Menopause is the final retirement of the ovaries and as it is with most people, retirement is not something that happens overnight. However, with nearly 60,000 hysterectomies annually, most often in women between ages 40-44, the instances of surgical menopause are also increasing, even when the ovaries remain intact. In most cases, the shutdown of the ovaries is a process that happens gradually over the period of 10-15 years. This period is known as perimenopause, which simply means “around menopause”. The average age for women to experience menopause is 52, meaning that the perimenopause process usually begins in the late 30s. Genetics, exposure to environmental contaminants and certain medications make this happen faster, and the result is hormonal deficiencies that negatively impact the health of women of all ages.
Women’s hormonal makeup is approximately 60% estrogen and 40% testosterone. Our ovaries make most of the testosterone for our bodies, but it’s not stored in fat like estrogen. During perimenopause, testosterone is the first hormone to decline, and it can happen faster due to use of oral contraceptives, antidepressants and other drugs. Testosterone deficiencies, or low T, cause weight gain, fatigue, low libido, affect mental clarity, and increase insulin resistance, raising the risk for diabetes, heart disease, strokes, and other serious conditions.
As if that wasn’t enough, once we reach our early 40s, estrogen levels also begin to decline, and symptoms like memory loss, weight gain, mood swings, hot flashes, low libido, vaginal dryness, night sweats and insomnia increase. Once our periods become irregular or abnormally heavy, we’re usually within a year or two of ovarian retirement/failure. Lab tests are not the best indicator of estrogen reserves, so listening to the symptoms the patient is exhibiting is critical.
With women living longer after menopause than any other time in history, and with so many factors negatively impacting hormone levels at earlier ages, the ups and downs related to fluctuating levels and health issues that stem from deficiencies are easily treatable through hormone replacement therapy, or HRT. One very important note: if you’re experiencing symptoms normally associated with menopause and your doctor tells you that you’re too young to have hormonal deficiencies, it’s a sign that you need a new doctor, STAT. Consult a hormonal health specialist for a complete evaluation.