Female Hormones 101 As You Age

Female Hormones 101 as you age will help you understand how hormones change throughout your life, affect many systems in your body, and how to feel your best.

The main female reproductive hormones are estrogen and progesterone. These hormones are responsible for sexual development and preparing the uterine wall to nurture fertilized eggs during pregnancy.

They are also responsible for many other functions, which will help you understand how the decline in their levels contributes to a host of symptoms you will experience as you age. These hormones can begin changing drastically for some of you in your mid-30s to early 40s (see graph below with perimenopause fluctuations).

I was in full menopause, no period for one year, at age 44. Looking back, I know a lot of unexplained changes, physically and mentally, were attributable to changing hormones beginning in my late 30s.

It can be very confusing to know what to do to feel better especially as you enter perimenopause, where the hormonal changes really feel like a rollercoaster ride. Let’s break it down.

The balance of hormones produced by your body is important to good health and feeling your best!

The Journey Begins: Puberty

Puberty arrives around the age of 10-12. It’s not uncommon for some of you to have been a bit younger or older. Hormones from the brain trigger the start of puberty. Essentially, these hormones tell your ovaries to make estrogen. This triggers the growth and release of eggs. Noticeable changes will arrive — breast development, menstruation, pubic hair, and a change in moods. And you can now become pregnant.

Progesterone levels change throughout your menstrual cycle. This hormone maintains your uterine lining during pregnancy; you need an adequate level until you’re ready to deliver your baby. Small quantities of the hormone testosterone (about 1/10th of what men have) are also produced in the ovaries and peak mid-cycle. This hormone essentially converts to estrogen and supports a woman’s growth, reproduction, sex drive, mood, and vaginal health.

Periods will continue (if you have no health issues) for 20 to 40 years and will be affected by the birth control you may be using. As shown in the graph below, premenopause is the years you have your period consistently. Hormone levels will ebb and flow with your cycle, but things feel pretty predictable.

As you age, it’s time to look ahead and face hormone changes that are coming or are already here for many of you. Puberty is in the rearview mirror. You need to make lifestyle changes to help manage symptoms of declining hormones in your 30s and 40s and prevent inevitable health risks.

If I Could Go Back and Understand My Hormones

I wish someone told me that perimenopause was showing up in my 30s. As my body and mind were changing due to the fluctuating hormones, I continued doing what I was doing when I was younger.

Consuming alcohol the way I always did (even though I was metabolizing it differently), eating and exercising the same but seeing a lot of changes in my body. Not questioning the anxiety and stress I was feeling, which I now know was mostly attributable to changing hormones.

I wish I were kinder and less harsh with my changing body and mind. I needed to make changes sooner surrounding my nutrition, stress management, sleep, and movement. I also wish I had started hormone therapy (HT) (also referred to as Hormone Replacement Therapy) earlier in my perimenopause journey.

Courtesy of declining estrogen (which is anti-inflammatory), you’re now at risk for heart disease, diabetes, osteoporosis, dementia, and bone loss. Many of these health risks are happening silently within the body until they become more advanced.

Ignore them for too long, and they will then demand lifestyle changes and possibly prescription medication as evidenced by symptoms and test results.

Three Stages of Menopause

Perimenopause

This is the period when women start to notice changes in how they feel mentally and physically. It’s the 7 to 10 years before menopause. Symptoms can be subtle at first and sadly, many women feel there isn’t much they can do to change how they are feeling.

Perimenopause is usually diagnosed with age, family history, and symptoms:

• irregular periods
• hot flashes/night sweats
• moodiness/anger/rage
• difficulty concentrating
• poor sleep
• change in libido, sex drive
• decreasing fertility
• vaginal and bladder problems
• joint pain
• change in cholesterol levels

There will be no big announcement to tell you that perimenopause is starting. It’s essentially a gradual transition. Unless you have surgery to remove your ovaries, which means you will be thrust past perimenopause into full menopause. It’s an ideal time to have a conversation with your doctor about hormone replacement therapy options and lifestyle choices.

Menopause

It’s more obvious when menopause arrives — you will have no period for 12 full months. The average age is about 51. But, like I mentioned, I was 44 when I was in full menopause, which is normal.

Don’t ignore how you feel like I and many of the women I work with did! Reach out to me or talk to your physician, friends, or family members to get support. Other women may have advice to help you with your journey.

Post-Menopause

Post-menopause is when your ovaries are no longer producing estrogen and progesterone. Your adrenal glands must take over some of the functions of the ovaries and help with the production of these sex hormones. Since they are also involved in producing cortisol, the stress hormone, it’s important to manage your stress levels.

If you are overly stressed and really feeling a lot of the hormone changes — the inability to deal with stress, insomnia, hair loss, irritability, and rage — you want to get your stress under control to reduce these menopausal symptoms. Learn more about Adrenal Fatigue Weight Gain on my blog.

