The Ovaries and Aging
Let's talk about what happens to a woman's ovaries beginning around the age of 40. Before menopause occurs, a woman (the average age of menopause is 51 but can range from 40 to 60), will go through perimenopause. This is the transition period from normal ovulatory cycles to menopause. The average cycle length for a woman in her 40's is 21-24 days. Shorter than in her earlier years, and many times ovulation does not occur.
Hormone levels can fluctuate wildly causing PMS symptoms to worsen with age. Menstrual cycles become irregular, hot flashes occur along with mood swings and, often, sexual desire diminishes. Perimenopause begins about 3-5 years before the last period and lasts until 12 months after the final menstrual cycle.
Often, to relieve symptoms, perimenopausal women are given low dose birth control pills or hormone replacement therapy to stabilize their cycles and hormone levels. Others deal with their symptoms with careful attention to healthy lifestyle - lots of exercise, cessation of smoking and excessive alcohol intake, good nutrition and a focus on cutting down on life's stressors. Just like menopause, a woman's perimenopause is uniquely hers - like her fingerprints - and must be approached with the nature and intensity of her particular symptoms in mind.
Until recently, the importance of the perimenopausal transition has been neglected. Since it's an extremely important transition in the female life span, it deserves increased attention. Perimenopause is the perfect time for a woman to evaluate her risks for the diseases of aging many of which can be hormonally controlled. With the aging baby boomers, 21 million women in the U.S. are projected to enter menopause during this decade.
Menopause is marked by the last menstrual cycle and becomes official when a woman has not had a period for one year. When her cycles have stopped, so has her ability to get pregnant. Women who have passed menopause are now classified as postmenopausal, a reference that lasts for the rest of her life.
Menopause is a normal stage in a woman's aging process. The ovaries stop releasing eggs and menstrual flow ceases. The ovaries become less responsive to stimulation by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Trying to compensate for the lack of response from the ovaries, the pituitary sends out more FSH and LH thinking that the ovaries just aren't paying attention. Measuring the high blood levels of FSH and LH is normally what is used to identify menopause. The pituitary finally gets the message that the ovaries are never going to respond and levels of FSH and LH eventually drop.
The menopausal ovaries still produce some hormones but in drastically lower amounts - less than 10% of previous production. The ovarian hormones, estrogen and progesterone, plummet. (It should be mentioned that the category 'estrogen' is used to refer to the body's three naturally produced estrogens: estradiol, the most potent estrogen and the one responsible for cycling; estriol, the hormone that rises dramatically during pregnancy; and estrone. This clarification of the 'estrogens' is important when we discussing the various choices of estrogen hormone replacement therapy on the market.)
Testosterone, partially responsible for a woman's sexual desire and produced in small amounts by the ovary, also diminishes with age though not as dramatically as estrogen and progesterone.
It is this significant drop in ovarian hormones, especially estradiol, that is responsible for the following common and treatable short term menopausal symptoms:
About 20% of menopausal women experience symptoms that are severe enough to affect their daily functioning. Women who undergo complete hysterectomies, will experience a “surgical menopause”. An immediate rather slow reduction of hormones. For those women, the symptoms of menopause can be extremely intense and are usually treated with hormone supplementation.
Menopause, with its near elimination of natural ovarian hormone production, brings with it some serious long term challenges. The menopausal woman, without the protection of her reproductive hormones, is now at an increased risk for a number of aging diseases.
It is clear that menopause is a natural aging process of the female reproductive system, it can bring with it a number of potential health problems. The thing to note about all this is that hormone depletion can be addressed.
In my next installment of Hormones and Performance I will discuss some ways that we can address hormone deficiencies cause by aging nutritionally. We will take a look at some foods we should be incorporating in our daily and or weekly intake as well as some we might want to consider avoiding.
Thomas Sampson CFL-3, USAW-2, Sports Nutritionist
International sports science association. Sports nutrition. 5th edition. 2018 carpinteria CA
Nancy Clarks Sports Nutrition Guidebook. 4th edition. 2008 champaign IL
Kelly D. Brownwell LEARN Program for Weight Management, 10th edition. 2004 Yale University