Understanding our hormones and bodies during mid-life and beyond

There seems to be a lot of mystery and confusion surrounding menopause. Even choosing a heading for this post led me to consider – do I call it mid-life, menopause, the transition, the change? I went with mid-life and transition, and I’ll use these interchangeably from here.

Personally, I was in denial as my transition began. Underneath, I was scared. I didn’t understand it, my experiences around women who had gone through it were negative (at best), and I couldn’t find anyone I trusted to give me guidance.

During the profound hormonal changes that take place in mid-life, many of us feel uncertain about what is happening, and why. In this post I’ll share that information, so you can understand your own body before you go on to consider how you will choose to support her.

As a side note, I believe the transformation that is occurring during this time of life goes well beyond the physical. If you’re interested in learning more, check out this post.

Let's start with the basics - what are hormones

Our hormones are chemical messengers. They’re produced in one part of our body and travel through our blood to other parts where they coordinate various processes.

You’re probably familiar with at least a few:

Cortisol, which is produced in the adrenal glands,  modulates our stress response. Thyroid hormones (T3 and T4) regulate our energy, metabolism, and weight. Insulin, produced by our pancreas, harmonizes our blood sugar and sex steroids (including estrogen, progesterone, and testosterone), and influences muscle mass, bone density, and cardiovascular health. And there are so many more.

Throughout our lives, our various hormones influence our appetites, energy, metabolism, sleep cycles, reproductive cycles, body temperature, mood, immunity, overall health and vitality, and even our perception of our bodies.

In this post, we’re going to focus on the sex hormones primarily involved during our transition – estrogens (of which there are 3 – e1, e2, and e3) and progesterone.

The so-called mid-life transition

Given the average person in the west lives until around 80, mid-life generally occurs between the ages of 35 and 45. Transition refers to a process. It could be short or long. It likely includes periods of turbulence, interspersed with times of relative calm. Whenever it occurs, and in whatever form, for most women, this time coincides with perimenopause. 

Perimenopause - the beginning of the change

Perimenopause is the natural time leading up to menopause. It tends to begin around eight to 10 years before menopause. The duration varies from a few months to several years, with the average being about four years.

Generally, the first sign of perimenopause is irregular periods. During this time, the levels of our sex hormones fluctuate.  Estrogen starts to decline and its balance with progesterone is thrown off. How our body reacts is unique to us. However, the resulting fluctuations tend to bring on symptoms like erratic cycles, hot flashes, sleep changes, emotional shifts, and more. Our body is moving toward the end of her reproductive years when our cycle will permanently end. 

a short aside -

I think it’s important to understand that “estrogen” actually refers to a family of 3 hormones. The members are: estrone (e1), estradiol (e2), and estriol (e3). Our body doesn’t actually stop making estrogen. She produces different amounts, of these 3 different types, at different times in our life.

Estrone (e-1) is a relatively weak estrogen (about one tenth as potent as estradiol). It becomes our primary source after menopause. Estrone levels are inversely related to our estradiol levels. As our ovaries age, estradiol production decreases and estrone levels rise to make up for the decrease. Simplistically, e-1 is produced in our ovaries, but mostly in our fat cells and adrenal glands.

Estradiol (e-2) is the most potent form of estrogen. It’s the major hormone produced during our reproductive years and varies over the course of our menstrual cycles. E-2 is primarily produced by our ovaries.

Estriol (e-3) is the main form of estrogen during pregnancy. It’s largely produced by the placenta when pregnant and in the breast cells and liver when not pregnant.

So, our intelligent bodies do produce estrogen after menopause - mostly in the form of estrone. While not as potent as estradiol, estrone still stimulates our brain and serves numerous functions throughout our bodies.

Menopause - a point in time

Meno (menstruation) pause (stop) is a point in time one year after our last period. So, we reach menopause after 12 consecutive months without a period. Our body makes so little (e-2) estrogen that our ovaries no longer release eggs (ovulation). After this, we are in post-menopause. When this occurs due to a medical condition or treatment, it’s referred to as induced menopause.

Post-Menopause - the rest of our life

Regardless of what led to that point in time that was menopause, post-menopause is the rest of our life. While most symptoms of perimenopause gradually ease after menopause, hormonal changes continue to influence our well-being, from metabolism to sleep to mood and memory. Some factors to be aware of in post-menopause are potential increases in the risk of osteoporosis, heart disease, and diabetes.

The details - a closer look at our brains, bodies, and cycles

Many of us have very little understanding of what is going on in our bodies each month during our reproductive years, let alone during the transition. But this information can be very helpful, orienting.

in the beginning -

When we were born, we had all the eggs our body was ever going to make. Around one to two million of them. They were unmatured and encased within the follicles in our ovaries.

during our reproductive years -

Roughly between 10 and 16, our brain (hypothalamus and pituitary gland) started sending chemicals (FSH and LH) to our ovaries to stimulate ovulation each month. Ovulation is the release of a mature egg from our ovary.

If we were healthy, our cycle was generally regular and predictable:

Our estrogen would rise and fall at mid-cycle, with an additional small bump toward the end. Progesterone would rise after we ovulated and then go back down to baseline.

Testosterone would fluctuate slightly during mid-cycle.

during perimenopause -

Sometime in our mid-forties (on average), ovulation starts becoming erratic. Due to our declining egg supply, our ovaries become less responsive to the chemical signals coming from our brain. But our brain keeps asking “where is my estrogen?” and sends more FSH and LH to stimulate ovulation. This causes estrogen and progesterone levels to become more chaotic. We no longer experience the predictable cycles of our reproductive years.

Our brains tend to take the biggest early hit as it attempts to adapt to shifting hormone levels. For example, when our brain’s temperature regulation is thrown off by low and fluctuating estrogen levels, our body tries to dissipate the heat and we get hot flashes. We might experience cognitive changes, such as brain fog and difficulty concentrating. We may also notice shifts in mood, including irritability, anxiety, and depression.

Since there are estrogen, progesterone, and testosterone receptors in almost every organ system of our bodies, we experience changes everywhere.

Look at it this way - our hormonal life-cycle

I really “got it” when I thought of the menopausal transition almost like puberty in reverse.

Our hormonal lifecycle sits on a continuum. The details of this lifecycle are unique to each of us.  At one end is puberty, at the other is the menopausal transition. Like in puberty, the menopausal transition takes place over time.

We don’t go from childhood to our reproductive years overnight. Our bodies and brains develop over years, guided by fluctuations in our hormones. The process of puberty begins before our first period. Signs include widening hips, breast buds, and pubic hair. The process of menopause also begins before our last period. Signs, otherwise known as symptoms, include those mentioned in perimenopause (above). 

Menopause is just one point along a continuum of our ever shifting hormones. It marks the end of our reproductive years, much like our period marked the beginning.

Post-menopause begins a new chapter, in which we may spend up to 40 percent of our lifetime. That’s a lot of life left to live.

To learn more

Check out these resources:

The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts. Mary Claire Haver.

The Menopause Brain: New Science Empowers Women to Navigate the Pivotal Transition with Knowledge and Confidence. Lisa Mosconi.

The Wisdom of Menopause: Creating Physical and Emotional Health During the Change.  Christiane Northrup.

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