Why do we have the perimenopause and menopause and what exactly has it got to do with your hormones? Hormones are your body’s communication system, carrying instructions from one set of cells to another. But what role your hormones and endocrine system (the glands that make hormones) play and their impact on your perimenopause and menopause can be confusing. So let's take a look at some of the basics:

What’s happening with the hormones?

During a woman’s reproductive years, the ovaries produce two main hormones: estrogen and progesterone. This happens in a cyclical manner and results in the regular release of eggs and regular periods (or menstrual cycle). 

As you enter the perimenopause life stage, women will experience a hormone imbalance due to the fluctuation and then decline of three main hormones that regulate the menstrual cycle, sexual desire and, as research is discovering, many other functions in your body. Estrogen, progesterone, and testosterone are all naturally occurring hormones that, when levels go up and down, have a direct effect on the way your body reacts, which leads to perimenopause and menopause symptoms

What are these three hormones all about?

Estrogen:

• Estrogen is one of the main female sex hormornes and while both men and women produce it, it has a bigger part to play in the female body. 
• Estrogen is mostly produced by the ovaries and is needed for puberty, breast development, the menstrual cycle, fertility and pregnancy, bone strength and maintaining normal cholesterol levels. 
• Estrogen affects your brain and heart and can protect your skin from ageing and help bladder control.
• Estrogen levels change depending on where you are in your menstrual cycle and stage of life. Levels are highest in the middle of your cycle and lowest during your period. 

Progesterone:

• Progesterone plays a significant role in the process of pregnancy. It’s a hormone that’s produced by the ovaries after ovulation (the moment when the egg is released from the fallopian tube) and gets the uterus ready to accept and maintain a fertilised egg.
• During the menstrual cycle, progesterone is usually low the first few days, goes up after ovulation for about five days, then comes back down.
• Progesterone stops muscle contractions from happening which would reject an egg.
• Progesterone helps regulate blood pressure and improves mood and sleep. 

Testosterone:

• Testosterone is a hormone common to both men and women although men produce 10-20 times the amount women do.
• In women testosterone is directly released by the ovaries into the blood stream, acting directly in cells but it’s also converted into estrogen.
• Testosterone levels peak in women in their 20s followed by a gradual decline to about a quarter of their peak as a woman reaches menopause and then increase in later age.
• Low testosterone is mainly associated with loss of sex drive and a reduced responsiveness to sex, but it also has a direct impact on energy levels, muscle mass and brain congnition. 
  
  

What happens to hormones during perimenopause and menopause?

Up to 10 years before menopause you may experience subtle (or not so subtle!) hormonal changes. This is the perimenopause period. One of the most obvious signs, although not always the first, is a disruption in your periods when they might become less regular, shorter, longer and have a different flow. 

All the way through perimenopause your hormone levels can fluctuate from day to day and week to week. As well as disrupted periods these yo-yoing hormones can cause other symptoms such as mood changes, disturbed sleep and hot flushes. For a more in-depth look at the symptoms, see our Symptoms checklist here.

When progesterone is low compared to estrogen this can cause very heavy or painful periods. This is because estrogen thickens the uterus lining, while progesterone thins it. 

When estrogen levels are low or dropping rapidly as you come into menopause (when you don’t have a period for 12 consecutive months) you might experience hot flushes and night sweats, the vasomotor symptoms related to the constriction and dilation of blood vessels.

When estrogen levels have been low for some time, it is common to experience dry skin and eyes, as well as dryness of the vaginal tissue, which for some women can make sex quite uncomfortable, even at times painful. 

Testosterone plays an important role in muscle mass, bone strength, cardiovascular health, cognitive performance, and overall energy levels, while also influencing libido and sexual pleasure. So as testosterone levels decline, many women experience fatigue, brain fog, and decreased sexual desire, regardless of their emotional connection with their partner.

 

After menopause

Postmenopause is the final stage of the menopause journey, and officially begins 12 months after your final period (the menopause). During postmenopause, your body continues to produce testosterone and estrogen, although in smaller amounts. The production of progesterone stops because it is made by the ovaries after ovulation, which stops at menopause.

Hormones stabilise at lower levels after menopause, although some symptoms may persist for a while as your body adjusts. For most women, symptoms start to become less troublesome, even disappearing altogether.

At any stage of your menopause journey, if symptoms are interfering with your quality of life, it's worth discussing the pros and cons of medications with your doctor, as well as considering dietary changes, exercise, weight management, and permium supplements, which all play an important role in our overall health.