Hormones and Menopause

Hormones and menopause are like carefully choreographed dance partners in a woman’s body. As we age, this dynamic performance changes, leading to the end of reproductive years

Let’s explore the key players in this hormonal ballet and uncover their roles in the menopausal transition.

 

The Hormone and Menopause Ballet:
The Key Performers

 

GnRH: The Master Choreographer

GnRH acts as the master choreographer of the reproductive endocrine system, directing the pulsatile release of FSH and LH to craft the intricate hormonal ballet of the menstrual cycle and the grand finale of menopause.

Gonadotropin-Releasing Hormone (GnRH) is a crucial hormone that originates in a part of the brain called the hypothalamus.

GnRH sets the pace for the entire reproductive cycle, making it an essential part of the conversation about hormones and menopause.

Its role is to regulate the reproductive system by controlling the release of two other important hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH)  from the pituitary gland. These hormones are critical for the development and function of the ovaries.

GnRH acts as the starting signal for the menstrual cycle, secreted in short, pulsatile, rhythmic bursts from the hypothalamus.

This pulsing rhythm is crucial as it keeps pituitary receptors sensitive to GnRH, preventing the desensitization that would occur with constant exposure.

The pulsatile release is crucial because it stimulates the pituitary gland to release FSH and LH; the frequency and strength of these GnRH pulses can favor the production of one hormone over the other, allowing precise control.

FSH promotes the development of follicles, each containing an egg, while LH triggers ovulation, the release of a mature egg from the ovary.

GnRH thus coordinates the timing of these events, ensuring that the menstrual cycle proceeds in an orderly fashion.

By controlling the release of FSH and LH, GnRH indirectly regulates the productioin of the hormones estrogen and progesterone, which are vital for maintaining the uterine lining and preparing the body for a potential pregnancy.

As women age and approach menopause, the function of the ovaries naturally declines, leading to a reduction in the production of estrogen and progesterone.

In response to declining levels of these hormones, the hypothalamus increases the release of GnRH.

 

This rise in GnRH prompts the pituitary gland to produce more FSH and LH in an effort to stimulate the maturation of the remaining follicles and trigger ovulation.

However, due to overstimulation by the increased levels of FSH and LH, the remaining follicles become less responsive to the effects of these hormones.

This diminished responsiveness results in a continued decline in estrogen and progesterone production.

This shift marks the transition into menopause and underscores the complex interplay between the endocrine system and the aging reproductive organs.

The elevated levels of GnRH, FSH, and LH, resulting from the decline in ovarian follicles, create a hormonal imbalance that leads to common menopausal symptoms such as hot flashes, night sweats, and irregular periods.

Direct measurement of GnRH for menopause diagnosis is not typically done in clinical practice because its release is pulsatile and occurs in small quantities, making it difficult to measure accurately.

Instead, the effects of GnRH are inferred through the measurement of FSH and LH levels, which are easier to detect in the blood.

 

FSH: The Ballet Master

FSH serves as the ballet master of the ovarian follicles, guiding their growth and development with precise timing and coordination throughout the menstrual cycle

Follicle-stimulating hormone (FSH) is produced and released by the pituitary gland, a small but powerful gland at the base of the brain. Its primary function is to stimulate the growth of follicles in the ovaries. Follicles are tiny sacs housing developing eggs.

FSH is also a crucial component of the intricate system regulating the reproductive cycle and plays a significant part in the transition to menopause.

The production and release of FSH is part of the hypothalamic-pituitary-ovarian (HPO) axis, which facilitates communication between the hypothalamus, pituitary gland, and ovaries. Through this system, FSH works alongside other hormones, particularly LH, to regulate the menstrual cycle.

In the context of hormones and menopause, FSH serves as a valuable marker. Its levels can provide important information about a woman’s reproductive status and can help healthcare providers diagnose the onset of menopause.

At the start of each menstrual cycle, FSH levels rise, signaling the ovaries to begin maturing a group of follicles. Usually, one follicle becomes dominant and continues to grow, while the others regress.

FSH also stimulates the production of estrogen by the growing follicles. This increase in estrogen is essential for preparing the uterus for potential pregnancy and triggering other hormonal changes in the body.

FSH levels begin to increase approximately six years before menopause and rise sharply in the two years leading up to the final menstrual period. About two years after menopause, FSH levels stabilize.

