At the end of the active reproductive years, as the ovaries start to fail in their role of egg and hormone production, women around the age of 50 approach the menopause.
The process is complex, beginning several years before the actual menopause, as hormone levels dip and the brain responds by increasing its own pre-hormone chemicals in an attempt to keep the ovaries going.
Surges of Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) are thought to be responsible for the sweats and flushes that start around this time. Despite the brain's efforts, egg production decreases and hormone levels fall. The effect on the body is widespread. The ovaries stop functioning. With falling hormonal stimulation the growth of the endometrial lining of the uterus becomes erratic before finally ceasing and periods stop.
Without the effects of oestrogen, the soft tissues are more likely to shrivel and thin, so everything from external skin and hair to vaginal walls lose their youthful plumpness, becoming drier, droopier and more friable, which for many women can make sex difficult or downright painful.
Urinary symptoms are also common as the entrance to the bladder can be affected. Without the protective effect of oestrogen the risk of osteoporosis increases and women may experience bone pains. The effect on the brain is less well understood but emotional swings, poor concentration and irritability are common.
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