissues, including the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, and skin. These fluctuations in hormone levels are responsible for most of the symptoms associated with menopause and can affect any of the tissues affected by the ovarian hormones and/or the endocrine system; this is why women can have so many different symptoms.

Factors Affecting Menopause

There are many factors that play a role in the age of onset or the severity of the symptoms associated with menopause. Studies have shown that women who experience prevalent symptoms related to premenstrual syndrome (PMS) or whose mother experienced sever vasomotor (i.e., hot flashes, night sweats, etc.) symptoms during menopause have an increased prevalence of experiencing vasomotor symptoms during their menopause. These results may be due to a consistent pattern of hormone regulation throughout ones life through similar patterns of diet and exercise (and may even be genetically related) or may be a function of increased scrutiny and awareness of these symptoms.

Fat and Stress - Friend or Foe?

Two sources of estrogen other than the ovaries exist that allow for buffering the dramatic decline of estrogen at menopause. The adipose (fat) tissues are capable of producing estrone and this is thought to play a role in reducing some symptoms in heavier women. While no direct relationship between body mass index (BMI) and hot flashes (or other symptoms) can be predicted in each case, in many individuals more body fat may decrease menopausal symptoms. However, increased weight also leads to an increase in a number of other health concerns, such as cardiovascular disease, joint pain and deterioration, and musculoskeletal disorders, so a little extra weight is okay, a lot is definitely not better J .

The other buffering source is the adrenal glands. Recall the adrenal glands produce several chemicals in reaction to stress, often known for initiating the 'flight or fight' response in times of acute stress. When the adrenal gland is incapable of responding adequately to the stresses put upon it, the symptoms of menopause are likely to be aggravated and/or intensified. Due to the hussle-and-bussle of today's hectic lifestyles and the increased demands placed upon women, most peoples' adrenal glands are very taxed and in need of support. This is one of the keys to a healthy transition. The role of the adrenal glands and their ability to modulate stress is often not taken into consideration by medical doctors when treating clients with menopausal complaints.

Checking adrenal stress (via cortisol and DHEA-S levels) is a simple salivary test that can help determine adrenal involvement and the need for support. Treating an exhausted adrenal system may dramatically improve symptoms with little other intervention. Many other factors play a role in the onset or severity of menopausal symptoms as the chart below details.