Menopause means the cessation of a woman’s menstruation. Technically a woman has to have no menses for 12 months before she is described as menopausal.

During the reproductive years, oestrogens are produced from the ovaries, which stimulate the lining of the uterus for implantation of a fertilised egg, the beginning of pregnancy. The principle oestrogen of the menstrual cycle is estradiol.

As a woman enters her mid-thirties, her reproductive capacity starts to decline, with a decrease of oestrogens and progesterone production. During this time, however, she usually continues to ovulate and her menstrual cycle generally remains regular and normal.

When a woman reaches 40 - 45, her menstrual cycle can become very disrupted and oestrogens levels can swing from very high to very low. This can result in alternating sensations of enlarged and tender breasts with bloating and irritability when oestrogens are dominant; and hot flushes, confused thinking or lack of concentration, memory difficulties and vaginal dryness when the oestrogens levels plummet. There may be time with no bleeding, followed by heavy bleeding accompanied by severe cramps. This is referred to as peri-menopause, which precedes the true menopause by 5 - 10 years.

Symptoms & Implications

At a woman enters the menopause, oestrogens levels have become so low that the lining of the uterus is not stimulated to build up enough to shed, and therefore periods no longer occur. These continued low levels cause:

  • Increase in hot flushes
  • Difficulty concentrating and memory problems
  • Accelerated loss of bone at a faster rate than at any time in her life.

Other symptoms of the peri-menopause may intensify, such as:

  • Vaginal dryness
  • Decreased libido
  • Dry skin
  • Loss of skin elasticity
  • Shrinking breasts
  • Decreased mood and energy.

Few years after the menopause, the body will settle into a lower oestrogens state, and many women become acclimated to the symptoms. Bone loss slows down, but definitely continues. The damage to the many organ systems that need oestrogens continues insidiously, with increase in:

  • Cardiovascular disease
  • Osteoporosis and fracture
  • Diabetes
  • High blood pressure
  • Strokes
  • Alzheimer's disease.

The aging of a woman's reproductive system is actually a fairly continuous process that starts in the early thirties. An anti-aging approach takes this into account, and intervenes before the actual menopause to treat the symptoms and long-term consequences that result from less than optimal hormone levels.


Apart from the clinical symptoms and signs that accompany the cessation of menstrual periods, blood tests can be done to measure the levels of estradiol and progesterone.

Treatments & Options

This is done through Hormones Replacement Therapy, which include estradiol, progesterone, and in cases, the male hormone testosterone too. This is discussed in the sections of Oestrogens & Progesterone, and Testosterone.

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