The rising FSH and LH levels, combined with declining estrogen and progesterone and other hormonal changes, contribute to many of the symptoms associated with menopause.

Women Experience:

Irregular periods: As ovarian function declines and hormones fluctuate, menstrual cycles become unpredictable.

Hot flashes and night sweats: These common symptoms are primarily linked to fluctuating and declining estrogen levels.

Mood changes: Fluctuations in estrogen, progesterone, and other hormones can affect mood and emotional well-being.

Vaginal dryness: As estrogen levels decline during menopause, vaginal tissues may become less lubricated.

It’s important to note that while rising FSH levels are a key marker of the menopausal transition, many symptoms are more directly related to the decline in estrogen.

The timing and severity of these symptoms can vary significantly between individuals.

Measuring FSH levels is a critical step in diagnosing menopause and understanding a woman’s reproductive health.

The FSH test is typically performed in the early follicular phase of the menstrual cycle, usually on the second or third day after the start of menstruation. This timing is essential because FSH levels fluctuate throughout the cycle, and measuring them at this point provides a clearer picture of ovarian function.

FSH ranges:
The measurement of FSH is in IU/L (International Units per Liter) or  (milli-International Units per milliliter (mIU/mL)).

Reproductive Years: FSH levels: 4.7 to 21.5 IU/L (or mIU/mL)

During Menopause: FSH levels begin to rise, often exceeding 30 IU/L

Post Menopause: FSH levels: 25.8 to 134.8 IU/L

Normal ranges for FSH can vary between laboratories, so it’s important to reference the specific lab’s range on your blood test report.

Interpreting FSH results can be complex, as individual variations and other factors, such as age and overall health, can influence hormone levels.

Therefore, it’s essential for women to discuss their FSH test results with their healthcare providers to understand what they mean for their specific situation.

In addition to FSH testing, healthcare providers may also consider other hormone levels, such as estrogen and LH, to gain a comprehensive understanding of a woman’s hormonal status.

Together, these tests can help create a clearer picture of the changes occurring  and guide appropriate management strategies for symptoms associated with menopause.

 

LH: The Prima Ballerina

LH delivers a show-stopping surge to trigger ovulation, while performing essential supporting roles throughout the hormonal ballet.

Produced by the pituitary gland, LH works alongside follicle-stimulating hormone (FSH) to regulate ovarian function and ensure smooth reproductive processes.

LH gets its name from the word “luteinise,” which means to form a corpus luteum. This structure is crucial after an egg is released from the ovary, as it produces progesterone, a hormone necessary to maintain the early stages of pregnancy.

The menstrual cycle is divided into phases, and LH is particularly significant during the ovulatory phase. At the start of the menstrual cycle, FSH stimulates the growth of ovarian follicles. As these follicles mature, they release estrogen, which in turn signals the pituitary gland to release a surge of LH.

This surge of LH mid-cycle, triggers ovulation, the release of a mature egg from the ovary. Once ovulation occurs, the ruptured follicle transforms into the corpus luteum, which starts producing progesterone to thicken the uterine lining for potential pregnancy.

LH also stimulates the production of estrogen and progesterone in the ovaries, maintaining the delicate balance necessary for reproduction.

If fertilisation does not occur, the corpus luteum breaks down, leading to a drop in progesterone levels, and menstruation begins.

During the reproductive years, LH levels fluctuate in a predictable pattern, rising sharply to trigger ovulation. However, as women age, the number of ovarian follicles naturally declines. This decline leads to a decrease in estrogen production by the ovaries.

The pituitary gland, sensing lower estrogen levels, responds by increasing the production of LH and FSH, resulting in consistently elevated levels of both hormones.

Over time, this persistent high level causes desensitization of the follicle receptors. As a result, the follicles become less responsive to hormonal signals, leading to irregular ovulation, which eventually ceases as menopause approaches.

The fluctuation and eventual rise in LH and FSH levels contribute significantly to the hormonal imbalance associated with menopause.

While many symptoms are primarily linked to declining estrogen, high and erratic LH levels, along with fluctuating FSH, can lead to irregular periods as the hormonal balance required for a regular menstrual cycle is disrupted.

However, it’s important to note that the experience of these symptoms can vary greatly among individuals, reflecting the complex interplay of hormones and menopause.

LH plays a crucial role in women’s reproductive health and undergoes significant fluctuations during the menopausal transition.

