• Home

Home > Medical Reference > Patient Education

• Highlights
• Introduction
• Complications
• Symptoms
• Lifestyle Changes
• Medications
• Resources
• References

Menopause

Description

An in-depth report on the treatment of menopause-related symptoms.

Alternative Names

Estrogen; Hormone replacement therapy

Introduction

The ovaries contain between 200,000 and 400,000 follicles, tiny sacks that contain the materials needed to produce mature eggs, or ova . The ovaries produce two major female hormones: estrogen and progesterone.

Estrogen. Estrogens have an effect on about 300 different tissues throughout a woman's body:

• They are essential for the reproductive process and for the development of the female organs.
• Estrogens determine the characteristic female distribution of body fat on the hips and thighs, which develops during adolescence.
• They also are involved in tissues in the central nervous system (including the brain), the bones, the liver, and the urinary tract.

Estrogen has different forms:

• The most potent form is estradiol .
• The other important, but less powerful, estrogens are estrone and estriol .

Most of the estrogens in the body are produced by the ovaries, but they can also be formed by other tissues, such as body fat, skin, and muscle.

Progesterone . Progesterone, the other major female hormone, is necessary for thickening and preparing the uterine lining for the fertilized egg.

Menopause and Perimenopause

As a woman ages, her supply of eggs declines. Menopause occurs naturally after the woman's supply of follicles has been depleted and menstruation ends completely. (Menopause may also be induced if the ovaries are surgically removed.)

Perimenopause. Menopause does not occur suddenly. A period called perimenopause usually begins a few years before the last menstrual cycle. Some experts believe there are three stages in the transition:

• Early Stage. The beginning of perimenopause can begin in some women in their 30s, but most often it starts between ages 40 and 44. It is marked by changes in menstrual flow and in the length of the cycle. There may be sudden surges in estrogen.
• Middle Stage. In the middle cycle, periods become irregular but they are not skipped.
• Late Stage. In the late stages, women begin missing the periods until they finally stop. About 6 months before menopause estrogen levels drop significantly. The fall in estrogen triggers the typical symptoms of vaginal dryness and hot flashes (which can last from half a year to more than 5 years after onset of menopause).

Menopause. At the point at which menopause occurs, the following hormonal changes occur:

• Ovarian secretion of estrogen and progesterone ends.
• Once the ovaries have stopped producing estrogens, however, they still continue to produce small amounts of the male hormone testosterone, which can be converted to estrogen (estradiol) in body fat.
• In addition, the adrenal gland continues to produce androstenedione (a male hormone), which is converted to estrone and estradiol in the body fat.

• The total estrogen produced after menopause, however, is far less than that produced during a woman's reproductive years.

The average age of women at menopause today is 51.4 years although it can occur as early as age 40 to as late as the early 60s. Women now have a life expectancy of more than 80 years. Currently, women can expect to live some 30 or 40 years of their life in the postmenopausal state.

Menopause is not a disease. However, many conditions are associated with estrogen depletion, including heart disease, osteoporosis, and other complications. Fortunately, effective treatments are available for these conditions.

In a number of studies, most women have reported menopause as a positive experience and have welcomed it with relief and as a sign of a new stage in life.

• Review Date: 6/11/2006
• Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.