Understanding the Changes In Hormone Levels During Postmenopause

What is postmenopause? 

Postmenopause is the period after a woman experiences menopause. It begins at the onset of menopause, marking the end of menstruation and thus completing the end of the woman’s fertile years. It is the third stage of menopause after perimenopause and menopause.  

An essential part of all stages of menopause is the fluctuations in hormone levels, resulting in several uncomfortable and sometimes life-changing symptoms. In this article, we'll go over what those hormones are, how they change during postmenopause, and the effects these changes have on women's bodies.  

Menopause Hormone Basics  

A number of hormones are involved in the physical and psychological changes women undergo during menopause. Estrogen, progesterone, and testosterone are the main hormones responsible for those changes. The less prominent are the follicle-stimulating hormones (FSH) and luteinizing hormones (LH). 

By definition: 

  • Estrogen is a reproductive and sex hormone mainly produced in the ovaries, with smaller amounts coming from the adrenal glands. It presents in three forms, namely estrone, estradiol, and estriol. All three are responsible for developing, maturing, and maintaining the female reproductive system in varying degrees and quantities. 
  • Progesterone, the steroid hormone, prepares the female body for pregnancy. The corpus luteum is a small mass of cells that forms where the ovary releases the egg and is where progesterone is produced. If fertilization doesn’t happen, the corpus luteum disintegrates, and progesterone levels fall, triggering the menstrual flow.  
  • You might know testosterone as a male hormone, but it is also present in women. In the female body, the adrenal glands and ovaries produce testosterone. It contributes to libido levels, sexual drive, and orgasms and helps the body maintain cognitive function, mood, bone strength, and metabolic function. 
  • Follicle-stimulating hormone (FSH) promotes the development and growth of follicles in the ovary during the follicular stage of the menstrual cycle.  
  • Luteinizing hormone (LH) is produced in the brain, specifically in the pituitary gland. When it’s released, it signals the start of ovulation by letting the ovary know to release an egg for fertilization and triggers the formation of the corpus luteum. It essentially controls the “when” of reproductive function in the ovary. 

Are Hormones High or Low During Menopause? 

Your hormones will vary during menopause, meaning some will increase in quantity, and others will drop. Many of your hormones will be sporadic. For example, your estrogen levels may vary greatly during perimenopause but demonstrate a downward trend before stabilizing at a lower level around menopause and post-menopause.  

These fluctuations result in hormonal imbalance and trigger perimenopause, the first stage of menopause.   

For example, Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) are hormones that are released when it’s time to mature ovarian follicles and trigger ovulation. But due to menopause, the ovaries stop working and can’t produce follicles that release the egg for fertilization.  

By extension, the corpus luteum that produces progesterone to stop the release of LH and FSH isn’t present. This absence of progesterone causes LH and FSH levels to keep rising during menopause.  

Also, estrogen and progesterone are tag team champions when it comes to fluctuating hormones. Before perimenopause, when a woman still has her period, these two hormones balance each other out.  

During the menstrual cycle, estrogen rises to promote the egg’s development, and then progesterone enters the system to prepare the woman’s body for pregnancy. But as the woman gets older, say in her 40s to 50s, her ovaries become less responsive, causing hormone levels to fluctuate.  

Once estrogen levels and progesterone levels begin to drop, she’ll experience emotional and psychological changes. Once these hormonal changes kick in, she’ll experience some of the symptoms of perimenopause like:  

  • Bloating 
  • Heavy or light menstrual bleeding and irregular periods 
  • Breast tenderness 
  • Vaginal dryness 
  • Headaches
  • Trouble sleeping
  • Hot flashes
  • Night sweats 

A drop in progesterone could also trigger psychological changes such as: 

  • Memory lapse 
  • Reduced concentration 
  • Mood Swings 
  • Rage 
  • Irritability

These symptoms start during perimenopause and should normally begin tapering off when postmenopause hits. Symptoms of postmenopause could also include those of perimenopause, but they won’t be as intense as before. Postmenopausal women start to feel better as their body adjusts to the new changes. 

Testosterone also declines as women get older, but not as quickly as estrogen and progesterone.2 Though the body does continue to produce some testosterone after menopause, the effects of its decline after the fact (as a woman reaches middle and higher ages) are uncertain.  

