Hormonal changes in women can be divided into four different stages: premenopause, perimenopause, menopause and postmenopause. In each stage, the hormones estrogen, progesterone and testosterone fluctuate.
Premenopause is the time in a woman's life that spans from her first period during puberty to when she starts experiencing the symptoms of perimenopause. During this time, estrogen and progesterone facilitate and regulate monthly menstruation and fertility.
Perimenopause is considered as the months or years which precede a woman's last period. During this time, estrogen and progesterone are in flux, and sex hormone production slows down until ovulation stops. Women may experience menopausal symptoms such as hot flashes, loss of libido, headaches, fatigue and night sweats.
Menopause occurs when 12 months have passed since a woman has had her last period.
Postmenopause is the period of time after menopause has been declared. From this point onward, a woman will no ovulate or menstruate, but this does not mean that hormone levels are entirely depleted.
Estrogen is often referred to as the “female hormone”, as it instigates changes to the female reproductive system. It is a compound hormone, made up of the three hormones estrone, estradiol and estriol. During postmenopause, the ovaries have already greatly reduce estrogen production, which can cause estrogen deficiency. Symptoms of low estrogen levels include hot flashes, mood swings, fatigue, and headaches.
Progesterone works with estrogen during pregnancy, lactation and menopause, and plays an important role in menstruation. It is also a compound hormone, and its levels fluctuate throughout a woman's life. Levels of progesterone are normally low during postmenopause, and because of this women may feel muscle weakness, a racing heart, and be at higher risk for vaginal infections.
Testosterone is responsible for regulating the reproductive system in women. It plays an important role in a woman's lifelong sexual development, and her levels of fertility. Levels of this hormone decline during perimenopause and into postmenopause.
As testosterone levels in women are much lower than estrogen and progesterone, and these levels naturally decline in postmenopause, many women do not notice a testosterone deficiency. Low testerone levels can cause a decreased libido, low mood, and a lack of energy.
Postmenopause is usually when women start to feel better and adjust to the lower levels of hormones in their bodies. Hormone replacement therapy is commonly prescribed to menopausal women to help treat some menopausal symptoms. However, it is usually not recommended that women take hormone replacement therapy for extended periods of time during postmenopause.
Many women find postmenopause empowering and freeing because they no longer have to worry about a monthly period or worry about taking birth control. Although most menopause symptoms dissipate in postmenopause, during this time women are at a higher risk for osteoporosis, heart disease, and urinary incontinence so it is important to take what preventative measures you can and see a doctor if you have concerns.
- The Cleveland Clinic. (2013). Menopause. Retrieved from http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause
- National Institute on Aging. (2015). Menopause: Time for a Change. Retrieved from https://www.nia.nih.gov/health/publication/menopause-time-change/postmenopausal-health-concerns