The 30-second article
recognised until after 12 months of a woman’s
periods ceasing. This cessation of menses is
known medically as the climacteric, the end
of a woman’s reproductive potential. With the
huge decrease in oestrogen levels that occurs
at this time, it is no wonder that, for some
women, havoc is wreaked on the endocrine
(hormonal), psychological and somatic (bodily)
systems. This is the time when thousands
of women may spiral into negative health
changes, which may affect how healthy they
will continue to be as they age.
Let’s examine these changes and take a
look at why it can be a time of physical and
psychological chaos.
It’s all about the hormonal
cascade
In the peri-menopausal transition, women
experience an accelerated loss of ovarian
follicles. This can take from two to eight
years. With the human endocrine system
working as a negative feedback loop (i.e.
when a single hormone production is
decreased or increased it influences other
hormone production in the body), this
subsequently has an effect on the amount of
follicle-stimulating hormone (FSH) released
from the pituitary gland. FSH simply tells the
ovary to recruit eggs, and oestrogen is made
by the developing eggs. In normal ovulation
another hormone, luteinising hormone (LH),
works in tandem with FSH in oestrogen-
18 | NETWORK SUMMER 2015
For fitness professionals, especially
personal trainers, training menopausal
women can be challenging
producing ovulation. This cycle forms the
normal menstrual cycle in younger women.
As
peri-menopause
approaches,
however, the ageing ovaries become less
responsive to FSH. As such, the amount of
FSH rises 10 to 20-fold as more and more
FSH is released by the pituitary gland to
‘bribe’ the ovaries into responding. LH is
cleared from the blood faster, so the real
culprit in peri-menopause – causing havoc
on menopausal symptoms during this time –
is FSH, and for some it can go on for years.
As a woman hits her fifties, fewer and
fewer follicles respond. The overwhelming
effect of this is that the amount of oestrogen
made begins to decrease significantly.
This drop in oestrogen (which is quite
dramatic in some women, especially those
who are already overweight) can often be
the start of the chaos that some women
experience at this time, both physically and
psychologically.
Another hormone, progesterone, is
also implicated in all of this turmoil. In the
younger menstruating female, progesterone
is made by the cells of the uterus to ready it
for receiving a fertilised egg. Progesterone
is the hormone of pregnancy and in perimenopause progesterone levels also
fluctuate. Although this uneven rising and
falling of various hormones can impact hugely
on how your client may be feeling at this time
of peri-menopause, it is post-menopause
that the real health impacts might occur.
Hormone production after
menopause
Once menstruation stops completely for 60
days or more (amenorrhea) there are few
remaining ovarian follicles. This doesn’t
mean that the ovaries cease functioning,
however. Post-menopause, the ovaries
continue to secrete hormones, although not
Figure 1. Hormonal fluctuations during menopause
80
Hormone levels
• Defined as the permanent cessation
of menstrual periods, the mean age
of menopause is 51.3 years
• Regardless of how active or healthy a
woman has been in the past,
menopause can seriously impact
hormones and metabolism
• A huge decrease in oestrogen levels,
as well as fluctuating levels of
progesterone and other hormones,
can result in both physical and
psychological disruption
• Some women experience irritability
and depression, weight gain around
the mid-riff, poor sleep patterns, hot
flushes and night sweats
• PTs can assist menopausal clients by
helping them put sleep strategies in
place, adopt a Mediterranean-style
diet, and adapting their training to
match their energy levels and how
they are feeling.
50
40
20
35
45
55
65
75
Age
Oestrogen
FSL
Progesterone
LH