Are your periods becoming irregular? Have you been sweating at night more than Schapelle Corby prior to her parole announcement? Do you have the sex-drive of a nun? Do you wonder if you need a psychiatric assessment as your moods are so up and down? Madam, you may be experiencing peri-menopause, the starter before the main dish of menopause!
So what exactly is happening to your body that makes these symptoms appear anywhere between your late 30’s and early 50’s? The chief hormonal culprits are oestrogen and testosterone.
Menopause originates from the Greek “meno” meaning monthly and “pausis” meaning to stop. Peri-menopause or as it used to be called “climacteric” relates to the period before menopause and can last anything from two to six years. Peri-menopausal symptoms are caused by the irregular functioning of your ovaries and big changes in the quantities of oestrogen and progesterone that are produced.
The number of follicles (immature eggs) you have in your ovaries decreases as you age. As you enter peri-menopause, the quantity of follicles further decreases. As your eggs produce oestrogen, this leads to a reduction in the amount of ovarian oestrogen produced. The lowered oestrogen levels do not reach the levels needed to tell your body to stop producing FSH (follicle stimulating hormone). FSH causes immature eggs to mature into the eggs that are released during ovulation over 14 days. However, as FSH is now released at too high a level as oestrogen is too low, follicles are maturing too quickly and becoming poor quality eggs.
As fewer and fewer follicles remain in the ovaries, oestrogen levels continue to drop. This also affects luteinising hormone (LH), and it is the rapid surge in LH that causes you to ovulate. Over time, ovulation then ceases completely. A bit like England’s ability to get runs during The Ashes Test!
Unfortunately the decrease in oestrogen and increases in FSH and LH can be erratic during the peri-menopausal period. When hormonal changes occur gradually, there are fewer menopausal symptoms. The symptoms actually relate to the erratic rising and falling of oestrogen, as opposed to a slow general decline of oestrogen. These sharp rises and falls of oestrogen are called the “overshoot phenomenon”.
Once you have not had a period for 12 months, you are officially in menopause! Congratulations! Now you have the joy of a possible prolapse, increased urinary tract infections, dry vagina, heart disease and osteoporosis to get excited about. Oestrogen is protective of all those aforementioned conditions. However, just because you are in menopause does not mean you are not producing oestrogen.
Oestradiol is the type of oestrogen produced by the ovaries. Post-menopausal oestrogen is oestrone, and this is less biologically active than oestradiol. In fact it is 12 times weaker than oestrogen and is produced from a hormone produced by your adrenals post-menopause.
The decline in testosterone as you age also causes menopausal symptoms. During menopause it drops by about 15%. Reduced testosterone contributes to low libido, depression and poor stamina. Some menopausal women find they suffer from male-pattern baldness countered by increased facial hair.
Progesterone production is also erratic around menopause, as you need follicles and ovulation for progesterone to be produced. Erratic levels of progesterone leads to changes in your menstrual cycle and mid-cycle bleeding during peri-menopause.
So what influences the age your menopause occurs?
There are a few predictors that indicate an earlier or later menopause. The age your periods began may influence the age your periods will cease. If you started bleeding at a young age, say 9 or 10 years old, your menopause may be later. If you started bleeding in your late teens, your periods may cease earlier. The age when your mother became menopausal is another indicator. If your mum doesn’t remember, I’m sure that felicitous time is etched in your father’s memory!
Body weight also influences the age of menopause. Thinner women are more likely to have an earlier menopause than heavier women. Being very overweight may delay menopause until you are in your fifties. So, if you want to delay hot flushes, low libido, hair loss and mood swings, you’d better reach for that shortbread instead of that skipping rope!