A simple blood test can measure LH levels, often used alongside other tests to assess a woman’s reproductive health and menopausal status.

As women transition through menopause, LH levels change dramatically:

Pre-menopause: LH levels:  5 to 25 IU/L.

Postmenopause: LH levels: 14.2 to 52.3 IU/L.

For women in their 40s and 50s experiencing symptoms such as irregular periods or hot flashes, elevated LH levels in a blood test can indicate the approach of menopause.

However, it’s important to note that LH testing is usually not done in isolation.

To get a comprehensive picture of a woman’s hormonal status and confirm menopause, doctors typically consider multiple factors:

• LH levels
• FSH levels
• Estrogen levels
• Overall health
• Reported symptoms

This holistic approach allows healthcare providers to accurately assess a woman’s menopausal status and provide appropriate care and guidance.

 

Inhibin-B: The Supporting Dancer

Inhibin-B plays a supporting role in the hormone dance, helping to regulate FSH production.

Inhibin-B is a hormone produced by the ovaries, specifically by the small, growing follicles that contain immature eggs.

It plays a critical role in regulating the production of another hormone, FSH (Follicle-Stimulating Hormone), by providing feedback to the pituitary gland in the brain.

Inhibin-B is part of the complex network of hormones that manage the menstrual cycle, and it offers valuable insights into ovarian function.

Inhibin-B primarily functions to regulate the levels of FSH. During the early part of the menstrual cycle, known as the follicular phase, rising levels of FSH stimulate the growth of ovarian follicles.

As these follicles grow, they produce increasing amounts of Inhibin-B, which then signals the pituitary gland to reduce FSH production.

This feedback loop helps ensure that only the strongest follicles continue to develop, eventually leading to the selection of a single dominant follicle that will release an egg during ovulation.

Inhibin-B thus plays a key role in the maturation of eggs and the timing of ovulation, helping to maintain a healthy and regular menstrual cycle.

As women age and approach menopause, the number of ovarian follicles decreases, leading to lower production of Inhibin-B.

This decline typically begins in the years leading up to menopause, known as perimenopause. With fewer follicles, there is less Inhibin-B to regulate FSH levels, causing FSH levels to rise in an attempt to stimulate the remaining follicles.

During menopause, when a woman’s periods have stopped for 12 consecutive months, Inhibin-B levels become very low or undetectable. This is because the ovarian follicles are nearly depleted, and there is little to no Inhibin-B being produced.

The drop in Inhibin-B is a significant marker of the transition into menopause, illustrating the changes in ovarian function and hormone levels that occur during this time.

As Inhibin-B levels decline, it triggers an increase in FSH. This decline also affects the quality and quantity of remaining ovarian follicles, impacting fertility.

For women in their late 30s and 40s, lower levels of Inhibin-B can serve as an indicator of reduced ovarian reserve, which may signal the approach of perimenopause and eventual menopause.

However, low Inhibin-B levels alone, especially in younger women, are not definitive predictors of imminent menopause.

While Inhibin-B itself doesn’t directly cause symptoms, its changing levels reflect the underlying shifts in ovarian function and hormone imbalance.

A blood test can determine Inhibin-B levels, with higher levels indicating a greater number of viable follicles and a lower likelihood of entering menopause soon.

In younger women, Inhibin-B levels are typically higher during the early follicular phase of the menstrual cycle, reflecting healthy ovarian function.

As women approach menopause, Inhibin-B levels decline. By menopause, Inhibin-B levels are often undetectable.

Although Inhibin-B alone is not used to diagnose menopause, it can be a useful part of a comprehensive hormonal assessment, helping to understand the status of ovarian function in relation to other markers like FSH and estrogen.

This makes Inhibin B a valuable component in the study of hormones and menopause, offering insights into the timing and progression of the menopausal transition.

 

•  What Causes Menopause?

  
  What Causes Menopause?

   

Estrogen – (E2): The Principal Dancer

Estrogen leads the female reproductive system, gracefully coordinating and regulating vital functions like a principal dancer guiding a ballet performance.

Estrogen is a key hormone that plays a critical role in the female reproductive system. It is one of the primary hormones that regulate various functions in the body, particularly in women.

Produced mainly by the ovaries, estrogen is responsible for the development of female secondary sexual characteristics, such as breast development, the regulation of the menstrual cycle, and the maintenance of pregnancy.

