Hormone Replacement Therapy

What Happens In Menopause?

A woman’s reproductive organs include:

• The uterus, or womb
• Two ovaries, which produce eggs as well as the female hormones estrogen and progesterone (and also produce small amounts of the male hormones testosterone and androsterone )
• Two Fallopian tubes, which transport the eggs from the ovaries to the uterus
• Two glands near the brain that release hormones, which stimulate the ovaries to produce estrogen

Menopause marks the end of menstruation in women. Estrogen and progesterone play important roles in menstruation and reproduction.

• Every month, estrogen causes the lining of the uterus to grow in preparation for pregnancy implantation.
• Progesterone causes the lining to thicken and produce glycogen – a source of food for the embryo.
• An egg is released from one of the two ovaries.
• If the egg is fertilized, it implants in the thickened lining, and pregnancy begins.
• If the egg is not fertilized, it does not implant. Progesterone production then stops, and this causes the lining of the uterus to shed, resulting in a menstrual period.

As hormone production by the ovaries gradually decreases, there is a length of time (it could be five years or more) when the levels of estrogen and progesterone in a woman’s body are unpredictable. This can cause:

• Menstrual periods that are very light or close together.
• Menstrual periods that may be skipped
• Menstrual periods than may be much heavier than usual.

The term menopause actually refers to the time that begins when a woman has her last menstrual period. However, many use it to cover the entire time during which the production of hormones by the ovaries gradually decreases and eventually stops. This is frequently called the perimenopausal period. For most women, this is a gradual process rather than a sudden event.