Menopause

The onset of menopause is defined as one year from the “last menstrual period”.  Ovarian function has been declining for several years, and now the levels are so low that menstrual periods cease.  The decline in ovarian hormones is sufficient to end the cycling pattern of the female reproductive years and produce the steady, low levels of a non-cycling hormone pattern of menopause.

At menopause, the ovaries do not cycle any longer, and the overall hormone production has decreased considerably.  After menopause women lose almost all of their estradiol production, and no longer make progesterone.  Women also lose anywhere from 50-60 percent of their testosterone production in their menopause years. 

The female ovary produces testosterone and DHEA so, as estradiol is lost after menopause, women begin seeing the “unmasking” of the testosterone that is present.  Noticeable changes occur in skin and facial hair, along with changes in body fat.  The “pear” shape female fat pattern around the hips and buttocks suddenly begins moving up toward the middle of the body to become the “apple” shape more typical of men.  In addition to body fat changes, women see a rise in blood pressure and cholesterol as the testosterone effects become more pronounced relative to estradiol declines.

The incidence of cardiovascular disease (CVD) increases dramatically as women lose the biologically active estradiol in menopause.  Regardless of age at menopause (whether it’s a natural menopause at age forty-five or a surgical menopause at age forty), the rate of CVD increases.  It is based on menopausal hormone levels, not just chronological age.  One cannot go by age alone, since women experience declining estradiol levels at a variety of numerical ages.  This loss of estradiol sends your cholesterol profile into a really negative spin.