Anatomy-Lexicon

Menopausal hormones

introduction

One of the main symptoms of menopause is headache.

Menopause, also known as climacteric or perimenopause, is the years before the last spontaneous menstrual period (menopause) to one year after the last spontaneous menstrual period. That is, menopause describes the transition from the fertile phase to the non-fertile phase in a woman's life. This is a phase in life that is characterized by changes in the hormonal balance. The control hormones secreted by the pituitary gland, also known as gonadotropins, LH (luteinizing hormone) and FSH (follicle-stimulating hormone), but also progesterone, estrogen, inhibin and the male sex hormones (androgens). The physical complaints can mainly be explained by the decreasing production of the female sex hormone estrogen.

For the treatment of menopausal symptoms, please also read: Medication for menopause or Hormone replacement therapy for menopause

progesterone

Before the last one Menstrual bleeding (Menopause), progesterone production decreases in the second half of the cycle (Luteal phase) until it finally stops.
The drop in progesterone levels makes it difficult to conceive (Conception ability), which means that the probability of a pregnancy becoming less and less due to the low progesterone level.

Also Menstrual cycle disorders with irregular bleeding can be explained by the decreased progesterone level. If this is to be determined in the blood, the blood must be taken in the second half of the cycle.
The decreased progesterone level can be the same as the lack of estrogen for menopausal symptoms, such as irritability or sleep disorders to care.

estrogen

With menopause, i.e. the last menstrual period, the production of the female sex hormone estrogen dries up due to an increasing functional weakness of the ovaries. Most of the symptoms complained of by women going through menopause can be explained by the rapidly falling levels of estrogen. The main symptoms are episodic hot flashes, sweats, headaches, forgetfulness and psychological symptoms such as depression, anxiety, nervousness, insomnia and mood swings. Cardiac arrhythmias, joint and muscle pain, a loss of libido and a decline in performance can also occur.

In addition, the lack of estrogen leads to urogenital atrophy, i.e. a tissue and functional change in the female external genital organs and the lower urinary tract caused by the hormone deficiency. This in turn leads to the following clinical symptoms:

dryness
itching
discharge
Painful intercourse (dyspareunia)
Vaginal infections
Urge to urinate
frequent urination
repeated urinary tract infections and
Urinary incontinence.

Another symptom of estrogen deficiency is collagen and mineral loss, which manifests itself in accelerated skin aging and an increased risk of osteoporosis. In addition, with increasing estrogen deficiency, the figure of the woman changes, which is often associated with weight gain, although nothing has changed in eating habits.

To do this, read the following article: Losing weight during menopause.

A hardening of the arteries (arteriosclerosis), which is associated with an increased risk of heart attack and stroke, is also favored by a lack of estrogen. Ultimately, increased hair loss and increased facial hair (facial Hypertrichosis) can be explained by the reduced estrogen level or the relative predominance of male sex hormones (androgens). All of these clinical complaints can be summarized under the term climacteric syndrome. The individual characteristics of the complaints differ from woman to woman.

Read more on the subject under Lack of estrogen

Inhibin

Also the secretion of the hormone Inhibin, which in women occurs in certain cells of the ovaries, the so-called Granulosa cells and with the man in the Testicles is formed, decreases. Inhibin normally inhibits the release of the control hormone FSH (follicle-stimulating hormone) from the pituitary gland without the release of LH (luteinizing hormone) to influence. The reduced release of inhibin, like the lower estrogen level, also causes an increase in the FSH level.

Gonadotropins (LH and FSH)

The pituitary gland produces the control hormones LH and FSH, which are also called Gonadotropins are designated, secreted. These stimulate the ovaries and thus normally stimulate the production of female sex hormones. A so-called exists between the gonadotropin FSH and the level of the female sex hormones negative feedback. This means that when the level of estrogen and progesterone is high, the release of FSH from the pituitary gland is reduced, whereas when the level of estrogen and progesterone is low in the blood, the release of FSH increases with the aim of driving up the level of female sex hormones again.

Since the release of LH and FSH is no longer slowed down by the actual sex hormones as usual during the menopause, there is a significant increase in the LH and FSH levels in the blood. An FSH serum concentration of over 30 IU / l, with a simultaneous low estradiol concentration (<30 pg / ml or <100 pmol / l), ensures the presence of postmenopause.After the menopause, the control hormones of the pituitary gland also decrease again, but remain elevated compared to the time before the menopause.

Male sex hormones (androgens)

The time after the last menstrual period is also called Post menopause designated. During this time, the production of male sex hormones (Androgens) from. This also causes a further drop in the estrogen level, since androgens can normally be converted into estrogens. If fewer androgens are available for conversion into estrogens, this also affects the estrogen level.

Hormone tests

For the diagnosis of the climacteric syndrome is in most cases that anamnese sufficient. The anamnesis is therefore the most important diagnostic step. The clinical examination, including a microscopic examination of the inner lining of the Scabbard, the Vaginal epithelium (so-called vaginal cytological examination) can verify the diagnosis. Hormone tests are therefore usually not necessary, but in certain cases, especially if the menopause occurs prematurely, they can make a diagnosis easier.

Before the age of 50, if there is no menstrual period, two blood samples should be taken at an interval of three months, as at this age there are other reasons for the absence of menstruation in addition to the menopause. The typical Laboratory constellation in the menopause is a so-called hypergonadotropic hypogonadismwhich simply means that the gonadotropin FSH is increased while the level of the gonadotropin is low female sex hormones. After the age of 50, as already described, the diagnosis of postmenopause after no menstrual period for one year can only be made on the basis of the anamnesis and clinical examination be asked.