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Physiological changes associated with menopause

Women are born with nearly one million egg follicles. Already at puberty is the number of viable eggs decreased to 300,000 as a result of normal decline. When menopause occurs, there are only a few hundred to a few thousand left. Most eggs are lost due to atresia and not at ovulation. Through 30-40 fruitful years, only about 480 follicles in a woman ripen their eggs.

The number of eggs seems to go steadily down to 35-38 years of age. Then the number drop sharply in the following period called premenopause.

Soon the number of follicles with functional eggs are  greatly reduced and those remaining are responding weakly to FSH and LH, hormones from the pituitary that commands eggs and egg folicles to mature. In the next period, the perimenopause the maturing of eggs practically ceases. After that period, in the postmanopause, there is no longer any new maturation of eggs appart from some occational instances.

Along with the reduction of the number of functional follicles, the ovaries also get steadily amaller. As fewer eggs mature and with amsller ovaries the levels of the hormons estrogen and progesterone that are produced by the ovaries will be lower. This can be measured by the FSH level in the blood increases.

Since these hormones command the menstrual cycle to occur, then menstruations wil be steadily few and cease with the cessation of the maturation of egg cells.

At the same time as the ovaries go through a slow and natural decomposition, there will be similar changes in other reproductive organs due to lack of stimulation from the female sex hormones that were produced by the ovaries.

The uterus and the vagina becomes smaller. The uterine mouth pulle itself  in and closes after a time completely. The breasts also get smaller. These changes are sure signs that the fertile age draws to a close.

How much these changes will be marked, vary greatly from woman to woman and is partly dependent on the individual's physical fitness and physical condition.

Ailments and discomfort associated with menopause

Two special aspects will often surprise many women associated with menopause. It is time for when the menopause-related symptoms occur and how wide the spectrum of discomfort and illness may be. These can be divided into three categories:

- Vasomotoriske ailments such as hot flashes, sweating, insomnia and more. They called vasomotoriske because they are related to the blood vessel's size or diameter..

- Psychological problems that can be mood swings, irritability, low energy levels, tiredness, fatigue and sometimes even clinical depression.

- Genital and sexual  problems caused by local estrogen deficiency. Provides dryness in the vagina, atrophic vaginitis, dyspareunia, etc.

- Increases bone loss in bones that can lead to osteoporosis (osteoporosis) and there is an increase in cardiovascular disorders.

Hormonal therapy treatment of problems caused by menopause

Hormonal repålacement therapy (HRT) to counteract the toublesome effects of menopause and the period thereafter is an establidhed therapy. It has however possible side effects that makes the over-all gain from the therapy doubtful.

Estrogen or variants resambling estrogen is the main substance used by this therapy. In woman that do not have any uterus due to hysterectomy, estrogen alone is usually chosen.

In women that have the utersus, progesterone is added to the therapy. Progesterone helps to prevent  the endometrium to over-grow and develop cancer.

Hormon therapy relieve the woman from symptoms like hot flashes and counteracts osteoporosis.

It has been claimed that HRT counteract aging symptoms. These claims have shown to not be true.

Conjugated equine estrogen is a variant of HRT. By this variant, one uses estrogens obtained from pregnant horses. The estrogens are further connected with sulphate gropus to make them more soluble in water.  This type of estrogen is also often combined withsynthetic progestrin.

Woman taking HRT, and especially those using conjugated equine estrogen therapies have a higher risk of breast cancer, heart disease, stroke, and Alzheimer's disease. The risk is not so high that HRT should probably only be used by women that have a high grade of problems due to menopsuse.