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Menopause and the Female Hormones

The Female Hormones

To understand the changes that occur in the peri- and post-menopause phase, it is important to understand the normal female cycle and the hormones that play a role in this.

Oestrogen and Progesterone

So as you can probably work out, progesterone and oestrogen are antagonists – they oppose each other and balance each other out.

Other Key Hormones

  • Follicle Stimulating Hormone (FSH): stimulates the growth of ovarian follicle and increases oestrogen production.
  • Lutenising Hormone (LH): stimulates the ovaries to release the egg.
  • Testosterone: an anabolic hormone, helps to grow and build things, relatively stable throughout but some women experience declines in this hormone too.

A Normal Menstrual Cycle

Before we try to understand what’s happening during peri-menopause, it’s necessary to review what should be happening during a normal period. So let’s track back to some early biology lessons, which I’m sure are a bit of a blur!

A regular cycle is effectively an intricate relay between the hormones we’ve described above. This step by step walk-through should help explain it.

  1. Your cycle actually starts in the brain, with the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus.
  2. GnRH then acts on the pituitary gland and causes it to start releasing FSH.
  3. FSH stimulates the follicles – the fluid-filled sacs in the ovaries that contain the eggs – to produce oestrogen. This in turn starts growing the lining of the uterus.
  4. As oestrogen increases, this is a signal to start producing LH (and turn off FSH production).
  5. As LH goes up, this signals the ovaries to let go of the egg (ovulation)
  6. The leftover follicle becomes the Corpus Luteum, which releases Progesterone.
  7. If pregnancy occurs, then progesterone continues to increase.
  8. If no pregnancy occurs then the Corpus Luteum will start to break down. All hormones will drop off, leading to another period. This is known as the low hormone phase.
Hormones in a normal cycle

Still with me?

I guess the point to make is that it’s a system of signals and checks and balances. Like an intricate realy race. It’s designed to help the survival of the species. But I guess not a lot of thought went into what happens if we run out of eggs AND are still alive AND want to live a full and vibrant life. And in part, we just weren’t supposed to live this long. Life expectancy has increased dramatically in the last 100 years or so but our biology / reproduction system has pretty much remained the same since early humans.

What happens in Peri-Menopause

In a nutshell, during peri-menopause, this intricate relay is broken. The brain does its thing and releases GnRH. The pituitary gland releases FSH. The follicles release the Oestrogen. Oestrogen levels increase. LH increases.

But there is no egg in the ovary to be released! So there is no release of progesterone to balance the oestrogen.

The result is a hormone imbalance. Oestrogen is unopposed. There is no antagonist.

Typically, during peri-menopause, oestrogen levels are typically high relative to progesterone, as progesterone flatlines. Note when we say “high” we are talking relative to progesterone. Overall oestrogen is declining over time. But within a cycle it could be anywhere. And the level of Oestrogen relative to progesterone is more significant than absolute levels.

This oestrogen dominance is the cause of many of the symptoms that women experience during peri-menopause, such as hot flushes, brain fog, mood swings, anxiety. Because oestrogen controls many of these functions. So figuring out how to best support the body throughout this period of high-oestrogen is key.

Once post-menopausal, oestrogen tends to flatline. So once again it is important to understand what we can do to help our body through the next decades of low oestrogen.

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