What Menopause Does To Your Body, According To Doctors
It's a time in life that inspires hope, dread, and Nancy Meyers movies: menopause. Menopause isn't one sudden event; people coming to the end of their periods can also experience the symptoms of perimenopause, or a transition into menopause, for years at a time before periods finally cease. But if you're thinking about how menopause affects your body, there isn't a one-size-fits-all answer. Menopause can show up very differently depending on a wide range of factors, including whether it's happening naturally or as a result of a medical condition, how much estrogen your body has produced, and even your mental health history.
"There isn’t just one way to describe what happens to a body around menopause, as symptoms can be absent, very mild, mild to moderate, or severe," Dr. Nina Carroll M.D., a physician with medical consultancy Your Doctors Online, tells Bustle.
There's not one standard menopause timeline, either. Carroll tells Bustle that it can happen naturally over several years, or be triggered by medical conditions or surgeries, like ovarian removal surgery, chemotherapy, chronic fatigue syndrome, or autoimmune issues. It can also be triggered by a condition called primary ovarian insufficiency, where the ovaries stop working properly. Menopause means the end of your reproductive cycle — so no more periods and no more pregnancies — and it has many other consequences for health.
It's not known why we experience menopause; scientists think that it might be because childbirth in old age is too dangerous, or because we're supposed to take care of our grandkids rather than producing more children. Regardless of why it happens, experts tell Bustle it's a pretty remarkable process. Here's how your body changes when you go through menopause.
1. Your Reproductive Cycle Shifts
Menopause, when it finally sets in, is a complicated process. When a person with ovaries is pre-menopausal, an egg is released from the ovaries, waits to fertilized in the fallopian tube, and then, if it's not fertilized, is shed during your period. During these fertile years, ovaries also produce estrogen and testosterone.
Before you enter menopause, you go through a period called perimenopause, where the ovaries begin gradually to slow down. "During perimenopause, ovarian function can be unpredictable, with little to no production of estrogen from the ovaries," Dr. Caroll tells Bustle. That means the typical features of menopause, including hot flashes, night sweats and vaginal dryness. Then the ovaries will start up again, estrogen levels will spike and you'll experience periods again. Hormonal contraception can also mask the symptoms of perimenopause so you don't notice it happening.
When menopause finally occurs, the slowdown is complete: The ovaries stop releasing eggs, produce far lower levels of estrogen, and become less capable of maintaining a balance of hormones in your body. As a result, your periods cease and you're no longer capable of becoming pregnant.
This shift sets off a chain reaction in many other areas of the body. "Estrogen receptors are present throughout the female body, impacting far more than reproductive functions," Dr. Felice Gersh, M.D., an OB/GYN, founder and director of the Integrative Medical Group of Irvine, tells Bustle. "Every organ system of the female body is negatively impacted by menopause, and the earlier menopause occurs in a woman’s life, the more harmful it is."
2. The Body's Drop In Estrogen Can Affect Your Bones
When menopause causes estrogen levels to drop, it also creates knock-on effects for other parts of the body. Most of us know that menopause heightens the risk of osteoporosis, in which bones become more brittle, but Gersh tells Bustle bones need estrogen more than you might think. "Menopause also lowers bone’s ability to function as an endocrine organ," she says.
Bone helps maintain our insulin sensitivity, which helps us manage our blood glucose levels, and the loss of estrogen in our systems can hamper that process. When our bones become less sturdy after menopause, our endocrine systems also become a bit less effective.
3. Menopause Will Also Change Your Brain
Estrogen also has many other roles in the body, including neurological health. "Estrogen is a major neuroprotective agent, maintaining the health of neurons," Gersh tells Bustle. "It also maintains the proper function of the immune system of the brain, the blood brain barrier, the system that supports the brain with nutrients, and the brain's blood vessels."
Estrogen helps you maintain your brain health, and is also a key part of brain plasticity, or your ability to learn new things. As levels of estrogen in the body drop during menopause, your brain will likely negatively affected, particularly over the longer term.
