Menopause is a crucial step in a woman’s life. Menopause marks the time when a woman’s fertility comes to an end, but it is also a time when the woman’s body goes through many meaningful changes that are all driven by hormone fluctuation. Indeed, this is the main reason menopause can be so challenging and, second, different for each individual.
In this blog, I will summarise why hormone disbalance can cause so many changes, and what those changes are.
The Women’s Hormons: which is which, and what’s their role
Before we dive into what is happening during menopause, we have to take a look at the different types of hormones in a woman’s body and what they are responsible for.
Here is a simplified list:
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Estrogen
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Progesterone
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Follicle-stimulating hormone (FSH)
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Luteinizing Hormone (LH)
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Prolactin
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Oxytocin
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Testosterone (in women)
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The Role of Hormones during the Menstrual Cycle.
Since puberty, women’s lives are impacted by hormonal changes on a monthly basis. Indeed, once a woman starts her menstrual cycle, hormones dictate how she feels, how her skin looks, and how hair and other body parts feel.
This is possible because the body’s cells, in many of the body’s parts, are covered in hormonal receptors, especially for estrogen.
Here, you will find a graph that shows how the hormones fluctuate along the women’s menstruation cycle. Notice how in period time (Red bubble) and by the end of the Secretory Phase (Violet bubble), all the hormones, especially Estrogen, reach and maintain a low pick.
To simplify the blog, we would focus on estrogen and progestogen hormones because those are the two primary hormones that play a role in the menopause journey (which includes the perimenopause and postmenopause time).
Running low on Hormones and Menopause symptoms?
Now that we analyse the role of the hormone in the menstruation cycle, we have a clearer idea of what does what and which hormone fluctuates in which phase of the month.
Moving forward, we have to introduce the knowledge that women are born with all the eggs that they would ever release during menstruation. This is important information because this is what would roughly determine the start of women’s perimenopause and so menopause. I say roughly because during 
the 3 to 4 decades of menstruation cycles, each time, there would be a release of approximately 10.000 eggs per month for the first 2 to 3 decades and then less and less once perimenopause starts. So, on average, a woman is born with about 100.000 thousand eggs in her body, and on average, by the age of 30, she is lost about 90% of her eggs, and in her early 40′ s, she loses another 7% of those eggs, which marks already the perimenopause time (ZOE Podcast – with Dr Claire Haver).
Indeed, the symptoms of menopause do not happen one day to another, even if menopause marks the day of 12 months of no menstrual cycle, but they start during perimenopause, which is a phase that begins about 10 to 7 years earlier than menopause.
Now, you may start to understand all this “between” and “as per average,” which explains why the menopause experience is different from person to person, at least from the aspect of timing. Other factors play a massive role in symptom development and intensity, such as genetics, diet, external factors and stimuli, lack of exercise and movement, other pre-existing conditions, and more.
What Happens Once Fewer and Fewer Eggs Get Released in a Menstrual Cycle?
As we have previously seen, the level of hormones changes based on the body’s necessity to release eggs cyclicly.
But as a woman starts to run low on the amount of eggs released, the body changes also the production of hormones, and is here where things start get complicated. So from a more regular fluctuation of hormones level, the body finds itself with a more randomised and unpredicted production of hormones, and all the glands and organs responsible for the hormone production and for the body functionality would start to be heavily affected by this.
Indeed, as we already expressed earlier, Estrogen reaches its peak during the proliferative phase (the orange bubble in the above graph), which now is going to slowly disappear, and so less and less Estrogen is going to be produced. Estrogen, as described in the previous table, has a huge list of implications, and all the body functions that depends from Estrogen presence are going to be affected.
Here we go then, during the perimenopause, with symptoms like:
- Irregular periods (shorter, longer, heavier, or lighter)
- Missed periods or unpredictable cycles
- Sudden warmth, flushing, or sweating (mainly upper body
- Night sweats cause sleep disturbance
- Difficulty falling or staying asleep
- Waking up too early or feeling unrested
- Increased irritability or anxiety
- Depression or mood instability
- Brain fog or difficulty concentrating
- Vaginal dryness (leading to discomfort during sex)
- Reduced libido (sex drive)
- Increased risk of urinary tract infections (UTIs)
- Weight gain (especially around the belly)
- Decreased metabolism
- Thinning hair or dry skin
- Joint and muscle aches
- Similar to PMS but less predictable
- Changes in breast density
- Stronger premenstrual symptoms (bloating, mood swings, cramps)
- Increase in cholesterol, even thought your diet never changed
- Increase in body mass or how you process food, even thought your diet never changed
- and possibly more…
Again, these are symptoms that a woman may experience because of other underlying presentations, side effects of medications, and or perimenopause.
At this stage, there is no test that can help determine if a woman is in perimenopause, and blood tests that evaluate the hormone level are not reliable as the hormone can fluctuate heavily in terms of hours or days. So, data misinterpretation is high here.
How, then, can you know with certainty that you are going through perimenopause and that the symptoms that you are experiencing are related to this presentation? A diagnosis by exclusion is the only process that would help with this. So you will have to come out for help from your GP and gynecologist and talk to them about your symptoms, do a series of tests and tick off other potential causes of those symptoms.
Conclusion
Hormones and Menopause are related, and we now know that this can answer the question, “Why am I going through these difficulties?”.
Being able to be on top of this time of life can be difficult, and as a man, I can only admire the strength that women have to take out to do so, on top of all the other life challenge.
At Melbourne Massage and Treatment, in Fitzroy North, I started to look more into this topic, and write about it, as I started getting lot of patient sicking out for Manual Lymphatic Drainage for Menopause Symptoms relief. And As I had no idea what would do what, I start digging.
What I then found out is that, along with symptom relief from MLD, exercise can also help in terms of management. Indeed, to maintain the bond mass high and to maintain muscle and soft tissue strength, exercises are a must. Therefore if you are in need of symptom relief and a relaxation treatment or want to learn more about how exercises and what exercises can help in managing menopause, please, book your treatment plan consulation now.
Giovanni La Rocca
Giovanni moved to Melbourne, Australia, from Italy in 2008 and became a citizen in 2017. He started studying massage therapy in 2016, then completed a Bachelor of Health Science in Clinical Myotherapy in August 2024. During those years, he also specialised in Thai Massage and Manual Lymphatic Drainage for presentations like Lipedema and Lymphoedema. Nowadays, he runs his clinic in Fitzroy North, Melbourne, where he integrates movement therapy into his practice to enhance overall well-being. He also values meditation, having completed several Vipassana courses. Committed to continuous learning, he aims to share his expertise in integrated therapies to help others achieve balance and resilience.