This hormone is essential not just for reproductive health but also for bone health, cardiovascular function, and skin health.

There are three main types of estrogen: estradiol, estriol, and estrone. Estradiol is the most common and potent form in premenopausal women, estriol is primarily produced during pregnancy, and estrone becomes the main form of estrogen after menopause.

Estrogen’s importance makes it a significant focus when discussing hormones and menopause, as its levels change significantly during menopause, affecting various bodily functions.

Estrogen’s role in reproduction is multifaceted, acting at different stages of a woman’s reproductive life.

During the menstrual cycle, estrogen levels fluctuate to regulate the growth and release of eggs and to prepare the body for potential pregnancy.

In the first half of the cycle, known as the follicular phase, rising estrogen levels help stimulate the growth of the uterine lining (endometrium), creating a nourishing environment for a fertilized egg.

As estrogen levels increase, they signal the brain to reduce the production of Follicle Stimulating Hormone (FSH) and increase Luteinizing Hormone (LH). This hormonal shift triggers ovulation, where a mature egg is released from the ovary. After ovulation, estrogen levels decline slightly, but they are still necessary to maintain the uterine lining.

Estrogen also plays a crucial role in maintaining vaginal health, ensuring lubrication and elasticity, which are important for sexual function. Its influence extends to the overall health of the reproductive organs, making it a cornerstone in discussions about hormones and menopause, as its decline during menopause can have widespread effects.

During menopause, estrogen levels undergo a significant decline, which leads to many of the common symptoms associated with this transition.

In the years leading up to menopause, known as perimenopause, estrogen levels can fluctuate widely, causing irregular menstrual cycles. These hormonal fluctuations are a hallmark of perimenopause and can vary greatly from one woman to another.

As menopause progresses, the ovaries gradually produce less estrogen. This decline is not sudden but rather a gradual decrease that eventually results in consistently low levels of estrogen once a woman reaches menopause.

By the time menopause is confirmed—after 12 consecutive months without a menstrual period—estrogen levels have dropped significantly, marking the end of the ovaries’ role as the primary producers of this hormone.

The reduction in estrogen during menopause affects multiple systems in the body. Since estrogen helps maintain the health of reproductive tissues, bone density, and cardiovascular health, its decline is linked to common menopausal symptoms such as hot flashes, night sweats, and an increased risk of osteoporosis.

Understanding these changes is essential in the broader conversation about hormones and menopause, as the body adjusts to a new hormonal balance.

The decline in estrogen levels during menopause leads to a variety of symptoms, which are often referred to as menopausal symptoms.

Estrogen plays a significant role in the body’s ability to regulate temperature, so its decline can cause the body to react with sudden heat, known as hot flashes.

Night sweats are similar but occur during sleep, often disrupting rest and leading to fatigue.

Mood swings and emotional changes are also common as estrogen levels impact neurotransmitter function in the brain, influencing mood and emotions.

Vaginal dryness and thinning of the vaginal walls can lead to discomfort and sexual dysfunction, which are direct effects of decreased estrogen affecting the health of vaginal tissues.

The decline in estrogen also affects bone density. Estrogen helps maintain bone strength, so its reduction can lead to bone loss, increasing the risk of osteoporosis and fractures.

Understanding these symptoms in the context of hormones and menopause helps women manage and anticipate the changes that come with this life stage.

Measuring estrogen levels can provide important insights into a woman’s menopausal status and overall hormonal health.

Blood tests are commonly used to measure estradiol levels, the most potent form of estrogen.

Normal estradiol levels:
The measurement of Estrogen levels is in picograms per milliliter (pg/mL).

Reproductive Years: Estradiol levels: 30 to 400 pg/mL

Perimenopause: Estradiol levels: Eratic, swinging from hight to low, but declining as menopause approaches

Post Menopause: Estradiol levels:  below 30 pg/mL

These tests are often used alongside measurements of FSH and LH levels to diagnose menopause. High levels of FSH and LH, coupled with low estrogen levels, are indicative of menopause.

However, because estrogen levels can fluctuate widely during the perimenopausal phase, a single test might not provide a complete picture. Doctors may look at a woman’s symptoms, medical history, and other hormone levels to confirm a diagnosis.

By understanding estrogen’s role and how its levels change during menopause, women can better prepare for the physical and emotional shifts that occur during this natural part of aging.

