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Body Literacy: Fertility + Aging

Hot flashes. This is what I associated with menopause for many years. There is much more to the end of fertility for women than just a sudden urge to shed all clothing at a moment’s notice and pop down in front of a utility fan wearing only a bra.

Women are born with all of the eggs they will ever have, but we are not fertile until menarche: the first menstrual period. A woman has monthly cycles until she reaches menopause when she ceases to have a menstrual period (for 12 straight months) and is no longer able to get pregnant. The average age of menarche is around 12, and the average age of menopause is around 51.


By our late 30s, progesterone production is declining. The number and quality of follicles also falls leading to fewer and irregular ovulations. Consequently, by our 40s, cycle length can vary, and periods may become irregular.


Within NFP, it is noted that peak days will trend earlier as women move through perimenopause. So a woman who had 20+ years of peak between days 15-18 suddenly ovulates much closer to day 12. #ohheycaboosebaby


Estrogen may drop suddenly or spike higher than normal leading to mid-cycle bleeding in some women. It’s a rollercoaster ride. Generally (like over a 10 year period) estrogen levels are falling. But it’s not a steady decline, as medical professionals once thought. In fact, many women have signs of estrogen dominance in the years preceding menopause. For those who use Marquette Method of NFP, this looks like an increased number of “high” readings on the monitor because of elevated estrogen.


As discussed in a previous post, estrogen stimulates the production of cervical mucus. So for women who monitor mucus, the estrogen rollercoaster of perimenopause can be similar to the struggles when breastfeeding: constant mucus or no mucus.


Perimenopause can begin 2-10 years before menopause. Basically, as soon as you thought you were past breastfeeding craziness, a new season arrives with its own set of hormone-havoc-wreaking effects.


Symptoms

Hot flashes and night sweats

Vaginal dryness

Uterine bleeding problems

Sleep disturbances

Mood symptoms

Bone density loss (due to lower estrogen)

Cholesterol changes and increased risk of heart disease


A few more interesting stats to highlight how things change as we age.


Natural Conception Rates per cycle


Women under 30: 25% chance

Women over 30: 20% chance

Women at age 40: 5% chance

Women older than 45: 1% chance


According to estimates by the American Society for Reproductive Medicine


Natural Conception Rates per year

Source: Management of the Infertile Woman by Helen A. Carcio and The Fertility Sourcebook by M. Sara Rosenthal


By the time a woman is 45, she only has a 1% chance of naturally conceiving in any given month, and only a 5% chance when trying to conceive throughout an entire year.


Conventional medicine has left much to be desired when it comes to understanding and assisting women through the transition to menopause. As an acceptance of female biology {hopefully} permeates our society, a more accurate and effective understanding of perimenopause should follow.


References:

https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause




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