HOW THE MENOPAUSE BEGINS

May
08
2009

As the menopause approaches, eggs are produced by the ovaries less regularly, leading to irregular levels of oestrogen and then to an overall decline in the average amount of oestrogen produced each month. (The number of ovarian follicles, and the egg cells they contain, decreases steadily from birth onwards, accelerating after about the age of 35, until by the time of the menopause, only a few egg cells remain.) As ovulation becomes less frequent, the ovaries produce no more progesterone, the lining of the womb no longer thickens each month and periods cease.

Eventually, the time comes when the ovaries produce almost no oestrogen or progesterone, although they continue to produce hormones called androgens. Androgens (of which testosterone is an example) are hormones that produce male characteristics, but these androgens definitely belong in the female body, and influence general health, sexuality and muscular strength. Some androgens are converted to oestrogen in the body’s fat cells, so women with more fat produce more oestrogen after the menopause and may have fewer problems with hot flushes, vaginal dryness and osteoporosis than thinner women. So there is some advantage in having that extra body fat! The disadvantage is that overweight women may produce too much oestrogen, and run an increased risk of developing cancer of the womb or breast. Although all women will be producing some oestrogen from the adrenal glands, there is not enough after the menopause to keep bones strong, prevent menopausal symptoms and protect against arterial disease.

Until the menopause, a woman’s natural level of oestrogens is very much higher than her natural level of androgens. Once the menopause has passed, oestrogens fall to a very low level but androgens continue to be produced; this may explain why older women sometimes develop increased facial hair and their voices deepen slightly.

The coming of the menopause doesn’t mean you are now ‘unfemale’, or unfeminine, or old, unless you let it affect you that way. If you tell people you feel less female, they will start to view you that way; if you start to look, behave and dress like an old woman, people will treat you as old. There are so many advantages to reaching the time of the menopause, it would be a pity to let society’s view of older women spoil it all. You have now left behind you the difficulties of looking after young children, you are almost certainly more confident and self-assured than you were 20 years ago; your periods have ended, and with them premenstrual tension, pelvic aching, cramps, tampons, and the need for using birth control. You are probably better off financially than when you had children and a building society to support, and as family responsibilities lessen there is more time for new interests and activities. The end of fertility does not mean the end of your attractiveness as a person; it can mean a whole new era of your life dawning, full of possibilities for fulfilment that were unattainable when you were younger. In the days when most women didn’t live that long, the menopause meant old age; now women have at least another 30 years left to live, years full of new opportunities.