Hormonal Changes: From First Menstruation to Menopause

07 july 2023

As a woman, you will encounter hormonal changes. Although hormones play a significant role from birth, you only really notice them when you hit puberty and have your first period. Women experience various hormonal changes throughout their lives. In this blog, we will explain the hormonal changes that occur between your first menstruation and menopause. We will also explore some common hormonal complaints.

Puberty and the First Menstruation

The average age at which girls start their period and enter puberty is between 9 and 16 years. Most girls have their first menstruation between the ages of 11 and 14. The first period is also known as menarche. During puberty, hormonal changes begin that lead to the development of secondary sexual characteristics, such as breast development, hair growth, and menstruation. Oestrogen is the primary hormone involved in this process. Oestrogen stimulates the growth of breast tissue and the development of female reproductive organs.

When you reach childbearing age, you experience a monthly menstrual cycle. This cycle is regulated by a complex interplay of hormones, including oestrogen, progesterone, follicle-stimulating hormone (FSH), and luteinising hormone (LH). These hormones stimulate the growth of eggs and ovulation. Want to know more? Read here all about female hormones.

Hormonal Balance and Well-being

Between the ages of 18-45, you are in the prime of your life physically, and your hormones should have found a good balance. A well-balanced hormone level contributes to the regulation of the menstrual cycle, a healthy reproductive function, and the maintenance of overall physical and emotional balance. Additionally, a good hormonal balance can help reduce symptoms such as mood swings, fatigue, and sleep problems when these are caused by hormonal fluctuations. Our body is a very complex system where hormones can sometimes cause disruptions, particularly in women. You can experience unpleasant symptoms due to a hormonal imbalance, such as menstrual disorders like PMS or PCOS.

Hormonal Imbalance and Menstrual Disorders

During the different phases of the menstrual cycle, natural hormonal changes occur. These fluctuations can lead to physical and emotional symptoms in women, such as mood swings, fatigue, tender breasts, and changes in appetite.

Additionally, hormonal changes can also lead to menstrual disorders, such as amenorrhoea (absence of menstruation), dysmenorrhoea (severe menstrual pain), PMS (premenstrual syndrome), and PCOS (polycystic ovary syndrome).

What is Amenorrhoea?

Amenorrhoea is a menstrual disorder where menstruation is absent for several months while you are not pregnant or in menopause. Amenorrhoea occurs due to a low level of Gonadotrophin Releasing Hormone (GnRH). This hormone is important for regulating the menstrual cycle. When GnRH levels are low, it can lead to low levels of FSH and consequently low oestrogen levels. There are several causes that can suppress the production of GnRH:

Psychological stress, weight loss, or excessive physical exertion: Psychological stress disrupts the hormonal balance and affects the hypothalamus, a part of the brain, resulting in reduced GnRH production. Weight loss and excessive physical exertion can also affect the function of the hypothalamus and lead to a decrease in GnRH production.
An underactive thyroid (hypothyroidism): Hypothyroidism causes a deficiency of thyroid hormones, leading to increased levels of thyroid releasing hormone (TRH). Elevated TRH levels suppress GnRH production.
Medications such as antipsychotics, antidepressants, and antihypertensives: These medications inhibit the release of dopamine in the hypothalamus. Reduced dopamine release leads to increased prolactin levels, which in turn suppress GnRH production. Prolactin is a hormone produced in the pituitary gland and plays an important role in stimulating milk production in the breast tissue and suppressing ovulation in women.

What is Dysmenorrhoea?

Dysmenorrhoea is also known as menstrual pain. It is not just mild cramps but menstrual pain so severe that it hinders your daily life. With dysmenorrhoea, you experience pain in your lower abdomen or severe abdominal cramps just before and during menstruation. This pain can radiate to your lower back and legs. Additionally, you may experience symptoms such as nausea, diarrhoea, constipation, headaches, excessive sweating, and nervousness. Dysmenorrhoea is particularly common among young women between the ages of 12 and 24. There is a distinction between primary and secondary dysmenorrhoea:

Primary dysmenorrhoea is the form that most women with severe menstrual pain suffer from. In this form, no clear cause can be identified.
Secondary dysmenorrhoea is the form where identifiable causes are present. About a quarter of women have this form of dysmenorrhoea. Causes include endometriosis, fibroids, pelvic infection, or a narrowed cervix.

What is PMS?

PMS, also known as premenstrual syndrome, is a recurring monthly problem for many women. There are no specific characteristics, tests, or lab results that can diagnose PMS. Symptoms that women commonly experience during the period leading up to menstruation include:

Tension and irritability
Fatigue and general malaise
Mental issues such as depression and anxiety
Migraine, headaches, dizziness, fainting

Back pain, sore muscles and joints
Hives, boils, acne
Sensitive, painful breasts
Binge eating
Bloating, digestive problems

During the second half of the cycle, after ovulation has occurred, progesterone production increases, while oestrogen levels gradually decrease. Large hormonal fluctuations can disrupt metabolic and biochemical processes, causing PMS symptoms. Read here more about PMS and what you can do about it.

What is PCOS?

PCOS is short for polycystic ovary syndrome. Literally, this means that there are multiple (poly) fluid-filled sacs (cysts) present in the ovary. PCOS occurs in five to ten percent of all women.

PCOS is a condition in which the ovaries produce abnormally high levels of certain hormones, such as testosterone. This disrupts the normal maturation process of the follicles, resulting in the formation of cysts on the ovaries. A characteristic symptom of PCOS is an irregular menstrual cycle, where menstruation may sometimes be completely absent. Moreover, women with PCOS may experience excessive hair growth in unwanted areas, such as the face. Other symptoms include acne, weight gain, and enlarged ovaries with multiple cysts. This condition can also lead to fertility problems, as ovulation may be irregular or absent. The symptoms vary from woman to woman, and not every woman experiences all symptoms. Want to know more? Read here all about PCOS and what you can do about it.

Pre-menopause and Recognising the Transition

Menopause is a natural phase in a woman's life where fertility decreases, and menstruation stops due to hormonal changes. The transition is the overarching term to describe the different phases around menopause. There are three phases:

Peri-menopause: This is the phase before menopause, usually starting around the age of 40. It is characterised by changes in menstruation, such as irregular cycles, heavier or lighter bleeding, and the absence of ovulation. The production of FSH rises, while the production of oestrogen decreases.
Menopause: This is the last menstruation in a woman's life. It is officially reached when a woman has not had a period for 12 months. The ovaries almost no longer produce oestrogens and progesterone, leading to the end of fertility and the cessation of menstruation.

Post-menopause: This is the period from one year after the last menstruation. In this phase, the ovaries no longer produce hormones, and the body reaches a new hormonal balance. It can take several years for the body to adjust to these changes. Symptoms of the transition may still be present as the hormonal balance is restored.

Whatever phase you are in as a woman, managing your hormones is not always easy. We are here to help you with that. With knowledge, inspiration, and products specially for women. Because feeling good should not be an exception, but the rule.