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Sexual Dysfunction


A woman's body is truly an amazing machine with the reproductive system always running in the background like a finely tuned engine built with, hopefully, only the best parts. For years doctors have been writing about hormones and their interaction with the entire reproductive system. Oftentimes, the female reproductive system is referred to as a "symphony" with perhaps the ovaries representing the "conductor" of the orchestra. It has also been referred to as a finely "choreographed" movement that can become ugly and an almost unbearable performance to watch when any "dance" element (ovaries, uterus, cervix) is removed.

To gain a better understanding of how perimenopause (the time period prior to menopause marked by fluctuating hormonal levels) impacts your reproductive system, it's important to gain a better understanding of the hormones that drive your body.

The hypothalamus produces gonadotropin-releasing hormones (GnRH) which in turn controls the release of two other hormones in the pituitary gland - luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These two hormones subsequently control a woman's entire reproductive cycle. In the first half of your menstrual cycle, FSH stimulates the ovaries to produce estrogen and in the second half LH kicks in to stimulate the production of progesterone.

Basically, the hormones your body produces affect the entire production of estrogen in your ovaries as well as the growth of your endometrium that occurs each month. Estrogen then circularly affects your overall continuing release of hormones in the hypothalamus, pituitary gland, and central nervous system. Estrogen also brings on ovulation (release of eggs) and affects both the uterus and vagina - and, ultimately, the growth of uterine fibroids. All in all, it's an extremely delicate balance between your ovaries, your central nervous system, and hypothalamus and pituitary gland. Any disruption to this balance can create a bit of chaos. Perimenopause is a prime example.

As hormones start fluctuating in your mid to late 40s, symptoms such as hot flashes, insomnia, fatigue, irritability, depression, and difficulty concentrating are all common. Most of these symptoms settle down after menopause when hormones stop fluctuating on a daily and monthly basis.

Prior to menopause, is it any wonder that when your reproductive system develops polyps or possibly cysts that your body just doesn't run nearly as smoothly as it did previously? Throw in an extra fibroid or two as a result of the balance of hormones going haywire and you'll quickly understand why most women with fibroids suffer from anemia or fatigue during the perimenopausal stage as well.

Site Name/Author
What You'll Find Association of Reproductive Health Professionals
Arthur F. Haney, MD,
Durham, NC
Kirtly Parker Jones, MD,
Salt Lake City, UT
Leon Speroff, MD, Portland,
OR Susan Wysocki, RNC, NP, Washington, DC
Perimenopause. Pathways to Change. Detailed online brochure explaining the signs/symptoms of perimenopause.



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This page last updated Saturday, February 02, 2002