Hormonal Changes In Menopause

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Menopause is defined as cessation of menstruation and fewer remaining follicles causing infertility, generally at around 50 years of age. Perimenopause, the period of time leading into the menopause in women, is often characterized by irregularity in length of the menstrual cycle. Perimenopause is marked by dramatic changes in the hypothalamic-pituitary-ovarian axis. An early finding is a rise in circulating FSH levels unaccompanied by a rise in LH. It has been suggested that there is a decreased secretion of ovarian inhibin along with the decreasing follicular pool, which may be the primary cause of the rise in FSH. The resultant ovarian changes include short follicular phases with early ovulation, and ovarian insufficiency characterized by lower levels of estrogen and progesterone secreted for shorter periods of time compared with the luteal phase of younger women. The major significant endocrine event in women in the early perimenopausal phase is a fall in the circulating levels of inhibin B with no significant change in inhibin A or estradiol. Early onset of menopause, also known as premature ovarian failure, may be a cause of infertility in women greater than 30 years of age.15,16

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