| |
By: Sydney L. Murray
A woman's body is an intricate vessel. Within our monthly
cycle lies the possibility of life and birth. Looking at a
women's health one important aspect is our hormonal balance.
At the beginning of our lives there are approximately one
million ova (eggs) present at birth, with an estimated 400,000
present at puberty. The first half of a woman's menstrual
cycle is called the follicular phase, and is the body's preparation
for pregnancy. Without conception and implantation of the
egg a woman enters the luteal phase with the subsequent shedding
of the uterine lining rich in blood which was meant to support
the embryo and is called menstruation.
About 400 hundred ova mature during our menstrual years. Ovulation
which occurs at a woman's midcycle is accompanied by an abrupt
rise in FSH (follicle stimulating hormone) and LH (lutenizing
hormone).
Many of us remember our first menstrual period. But what we
were unaware of was the complex biological chain of events,
which marked the beginning of our womanhood, our fertility.
A woman's body is affected by the hypothalamus,
the pituitary gland, the ovaries, and the multiple hormones,
which are formed and affect these specific parts of the bodies.
The hormone GnRH is produced in the hypothalamus. FSH and
LH are both produced in the pituitary and they stimulate the
increase of progesterone and estrogen in a woman's monthly
cycle. Estrogen is formed in the ovaries, in a woman's body
fat, especially the fat in the hip and thigh areas and in
a few other parts of the body. Progesterone is created primarily
in the ovaries and along with estrogen prepares the uterine
lining for the implantation and growth of the embryo. And
the hypothalamus regulates and is regulated by these hormones.
This period of biological fertility lasts for most women for
about thirty-five years. Fertility then begins to taper off
in perimenopause and a woman may begin to experience some
of the symptoms usually associated with menopause. This period
lasts from two to ten years and is most likely during a women's
forties into her early fifties.
So when we think of menopause we are most likely thinking
of the period called perimenopause. Peri means around or near.
Meno is derived from the Greek meaning month or menses, and
pause is from pausis meaning pause: menopause. The period
including perimenopause, menopause and post menopause is known
as the climacteric.
Menopause is essentially the day you have not had your period
for at least one year. The cessation of a normal reproductive
cycle occurs between the ages of 45 and 55 in American women
with the average age of 51.5 years. So after a period of thirteen
months without a menstrual cycle you are in menopause and
then immediately you shift to post menopause.
In perimenopause levels of GnRH (gonadotropin-releasing hormone)
increase in the brain, in turn causing LH and FSH levels to
rise to their highest levels. When FSH and LH reach a certain
level in the blood women are said to be in the menopausal
range.
The typical perception of perimenopause is that estrogen levels
drop dramatically. This is not quite the case. Normally, the
first change in a woman's cycle is decreasing levels of progesterone,
while her estrogen levels usually stay the same or may increase
slightly. Estrogen and progesterone tend to balance each other
out within a woman's monthly menstrual cycle. With decreasing
progesterone and elevated or unchanged levels of estrogen
this results in estrogen dominance, which is the opposite
of the prevailing viewpoint.
As progesterone levels continue to decline estrogen levels
then begin to fluctuate radically. The increased estrogen
levels occur because the ovaries now allow multiple groups
of follicles to grow and mature during each successive menstrual
cycle versus one group per cycle. Nature seems to be trying
to utilize the remaining eggs in a short period of time. Hence,
the increase of twins in a woman's later reproductive years.
The decline in progesterone occurs because fewer eggs complete
the full ovulation cycle.
Then the pituitary produces increasingly erratic levels of
FSH and LH hormones as the ovaries begin to skip ovulations.
During the perimenopausal transition a woman might experience
fluctuating menstrual patterns: heavier or lighter, or occasionally
skipping a period. Their duration might be longer or shorter
than what a woman had previously experienced. Fluctuating
estrogen and progesterone levels cause these symptoms. If
a woman doesn't ovulate for one cycle, progesterone isn't
produced to stimulate menses as estrogen levels continue to
rise. This can cause spotting throughout a woman's cycle and
then a much heavier period during the following menses.
Symptoms resulting from these hormonal fluctuations range
from hot flashes, night sweats, insomnia, early wakening,
aching joints, difficulty in concentrating, changes in libido,
vaginal dryness and frequent urination. Increased urinary
troubles are encountered, as approximately one third of the
urethra is estrogen sensitive.
Many researchers believe there is a genetic link and that
women will experience perimenopause with many of the same
symptoms as their mothers and grandmothers. Yet lifestyle
factors such as smoking double the likelihood of early menopause
before fifty.
Closer to menopause hormonal levels begin to stabilize. FSH
and LH levels stabilize at a higher level which remains constant
for the rest of a woman's life.
The perimenopause is an individualized transition, which is
affected by lifestyle, and one's nutritional, emotional and
mental well being. Explore all of the options available to
you as well as explore your personal and family health histories
to create a healthy and full life for years to come.
Compiled from the National Institutes of Health reports on
the Biology of the Menopausal Process and Associated Health
Conditions During and After Menopause.
|