While these symptoms and changes can be scary, it’s possible to manage them, thanks to modern medicine. If you’re experiencing any of these changes, talk to your physician about your options. You could also try exercise, adjusting your diet, or taking a menopause supplement like Equelle, which has been shown to help relieve hot flashes, support sleep quality, reduce vaginal irritation, and help alleviate mood swings. 

What Hormones Drop Most Dramatically During Menopause? 

Among the hormones that respond during menopause, estrogen and progesterone levels fall quickly, and the body produces less quantity. The hormones that were so high in the woman’s body at puberty, following her all through the stages of her life from pregnancy and birth, begin to taper off, signaling the approaching end of her reproductive abilities.  

Although direct estrogen production stops at the ovaries, the body maintains a small amount gotten from testosterone produced in the ovaries. Fat deposits and the adrenal gland found in the kidneys also produce estrogen. 

On the other hand, progesterone is only produced by the ovaries after ovulation. And since menopause ends ovulation, postmenopausal progesterone levels stay persistently low. 

Lower estrogen levels can lead to postmenopausal bleeding, a condition where a woman experiences spotting or bleeding more than a year after her last menstrual period. This results from the thinning and inflammation of the womb lining or vaginal lining. 7  

If you have postmenopausal bleeding, visit your physician for testing. 

Normal Hormone Levels During Menopause  

So your hormones fluctuate, but what are the normal hormone levels in menopausal women? How do you know you’ve reached ‘that’ phase? There are two hormone-related telltale signs of menopause: Estradiol and FSH levels. 

Estradiol, the type of estrogen more prevalent in premenopausal women, is at a normal level of 30-400 picograms per milliliter (pg/mL) before menopause. After menopause, it will fall below 30 pg/m and become your new normal. 

FSH levels in women still menstruating reach around 4.7 to 21.5 IU/L, but after menopause occurs, it could spike to anywhere from 25.8 to 134.8 IU/L. Once it reaches 30 or above and the woman hasn’t had a menstrual period in a year or more, her reproductive system has likely reached menopause. 

Consistent and continual testing is vital to staying abreast of your hormonal levels. You should also keep tabs on your symptoms, no matter how minute. They’ll tell your doctor what they need to know and test for.    

References: 

1 Albert Einstein College of Medicine Jacobi. “HCG and FSH Levels during Early Pregnancy and Reproductive... : Obstetrics & Gynecology.” LWW. Accessed October 26, 2022. https://journals.lww.com/greenjournal/Abstract/2020/05001/HCG_and_FSH_Levels_During_Early_Pregnancy_and.46.aspx.  

2 “Changes in Hormone Levels.” Changes in Hormone Levels, Sexual Side Effects of Menopause | The North American Menopause Society, NAMS. Accessed October 26, 2022. https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels. 

3 Endocrine Society. “Menopause.” Endocrine Society. Endocrine Society, March 31, 2022. https://www.endocrine.org/patient-engagement/endocrine-library/menopause. 

4 “Estradiol (Blood).” Estradiol (Blood) - Health Encyclopedia - University of Rochester Medical Center. Accessed October 26, 2022. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=estradiol.  

5 JH;, Santoro N;Brown JR;Adel T;Skurnick. “Characterization of Reproductive Hormonal Dynamics in the Perimenopause.” The Journal of clinical endocrinology and metabolism. U.S. National Library of Medicine. Accessed October 26, 2022. https://pubmed.ncbi.nlm.nih.gov/8636357/. 

6 “Menopause.” Menopause | Penn Center for Women's Behavioral Wellness | Perelman School of Medicine at the University of Pennsylvania. Accessed October 26, 2022. https://www.med.upenn.edu/womenswellness/menopause.html. 

7 “Postmenopausal Bleeding: Causes, Diagnosis & Treatment.” Cleveland Clinic. Accessed October 26, 2022. https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding.  

8 “Testosterone Replacement in Menopause.” British Menopause Society, May 27, 2022. https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/. 

9 Tests to determine menopausal status. Accessed October 26, 2022. https://www.breastcancer.org/treatment-side-effects/menopause/types/testing.