Knowledge about hormones and menopause empowers women to manage their health proactively.

Progesterone (P4): The Pas de Deux Partner

If estrogen is the leading lady, progesterone is her trusty sidekick. These two hormones work together to maintain the menstrual cycle and prepare the body for pregnancy.

Progesterone is a vital hormone that plays a significant role in the female reproductive system. It is produced mainly in the ovaries following ovulation, and in smaller amounts by the adrenal glands.

During pregnancy, the placenta also produces progesterone. Known as a progestogen, progesterone is crucial for preparing the body for conception, maintaining a pregnancy, and regulating the menstrual cycle.

This hormone is a major player in the broader discussion of hormones and menopause, given its changing levels during the menopausal transition.

Progesterone is essential for reproductive health, working alongside estrogen to regulate the menstrual cycle. After an egg is released from the ovary during ovulation, the remaining follicle transforms into a structure called the corpus luteum, which secretes progesterone.

This hormone prepares the uterine lining (endometrium) to receive and nourish a fertilized egg. If fertilization occurs, progesterone levels remain high to support early pregnancy and prevent further ovulation. If fertilization does not occur, progesterone levels drop, leading to the shedding of the uterine lining, which results in menstruation.

Progesterone also helps maintain a healthy pregnancy by preventing contractions of the uterus, which could lead to premature labor. Its role in regulating the menstrual cycle and supporting pregnancy makes progesterone a key focus when examining hormones and menopause.

As a woman approaches menopause and ovulation becomes less frequent, the production of progesterone gradually decreases.

By the time a woman reaches menopause—defined as 12 months without a menstrual period—progesterone levels are very low or absent, as ovulation ceases completely.

The lack of progesterone can contribute to an increased risk of endometrial hyperplasia (thickening of the uterine lining) if not balanced with estrogen.

The decline in progesterone levels during menopause has several noticeable effects on a woman’s body.

Women may experience heavier or lighter periods, spotting, or skipped cycles as progesterone levels fluctuate.

Low progesterone levels can also contribute to mood swings and irritability, as progesterone has a calming effect on the brain and nervous system. Its decline can lead to sleep disturbances, such as insomnia, making it difficult for women to get restful sleep.

Additionally, progesterone’s role in maintaining bone health means that declining levels can contribute to the risk of osteoporosis, especially when combined with decreasing estrogen levels.

These symptoms highlight the importance of progesterone in the context of hormones and menopause, as its reduction impacts both physical and emotional well-being.

Measuring progesterone levels can provide insights into a woman’s ovulatory status and reproductive health, especially during the menopausal transition.

Normal Progesterone Levels:
The measurement of progesterone is in nanograms per milliliter (ng/mL)

Reproductive Years: Fluctuates during menstrual cycle: less than 1 ng/mL – 20 ng/mL

Post Menopause: May fall below .5 ng/mL

While progesterone levels are not commonly used alone to diagnose menopause, they can be part of a broader hormonal assessment. Measuring progesterone alongside estrogen and FSH can help provide a clearer picture of where a woman is in the menopausal transition.

A combination of low progesterone, low estrogen, and high FSH levels typically indicates that a woman is in menopause.

AMH: The Understudy

AMH is like a fortune teller for your ovaries, giving us a glimpse into the future of a woman’s fertility.

Anti-Müllerian Hormone (AMH) is a protein hormone produced by the cells of developing ovarian follicles, specifically the small, early-stage follicles. Unlike some other reproductive hormones, AMH levels remain relatively constant throughout the menstrual cycle.

AMH serves as a marker of ovarian reserve, which refers to the number of eggs a woman has available for fertilization. As a result, it is often used as a measure of a woman’s reproductive potential.

AMH plays a critical role in the early development of ovarian follicles, which are the small sacs within the ovaries that contain immature eggs.

By regulating the growth and maturation of these follicles, AMH helps ensure that a manageable number of eggs mature each cycle. AMH effectively helps to maintain the pool of available eggs, preventing too many from maturing at once.

AMH levels are highest in women during their late twenties, which is generally considered the peak of fertility. As women age, the number of remaining follicles decreases, leading to a decline in AMH levels.

This decline serves as a natural indicator of diminishing ovarian reserve, providing valuable information for assessing a woman’s reproductive lifespan.

AMH levels are closely tied to a woman’s ovarian reserve, and therefore, they change significantly as a woman approaches menopause.