4. Your Heart Will Be Affected Over Time
Like the brain, the heart also relies on estrogen to work properly. "It's key to a properly functioning heart and vascular system," Gersh tells Bustle. Estrogen keeps the heart's artery linings clear and dilated, and maintains the heart's energy and its internal electrical system. One of estrogen's main benefits for heart health, Dr. Gersh explains, is that it helps the body create nitric oxide, which helps the heart's arteries relax.
The American Heart Association says that people with ovaries face a higher risk of cardiovascular diseases after menopause, and that the body's decline in estrogen levels is at least partly responsible.
5. You'll Experience A Range Of Symptoms — But It's Hard To Predict Which Ones
People going through menopause can experience hot flashes, vaginal dryness, night sweats, insomnia, and other symptoms as the body reacts to the slowdown of ovarian production. However, there isn't a one-size-fits-all collection of symptoms for menopause in general. You could experience some of these, all of them, or other symptoms entirely.
Symptoms of menopause can depend on many different factors. A study published in Menopause in 2016, for instance, found that women who had experienced depression or anxiety in their lives were more likely to report having hot flashes during their menopause, and to have worse symptoms during perimenopause. It's not know what causes this link, but it shows that menopause is about more than just the ovaries.
6. You Won't Completely Run Out Of Estrogen
You're never completely without estrogen — the ovaries don't stop their production altogether, and a study published in 2013 found that the brain produces estrogen, too — because your body needs it to do more than just maintain the reproductive system. Estrogen is necessary for our immune systems, bones, cardiovascular health and brains.
However, once you stop releasing eggs, your ovaries slow down their hormone production significantly. The resulting hormonal shift, with lowered estrogen, is what causes many of the bodily symptoms of menopause, like hot flashes and vaginal dryness.
This is why people going through the menopause often have hormonal replacement therapy, in which they're given estrogen through patches or other methods to help replenish estrogen levels and manage the effects of menopause. "The loss of estrogen after menopause can be ameliorated by the appropriate use of hormone therapy," Gersh tells Bustle.
Menopause is pretty inevitable if you have ovaries; they have a built-in expiration date. However, the process isn't uniform, and as The Golden Girls clearly shows us, the end of fertility obviously doesn't mean the end of having fun.
Fisher, W. I., & Thurston, R. C. (2016). Measuring hot flash phenomenonology using ambulatory prospective digital diaries. Menopause, 23(11), 1222–1227. doi: 10.1097/gme.0000000000000685
Gold E. B. (2011). The timing of the age at which natural menopause occurs. Obstetrics and Gynecology Clinics of North America, 38(3), 425–440. doi:10.1016/j.ogc.2011.05.002
Guntur, A. R., & Rosen, C. J. (2012). Bone as an endocrine organ. Endocrine Practice, 18(5), 758–762. doi:10.4158/EP12141.RA
Kenealy, B. P., Kapoor, A., Guerriero, K. A., Keen, K. L., Garcia, J. P., Kurian, J. R., … Terasawa, E. (2013). Neuroestradiol in the Hypothalamus Contributes to the Regulation of Gonadotropin Releasing Hormone Release. Journal of Neuroscience, 33(49), 19051–19059. doi: 10.1523/jneurosci.3878-13.2013
Moolman, J. (2006). Unravelling the cardioprotective mechanism of action of estrogens. Cardiovascular Research, 69(4), 777–780. doi: 10.1016/j.cardiores.2006.01.001
Seungdamrong, A., & Weiss, G. (2007). Ovulation in a postmenopausal woman. Fertility and Sterility, 88(5). doi: 10.1016/j.fertnstert.2006.11.152
Zárate, S., Stevnsner, T., & Gredilla, R. (2017). Role of Estrogen and Other Sex Hormones in Brain Aging. Neuroprotection and DNA Repair. Frontiers in Aging Neuroscience, 9. doi: 10.3389/fnagi.2017.00430
Dr. Nina Carroll M.D., physician with medical consultancy Your Doctors Online
Dr. Felice Gersh, M.D., OB/GYN, founder and director of the Integrative Medical Group of Irvine