How Do You Know You Are in Perimenopause?

With the rise and fall of estrogen during this transitional time, it’s difficult to test your hormones and get a definitive answer that you are in peri-menopause. Additionally, low levels of estrogen can be caused by: excessive exercise, eating disorders, a low-functioning pituitary gland, toxins, chemotherapy, substance use disorder, and kidney disease.

Have your physician test your follicle-stimulating hormone (FSH). This is a hormone produced by your pituitary gland (located in the brain) that stimulates your ovaries to release an egg during ovulation. Symptoms and a consistently high level can indicate you are nearing menopause.

Your doctor can also do a blood test to check progesterone levels, which is most commonly used to determine ovulation. Too little progesterone and too much estrogen can also lead to estrogen dominance. Read more in my blog about this condition: Estrogen Dominance Symptoms and Solutions.

When you notice your body and mind changing, go to my resources page to get helpful information. You’ll find frequently asked questions and answers, a symptom tracker to identify how you’re feeling, how to stress less and sleep better, and recipes to feel your best.

It’s important to schedule an appointment with your primary care physician or gynecologist for further testing and discussion. Your physician may need to rule out other health issues as well, including thyroid health. Be sure you’re working with a doctor who is willing to discuss HT as an option.

You will need to advocate for yourself as you recognize a change in how you feel. Many doctors are not trained in women’s health and hormone changes.

It’s frustrating to have a conversation with your doctor and report your symptoms and be told, “It’s normal. You’re going through hormone changes.” When in reality, you feel like you are going crazy! To find a doctor in your area who is trained in menopause, go to the North American Menopause Society website and enter your zip code.

Although changing and declining hormones can start in your 30s, your doctor will need to rule out premature versus early menopause. It’s important to recognize what stage you’re in, especially if you plan to have children. You need adequate hormones, eggs and to continue ovulating for this to happen.

It’s important to remember that you can still become pregnant during perimenopause. You will enter menopause when your supply of eggs runs out and your ovaries stop making estrogen. This can’t be reversed, and you can no longer get pregnant. You should talk to your doctor about other options.

Is Hormone Therapy Safe?

Hormone therapy is a safe option for most women beginning early in their journey through perimenopause and the beginning of menopause. Since you are unique, your doctor should follow an individualized plan to help combat your perimenopausal symptoms and health risks.

Progesterone and estrogen work in tandem in the body and may need to be replaced based on your symptoms and healthy history. You can also talk to your doctor about testosterone. Women can feel fatigue, muscle weakness, mood changes, and low sex drive without this hormone.

Two basic types of Hormone Therapy:

• ET means estrogen-only therapy for women without a uterus due to a hysterectomy.
• EPT means combined estrogen plus progestogen therapy if you still have a uterus.

Two general ways to receive Hormone Therapy:

• Systemic products move throughout the bloodstream to all areas of the body. These are available as an oral tablet, patch, gel, emulsion, spray, or injection and can be used for vaginal symptoms, hot flashes, night sweats, and osteoporosis.
• Local, non-systemic, products affect only the area they are applied to. These are available as a cream, ring, or tablet and can be used for vaginal symptoms.

Your doctor should prescribe the lowest dose of hormone(s) for the shortest amount of time. The benefit-risk ratio is favorable for women who start HT when they are in peri-menopause or at the start of menopause.

There is evidence that health risks such as stroke, breast cancer, and blood clots can occur especially with systemic products if used for longer than five years. Some women will choose to continue taking HT their entire lives and should regularly weigh the benefits and risks by having ongoing conversations with their physicians.

How to Stay Healthy As Your Hormones Are Changing

Perimenopause, menopause, and post-menopause are natural processes in a woman’s reproductive cycle. Post-menopause is all the days after menopause when your body learns to function with low levels of sex hormones.

The hormonal changes you experience are mainly due to declining estrogen. Although, progesterone and testosterone will need to be checked as well. Many systems in your body will feel changes, but with improved lifestyle choices and possibly hormone therapy, you shouldn’t accept suffering as the new norm.

Improving your lifestyle is the best place to start to feel your best:

• Consume a nutrient-dense diet rich in protein, healthy fats, complex carbohydrates, fiber, fruits and vegetables.
• Maintain gut health to help balance hormones, keep your immune system strong, and optimize the absorption of nutrients.
• Get outdoors and move in some way every day. Incorporate weights into your exercise routine to help with muscle loss. Starting with 10-15 minutes twice a week is a great place to begin.
• Get 7 – 9 hours of good sleep each night. Check out my blog ‘Seven Ways to Get Better Sleep in Midlife‘.
• Manage your stress with paced breathing exercises, yoga, stretching or other relaxation techniques.
• Connect with others to get the support you need and deserve.

Reach out to me if you would like to have a discussion to further understand how to feel better in midlife. At this stage in your life, you deserve to truly thrive and not just survive!