The Role of Your Hormones

As you've probably learned by now — beginning in puberty and until the start of menopause — our ovaries produce two primary hormones, estrogen and progesterone. These are the hormones that play an integral part in regulating your period. And when we talk about the hormones of menopause, these are the ones we're referring to.

During the years just before menopause, there is a gradual reduction in your production of estrogen and progesterone. Eventually, you don't produce enough hormones to regulate your period and it stops altogether. And once your period has completely stopped for 1 year, menopause is considered to have started.

For most women, the hot flashes and night sweats can last between 4 and 5 years. This is from the first early symptom to the last. Unfortunately for some women, the menopausal symptom of hot flashes can last from 1 to 8 years.

Surgical menopause, of course, is different. If both of your ovaries are removed, menopause is immediate — there's no gradual anything — and the symptoms can be severe.

But whether menopause has occurred naturally or because you've had surgery, your estrogen levels have dropped and you've begun to experience hormonal changes, which can affect not only your body, but your state of mind as well.

There's little doubt that during menopause things can feel a bit hopeless. You have to weather hot flashes and night sweats, which can happen anytime, day or night, at work or at play.

Your mood changes during menopause can be extreme. Anxiety, depression, irritability, difficulty concentrating, or moodiness may find you. Your sex drive may seem to be slowing, though part of this issue is probably due to lack of sleep from the nighttime hot flashes and sweats you may be having.

It's very interesting what effect hormones can have, not only on your body, but also on your entire well-being. When your body is in balance, the mind tends to follow.

And when you no longer are faced with the distracting and sometimes debilitating symptoms of menopause, you're able to refocus on what's really important...you.

Menopause may cause other changes that may produce few symptoms, yet can affect your health. For instance, many parts of the body can be affected by estrogen — your breasts, bones, heart and arteries, and central nervous system.

Changing levels of estrogen could cause problems in some of these. For example, as you age and go through menopause, bone loss may occur and postmenopausal osteoporosis may develop. Some women will choose treatment for their menopausal symptoms and to prevent bone loss. If you choose treatment for both, estrogen alone or estrogen with progestin (for a woman who still has her uterus) can be used.

Knowledge of your family history can play an important role when evaluating your hormone therapy options. And it can be very helpful when talking with your doctor in general.

The goals of the WHI studies were to assess the effects of hormone therapy, diet modification, calcium, and vitamin D supplements on heart health, not to look at the proven effectiveness of hormone therapy on the most common symptoms of menopause — hot flashes and night sweats.

The studies included 161,808 postmenopausal women between 50 and 79 years old. The average age of the women was 63, well past 51, the average age of a woman with menopause.

— Doctors should prescribe the lowest effective dose for the shortest possible time

— Hormone therapy should not be used for the prevention of dementia or heart attacks

The study showed that for every 10,000 women taking estrogen for 1 year, the following results would be expected (versus sugar pill placebo):

• No difference in breast cancer and heart attacks
• Decreased risk for hip fractures
• Increased risk for strokes and blood clots

The study showed that for every 10,000 women taking estrogen plus progestin for 1 year, the following results would be expected (versus sugar pill placebo):

• Increased risk for stroke, blood clots, and breast cancer
• No difference in heart attacks
• Decreased risk for hip fractures
• Decreased risk for colorectal cancer

In April 2006, researchers who continued to look at the results of the WHI, published new data in the Journal of the American Medical Association (JAMA). In their article they showed that in the estrogen-alone study, postmenopausal women who took estrogens as prescribed did not have an increased incidence for breast cancer compared to women taking placebo.

As you know, there are always risks and benefits to consider when you are thinking of taking any medication.

Being involved in your own healthcare is very important. That's why creating a good dialogue with your doctor is not something to take lightly. In fact, asking questions and talking about your concerns are almost as important as eating right and getting regular exercise.

When you visit your doctor, talk with him or her about both your physical and emotional issues. And remember that your doctor may not be able to answer all of your questions — but perhaps together, you can find the answers that will help you.

For tips on talking with your healthcare professional, please click here.