Menopause: Recognising The Signs

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With menopause gaining so much attention recently, it’s more important than ever for women to have a clear understanding of the biochemical and hormonal changes that occur during this phase. While this increased awareness is a positive step, it can still leave many women feeling confused about what menopause truly means for them. This natural process marks a new chapter in a woman’s life, bringing significant changes to the body’s functioning. By exploring the complex mechanisms at play, women can gain valuable insights into how their bodies are adapting during this transformative stage.

Menopause: Recognising The Signs

The Hormonal Orchestra of Menopause

Follicle-Stimulating Hormone (FSH) and Luteinising Hormone (LH)

The transition to menopause begins with changes in the levels of follicle-stimulating hormone (FSH) and luteinising hormone (LH). As the ovaries become less responsive to these hormones, their levels start to rise in the pituitary gland, particularly FSH, which is often one of the earliest measurable indicators of the menopausal transition.

This rise in FSH is directly linked to declining levels of inhibin B, a protein produced by developing ovarian follicles. As the number of follicles naturally decreases with age, the production of inhibin B also falls, leading to the characteristic increase in FSH.

Menopause is clinically defined as the point when a woman has experienced 12 consecutive months without a menstrual period. In most cases, general practitioners diagnose menopause based on a combination of factors, including the patient's age, reported symptoms, and menstrual history. While hormone testing is not routinely practiced for diagnosing menopause, if a healthcare provider deems it necessary, they may conduct two separate tests for follicle-stimulating hormone (FSH) levels. These tests should be performed at least one month apart. However, it's important to note that such testing is not typically part of standard diagnostic procedures for menopause in women over 45.

Oestrogen Fluctuations

Oestradiol, the primary form of oestrogen during reproductive years, begins to fluctuate erratically during the perimenopausal phase. These fluctuations can lead to periods of relatively high oestrogen followed by sudden drops. Eventually as a woman nears menopause, oestradiol levels decline significantly as the ovaries cease their production.

Oestrogen Fluctuations

Image from https://www.mymenopausecentre.com/knowledge/menopause-explained/

 

The Shifting Roles of Endocrine Glands

Ovarian Function

As the ovaries gradually cease oestrogen production, the body adapts by relying on other sources for hormone synthesis. This shift marks a significant change in the endocrine system's functioning.

The ovaries don't simply "shut down" but rather transition from being the primary producers of sex hormones to playing a supportive role. They continue to produce small amounts of testosterone and androstenedione, which become increasingly important in the post-menopausal period.

Adrenal Glands: The Unsung Heroes

The adrenal glands take on a more prominent role in hormone synthesis during and after menopause. These small glands, situated on top of the kidneys, produce a variety of hormones, including:

  • Dehydroepiandrosterone (DHEA)
  • Androstenedione
  • Small amounts of oestrogen and testosterone

The adrenal glands increased importance lies in their production of these precursor hormones, which can be converted into oestrogens in peripheral tissues.

Progesterone Production in the Post-Ovulatory Era

Once ovulation stops, progesterone production significantly decreases. During reproductive years, the corpus luteum (formed from the ruptured follicle after ovulation) is the primary source of progesterone. Without ovulation, this source is lost.

However, the body doesn't completely cease progesterone production. Small amounts continue to be produced by:

  • The ovaries: Even without ovulation, the ovaries still produce small amounts of progesterone.
  • The adrenal glands: These glands produce small quantities of progesterone as part of their steroid hormone synthesis.

While these sources maintain some progesterone in the body, the levels are much lower than during reproductive years. This reduction in progesterone can contribute to various menopausal experiences and may influence the effectiveness of hormone replacement therapies.

Fat Distribution and Estrone

The Rise of Estrone

During menopause, the body's primary oestrogen shifts from Oestradiol to Estrone. Estrone is produced through the conversion of androstenedione, an adrenal hormone, in fat cells. This process, known as aromatisation, becomes a crucial source of oestrogen after menopause.

Abdominal Fat: More Than Meets the Eye

The increase in abdominal fat often observed during menopause is not merely a cosmetic change. It serves a biological purpose as an important site for oestrogen production. Adipose fat tissue contains aromatase, the enzyme responsible for converting androgens to oestrogens.

This shift in fat distribution is the body's adaptive response to maintain some level of oestrogen production. However, it's a double-edged sword: while it helps maintain oestrogen levels, it can also contribute to metabolic changes and increased health risks associated with central obesity.

Biochemical Ripple Effects

The hormonal changes of menopause trigger a cascade of biochemical alterations throughout the body:

Lipid Profile Changes

Menopause often brings about changes in lipid profiles. These changes may influence cardiovascular health and underscore the importance of regular check-ups and potential dietary interventions.

Bone Metabolism

The loss of oestrogen’s protective effects on bone density leads to changes in bone metabolism. This includes:

These changes may contribute to an increased risk of fractures in post-menopausal women.

Insulin Sensitivity

Hormonal shifts during menopause can affect insulin sensitivity. This may lead to:

Understanding these complex hormonal and biochemical shifts can empower you to navigate the menopausal transition with greater confidence. It’s important to recognise that while these changes are a natural part of life, your experience of menopause is unique to you.

Rather than viewing menopause as an ending, it can be helpful to see it as the start of a new chapter. By gaining insight into the processes happening in your body, you can make informed choices about your health, diet, and lifestyle to better support yourself through this transition.

Regular consultations with healthcare professionals, can offer you personalised guidance and support. With the right knowledge and care, you can embrace this stage of life and continue to thrive.

*The advice in this article is for information only and should not replace medical care. As with any nutritional supplement please consult your qualified healthcare professional before use, especially if pregnant, breastfeeding, if you have a known medical condition or are taking medication. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

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