In the years leading up to menopause, known as perimenopause, AMH levels can become undetectable.

The decline in AMH is one of the earliest signs of approaching menopause and can occur years before other hormonal changes become apparent.

Because of this, AMH is a valuable marker in the study of hormones and menopause, offering insights into a woman’s fertility status long before menopause actually begins.

AMH itself does not directly cause menopausal symptoms. Instead, its levels provide an indication of ovarian reserve and the broader hormonal changes occurring as a woman approaches menopause.

Typical AMH Levels

 

Low AMH levels signal a reduced number of viable eggs, which is associated with the onset of menopausal symptoms as other hormones, like estrogen and progesterone, also begin to fluctuate and decline.

Measuring AMH levels has become a valuable tool for assessing a woman’s reproductive health and predicting menopause. A blood test can determine AMH levels, providing an estimate of ovarian reserve.

In younger women, higher AMH levels suggest a healthy ovarian reserve, whereas lower levels can indicate a reduced reserve and potentially earlier onset of menopause.

In terms of specific measurements, AMH levels are considered low if they are below 1.0 ng/mL, indicating a decreased ovarian reserve. During the menopausal transition, AMH levels often fall below 0.1 ng/mL.

While AMH alone is not typically used to diagnose menopause, it is a useful indicator when combined with other hormonal tests, such as FSH and estrogen, to provide a comprehensive picture of a woman’s hormonal health.

By understanding AMH and its role in the body, women can gain insights into their fertility and the timing of menopause, empowering them to make informed decisions about their reproductive health.

In the broader discussion of hormones and menopause, AMH serves as a critical marker of ovarian reserve and an important predictor of reproductive aging.

Testosterone (TES): The Strength Coach

Testosterone is the driving force behind energy and vitality in the female body. Like a dynamic soloist, it enhances strength and endurance, playing a crucial role in overall well-being.

Testosterone is commonly known as a male hormone, but it is also produced in smaller amounts in women, primarily by the ovaries and adrenal glands.

Testosterone is a key hormone that contributes to overall hormonal balance, making it an important part of the discussion on hormones and menopause.

In women, testosterone plays a crucial role in regulating various bodily functions, including bone density and muscle mass.

During a woman’s reproductive years, testosterone levels are naturally higher, significantly influencing reproductive tissues and contributing to libido (sex drive).

This androgen also supports the production of other key hormones in the female endocrine system.

The presence of testosterone is vital for a well-functioning reproductive system, complementing the roles of estrogen and progesterone.

Understanding testosterone’s role helps paint a complete picture of how hormones work together to support a woman’s health, especially during the transition to menopause.

As women approach menopause, their hormone levels fluctuate, and testosterone levels generally decline.

Normal Testosterone levels:
The measurement of testosterone is in nanograms per deciliter (ng/dL)

Age (years)	Female (ng/dL)
18 and older	Premenopausal: 10 to 55 Postmenopausal: 7 to 40

This decrease can start in the years leading up to menopause, known as perimenopause. The reduction in testosterone is less pronounced compared to estrogen and progesterone, but it still plays a significant role in the overall changes women experience during this time.

By menopause, testosterone levels are typically lower than in the earlier reproductive years. Despite these lower levels, some women may experience an increase in the relative impact of testosterone due to the more significant drop in estrogen, which can lead to symptoms such as increased facial hair or changes in skin texture.

These shifts highlight the nuanced role of testosterone in the context of hormones and menopause.

Other symptoms associated with low testosterone levels, apart from a decrease in libido and reduced muscle mass, include fatigue and changes in mood, such as increased irritability or feelings of depression.

In addition to these symptoms, the balance between testosterone and estrogen shifts during menopause, which can affect the distribution of body fat, leading to changes in body composition.

These changes in testosterone and other hormones illustrate the interconnected nature of hormones and menopause, and how they influence a woman’s body and overall well-being.

A blood test can measure testosterone levels as part of a broader hormonal evaluation, particularly if a woman is experiencing symptoms that may be related to hormonal imbalance, such as low libido or unexplained fatigue.

While testosterone is not the primary hormone used to diagnose menopause, measuring it can provide valuable insights into a woman’s overall hormonal health.

Understanding testosterone levels in conjunction with other hormones like estrogen, FSH, and LH helps provide a comprehensive picture of the hormonal changes occurring during menopause.