So, let’s take a 25-year-old woman and talk about her ovarian hormones. At 25, the ovary is predominantly making estrogen and it makes it in two peaks, the second peak is right around the middle of the month. It also makes progesterone which starts with ovulation when the egg comes out of the ovary the ovary now makes estrogen and progesterone. And then if you don’t get pregnant, at the time of your next menstrual cycle those ovarian hormones basically go very low, not as your, but go very low and the cycle starts over again. In the background the ovary is making testosterone and the androstenedione everyday, all day, and as I said earlier, till age 80 it will make those hormones.
When you get to peri-menopause your hormones are much less predictable, so that instead of having a nice peak of estrogen twice in the cycle your estrogen can be all over the place and in fact, when I show women a graph of this they laugh because that’s how they feel. In the peri-menopause, you feel more moody or at least the way you feel is a little less predictable. When you’re 25 you kind of know how you’re going to feel everyday of your menstrual cycle. At peri-menopause you can’t do that anymore.
When you get to menopause and the ovaries have run out of eggs, the eggs can’t make estrogen anymore, then your hormones are very low, but again in the background the ovaries are making estrogen from these other male hormones so there’s a low level, but basically you’re back to everyday feels the same.
Women that have symptoms of the menopause, hot flashes, trouble sleeping, vaginal dryness, may choose or may not choose to take hormones at that point. About 20% of women in the menopause feel absolutely fine. They have no hot flashes; they don’t know what you’re talking about.
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