Women produce a number of different sex hormones including oestrogen, progesterone and testosterone. After the menopause, either naturally or surgically, these hormones will begin to diminish in quantity – some more quickly than others. It is this reduction which causes most of the menopausal symptoms that women can experience.
OESTROGEN is a powerful female sex hormone that regulates many aspects of our lives. Initially it makes girls develop into women at puberty by stimulating breast growth, laying down fatty deposits, thickening the vagina and causing it to secrete mucous. It affects how our skin looks, whether our bones are strong and healthy and it can protect us against heart disease. It also regulates our menstrual cycle. At the beginning of our cycle about 30 egg follicles will start to ripen and produce oestrogen. When levels of oestrogen in the blood are highest the hypothalamus in the brain release hormones that make a follicle release an egg, therefore if you are not producing enough oestrogen you will not ovulate. It is produced by the ovaries and naturally declines after the woman goes through the menopause.
PROGESTERONE is one of the female sex hormones produced by the ovaries and adrenal glands. It plays an important role in maintaining a pregnancy. As well as helping to sustain pregnancy it also regulates the monthly menstrual cycle.
Its most important function is to encourage the endometrium to secrete proteins in the second half of the menstrual cycle in preparation for a fertilised egg. If no egg is fertilised or implanted then oestrogen and progesterone levels fall and the endometrium breaks down and is passed out through the body through your period bleed.
High levels of progesterone are thought to be responsible for symptoms of PMS (pre-menstrual syndrome). These can include breast tenderness, bloat and mood swings.
There is some debate whether a woman who has had a hysterectomy that removes her ovaries needs to supplement with progestrone as well as oestrogen. The feeling is that it might balance any oestrogen supplements and prevent women from becoming oestrogen dominant, which is what may have caused problems in the first place. However the adrenal glands continue to produce small amounts of progesterone and we also produce some from dietary cholesterol. In most women this will be enough to prevent oestrogen dominance.
TESTOSTERONE is a male hormone but women still produce small amounts of it in their ovaries. Testosterone is produced by the ovaries and helps to regulate sex drive (libido), energy and mental state. Following a natural menopause testosterone will continue to be produced by the ovaries in significant amounts for approximately twelve years, therefore a woman that has her ovaries removed will no longer produce testosterone and this may be responsible for a poor libido, depression and lack of energy following surgery.
Testosterone may also have a role to play in conserving bone after menopause and supplementation with it may be more suitable for women that are unable to take oestrogen who have an increased risk of osteoporosis. However testosterone should not be taken orally, in the form of tablets as it can damage the liver. The usual form of administration is by implant or by injection at regular intervals.