The term menopause denotes the permanent cessation of menstrual bleeding. Menopause occurs on average around 50-52 years of age. Perimenopause is the period right before menopause and is characterized by the gradual shutting down of ovarian function. During this transitional period, ovulation is less frequent due to depletion of ovaries during the years of their full activity. After menopause, there is a decline in estrogen level.

three types of estrogen

Estrogen is responsible for the largest number of complaints and symptoms which the women encounter in this period: hot flashes, difficulties in bladder function, the feeling of vaginal dryness, low concentration, depression. Risk of cardiovascular disease, osteoporosis and malignant diseases of the breast is significantly increased in this period.

Menopause and Perimenopause

The main task of the menstrual cycle is to prepare woman’s body for pregnancy. During this process, the endocrine glands in the brain (hypothalamus and pituitary) produce hormones that act on the ovary causing the development, maturation and the release of eggs from the egg follicles. The follicle, which contains the egg cell, produces hormones whose task is to prepare the uterus for a normal development of the pregnancy.

If pregnancy does not occur, the menstrual bleeding occurs. Around 40 years of age the ovaries become less sensitive to hormonal signals coming from the pituitary: as a result, there is a disturbance in the production of estrogen and progesterone in the ovaries, leading to changes in character of menstrual bleeding. Menstrual bleeding at this time may be more abundant, sparse and untidy.

When estrogen production in the ovaries varies by quantity or decreases rapidly, a distortion of many body functions occurs:

age and menopause symptoms

Hot flushes

Hot flushes occur when the thermoregulatory center in the hypothalamus registers a drop in estrogen levels in blood. During the years of menopause a large number of women have these symptoms, but not all of them. Hot flushes are a sudden feeling of heat in the form of waves spreading from the chest through the neck to the face, and often extending down to the hands and sometimes the abdominal wall.

They last for several minutes and sometimes longer. Women can often predict them. If they happen overnight they often interrupt sleep. Fatigue and low concentration may be associated with hot flushes and can begin even during perimenopause. If during this period a woman takes the supplement of the missing hormone – estrogen – these problems can be successfully prevented, and if they are already present, they disappear quickly.

Genitourinary Changes

The tissue that builds the bladder and the vagina becomes thin and delicate because of long-term estrogen deficiency. Symptoms are reflected in vaginal itching, feeling of vaginal dryness, frequent urination and frequent infections of the bladder. Hormonal substitution may eliminate or significantly reduce these symptoms.

Skin Changes

After menopause, the skin loses much of the previous elasticity. The content of collagen in the skin decreases, and the results is a loose skin that begins to wrinkle. It is important to recognize that this is a normal aging process to happen in both women and men, and it is only to a lesser extent caused by estrogen deficiency. For these reasons, hormonal substitution has little influence on skin changes.

Changes in Breasts

Smaller amounts of hormones during menopause and perimenopause have an impact on the reduction of connective and glandular tissue, which causes breasts to slightly decrease and loosen. These changes, like those on the skin, are natural changes related to the aging process and therefore cannot be prevented by estrogen supplement.

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