Hormones & Cycle Regulation

Menstrual cycle disorders

During the reproductive years, menstrual bleeding typically occurs about every four weeks and lasts for three to five days each time. Usually, two to five tampons or sanitary pads are used per day. Larger amounts of blood, as well as the presence of large blood clots, can indicate hormonal, anatomical, or other problems and should be investigated promptly.Regular physical or emotional discomfort and problems occurring during the menstrual cycle can arise from peculiarities in the sequence of hormonal release. This can lead to real problems and sometimes considerable distress. Many women suffer from severe lower abdominal pain, headaches, swelling, irritability, sadness, and sometimes even feelings of anger and aggression in connection with the different phases of the menstrual cycle. This should not be accepted, and neither "enduring" nor "gritting your teeth" will help. This can lead to significant problems and distress that require precise diagnosis and therapeutic intervention (endometriosis, LPDD – Luteal Phase Dysphoric Disorder; PMS – Premenstrual Syndrome).

Hormonal imbalance

Too little estrogen can cause the mucous membranes to become thin and dry, making them more susceptible to infections. This can lead to bladder problems and frequent urinary tract infections. Insufficient estrogen can also negatively affect mood and libido.

Insufficient progesterone (for example, in cases of absent ovulation or luteal phase defect) often leads to delayed menstruation and significantly heavier, prolonged bleeding. This should be investigated and treated. A predominance of male hormones, as can occur in the common polycystic ovary syndrome (PCOS), some genetic conditions (adrenogenital syndrome), or other rarer diseases, frequently results in menstrual irregularities and more or less pronounced cosmetic problems (acne, oily hair, hair loss, increased hair growth, especially in atypical areas – hirsutism). Furthermore, over time, significant general medical problems can develop – elevated blood lipids (cholesterol), vascular problems, and arteriosclerosis. Elevated male hormones also frequently lead to ovulation disorders and thus to difficulties conceiving. In these cases, a systematic evaluation and optimization of hormone levels are always of great importance – also to prevent chronic health problems.

Ovarian aging - Reproductive aging

Ovarian reserve declines continuously until menopause – the final menstrual period controlled by the ovaries. The timing of this process varies considerably between women: while some women can still conceive relatively easily in their mid-forties, for others it can be difficult or even impossible as early as their early thirties. Approximately one in twenty women experiences menopause (the permanent cessation of ovulation and menstruation) before their 45th birthday, and pregnancies are rarely possible years before that. Ultimately, reproductive age depends on a multitude of factors, including familial and genetic predisposition, lifestyle (smoking, diet, weight, medications), and general health conditions, and these should be taken into consideration.

Premature exhaustion of the ovaries

In the Western world, the average age at menopause (the permanent cessation of ovulation and menstruation) is around 51. However, almost one in 20 women experiences menopause before the age of 45, and in about one in 100 women, menopause occurs at or before the age of 40. This is also referred to as premature menopause, and the medical term is premature ovarian insufficiency. In affected women, pregnancies are usually no longer possible for several years beforehand. But even regardless of personal family planning, careful medical evaluation and monitoring of this situation are of considerable importance, both immediately and in the long term, for one's health.

For years, I have been intensively involved with issues of so-called "reproductive aging," and especially with premature menopause. In doing so, it has become increasingly clear to me how important it is to pay close attention to symptoms and signs of premature ovarian decline and then to investigate them thoroughly through appropriate examinations. Chronic hormone deficiency has a wide range of health consequences and, without appropriate countermeasures, accelerates the aging process of the entire body. Especially with regard to a possible desire to have children, time is of the essence, because every month counts: It is crucial to quickly mature as many follicles as possible in the ovaries, retrieve the eggs, and either fertilize them or freeze them unfertilized. When this situation affects relatively young women, unlike women nearing natural menopause, each egg cell has a very high potential for development and therefore a high chance of pregnancy. In any case, prompt and targeted diagnostics are important, as is the planning of further steps with regard to potentially incomplete family planning (see also the sub-section on the desire to have children). Fertility protection for medical reasons.