Menopause is the time in a woman’s life when menstruation ends. It is part of a biological process that begins, for most women, in their mid-thirties. During this time, the ovaries gradually produce lower levels of hormones—estrogen and progesterone.
Estrogen promotes the development of a woman’s breasts and uterus, controls the cycle of ovulation (when an ovary releases an egg into a fallopian tube), and affects many aspects of a woman’s physical and emotional health.
Progesterone controls menstruation and prepares the lining of the uterus to receive the fertilized egg.
“Natural” menopause begins when a woman has her last period, or stops menstruating, and is considered complete when menstruation has stopped for one year. This usually occurs between the ages of forty-five and fifty-five, with variations in timing from woman to woman. Women who undergo surgery to remove both ovaries (oophorectomy) experience “surgical” menopause—an immediate end to hormone production and menstruation.
During menopause, a woman may experience problems such as hot flashes, night sweats, sleeplessness, and vaginal dryness. In addition, some long-term conditions, such as osteoporosis and coronary heart disease, are more common in women in the years after menopause.
By the time the menopause transition is complete, hormone production has decreased significantly. Even though low levels of estrogen are produced by the adrenal glands after menopause, they are only about one-tenth of the level found in premenopausal women. Progesterone is nearly absent in menopausal women.
Why are hormones recommended after menopause?
Menopausal hormone use (hormone replacement therapy, HRT, or post menopausal hormone use) usually involves treatment with either estrogen alone or estrogen in combination with progesterone or progestin, a synthetic hormone with effects similar to those of progesterone.
Estrogen usage, with or without progestin, approximately doubles the estrogen level of a menopausal woman; however, even with hormone treatment, the estrogen and progesterone levels do not reach the natural levels of a premenopausal woman.
Doctors may recommend using hormones to counter some of the problems often associated with menopause or to prevent some long-term conditions that are more common in postmenopausal women, such as osteoporosis.
