What Is Menopause?

What Your Doctor May Not Tell You About Menopause : The Breakthrough Book on Natural Hormone Balance
by John R. Lee, M.D., Virginia Hopkins

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Strictly speaking, menopause is the cessation of menses, the end of menstrual cycles. The unpleasant “symptoms” of menopause that some women suffer, such as hot flashes, vaginal dryness, and mood swings, are peculiar to industrialized cultures and, as far as I can tell, they are virtually unknown in agrarian cultures. In native cultures menopause tends to be a cause for quiet celebration, a time when a woman has completed her childbearing years and is moving into a deeper level of self-discovery and spiritual awareness. She is becoming a wise old woman. In these cultures menopausal women are looked up to and revered. They are sought out for advice and their opinions are heavily weighed in the decision-making process of the community.

How strange that sounds to us! We know menopause as a death knell, the end of a woman's sexuality, a descent into a dried-up and painful old age of arthritis and osteoporosis. How did this experience of menopause come to be? I believe it's a combination of poor diet, unhealthy lifestyle, environmental pollutants, cultural attitudes, the incorrect use of synthetic hormones, and advertising. But first, let's look at what happens in a woman's body as menopause approaches.

The Rise and Fall of Hormones During the Menstrual Cycle

In a normal menstrual cycle, every 26 to 28 days, the ovaries, which hold a woman's eggs, receive a hormonal signal from the brain that it's time to get some eggs ready to be fertilized. Anywhere from a few to a few hundred eggs begin to mature inside sacs called follicles. After 10 to 12 days one egg has moved to the outer surface of the ovary and the follicle bursts, releasing the egg into the fallopian tube for its journey to the uterus.

As the egg is ripening in the ovary, the uterus is ripening in preparation for the possibility of growing a fetus. The uterine lining thickens and becomes engorged with blood that will nourish the growing embryo. If no fertilized egg implants itself in the uterus, it sheds its lining. This shedding is the blood of menstruation. Then the cycle begins again, with the signal from the brain telling the ovary to ripen an egg.

Estrogen (from estrus, meaning “heat” or “fertility”) is the dominant hormone for the first week or so after menstruation, stimulating the buildup of tissue and blood in the uterus as the ovarian follicles simultaneously begin their development of the egg. Around the time of ovulation, estrogen causes changes in the vaginal mucus, making it more tolerant of male penetration during sexual activity and more hospitable to sperm. At this phase in the menstrual cycle, the vaginal mucus tends to somewhat resemble uncooked egg whites. Watching for this change in mucus combined with a rise in body temperature is one of the best nonlaboratory methods for identifying the time of ovulation.

About twelve days after the beginning of the previous menstruation, the rising estrogen level peaks and then tapers off just as the follicle matures and just before ovulation. After ovulation the now-empty follicle becomes the corpus luteum (so named because of its appearance as a small yellow body on the surface of the ovary). The corpus luteum is the site of progesterone production, which dominates the second half of the menstrual month, reaching a peak of about 20 milligrams (mg) per day.

Progesterone production during this phase of the cycle, along with estrogen, leads to a refinement and “ripening” of tissue and blood in the uterus. Progesterone also contributes to the changes in the vaginal mucus seen at the time of ovulation. The rise of progesterone at the time of ovulation causes a rise of body temperature of about one degree Fahrenheit, a finding often used to indicate ovulation.

If pregnancy does not occur within 10 to 12 days after ovulation, estrogen and progesterone levels fall abruptly, triggering menstruation, and the cycle begins anew. If pregnancy occurs, progesterone production increases and the shedding of the lining of the uterus is prevented, thus preserving the developing embryo. As pregnancy progresses, progesterone production is taken over by the placenta and its secretion increases gradually to levels of 300 to 400 milligrams per day during the third trimester.

About the Author

John R. Lee, M.D., is the author of Natural Progesterone. Recently retired from private practice after thirty years, he now teaches medical professionals and lay audiences about hormone balance and health.

Virginia Hopkins, M.A., is a medical writer specializing in women's health and nutrition.