Physiology of Menopause

Menopause is characterised by a marked reduction in oestrogens and progesterone, and to some extent a reduction in androgens (testosterone, dehydroepiandrosterone sulphate and androstenedione)¹³. Reduced hormone levels cause progressive atrophy of the reproductive organs and the endometrium¹⁴ and menstrual periods stop. Fluctuating hormone levels also have significant systemic effects including on mood and affect skin, circulation and cardiovascular health. Atrophied endometrium is susceptible to friction injury and inflammation, causing spotting and light bleeding. This is the most common cause of PMB.