Reporter interviews reveal that in recent years, clinical cases have emerged of women experiencing menopause as early as age 36 or 39.
Experts indicate this is often due to changes brought by estrogen. For a woman, estrogen plays a vital role throughout her life: without it, she cannot menstruate, bear children, and will experience menopausal symptoms and osteoporosis. Estrogen is crucial to women's health.
Adult Women Should Understand Estrogen
【Clinical Case】
Patient One, 28 years old, presented with amenorrhea and infertility.This patient delivered a full-term female infant via cesarean section in 2006 and underwent one induced abortion in December of the same year. In the latter half of 2007, her menstrual flow became sparse and gradually decreased. She experienced amenorrhea starting in June of last year, presenting with hot flashes, flushing, spontaneous sweating, palpitations, and vaginal dryness. She was clinically diagnosed with premature ovarian failure.[Expert Explanation] Estrogen is a female hormone secreted by the ovaries. Its levels are extremely low. Together with progesterone and androgens, it operates under the regulation of the brain's higher centers through a three-tiered structure: the hypothalamus-pituitary-gonadal (ovarian) axis. This system effectively controls female development, menstruation, and sexual function. The three components of this axis mutually constrain and influence each other.In other words, disruption at any point along this pathway from the brain to the ovaries can upset the balance, leading to irregular estrogen secretion.
What role does estrogen play in women? It promotes the development and maturation of reproductive organs such as the uterus, fallopian tubes, vagina, and vulva, maintaining them in a healthy state. It facilitates breast development, broadens the pelvis, and encourages subcutaneous fat accumulation, contributing to the characteristic feminine physique. Working in tandem with progesterone, it induces cyclical changes in the uterine lining, resulting in the menstrual cycle.It promotes proliferation and keratinization of vaginal epithelial cells while increasing glycogen content, maintaining an acidic vaginal environment that enhances resistance and prevents bacterial infections. It relaxes the cervical opening and increases cervical mucus secretion, thinning it to facilitate sperm passage and aid conception.
Additionally, estrogen influences skin smoothness and sexual desire in women. However, estrogen levels do not remain constant indefinitely. By following the path of harmony, women can maintain health throughout their lives.
Insufficient estrogen prevents childbearing
【Clinical Case】
Patient 2, 36 years old, presented with amenorrhea for six months and infertility for ten years. She underwent surgical removal of bilateral ovarian fibroids eight years prior. Her menstrual flow decreased one year ago, leading to complete amenorrhea in the past six months, accompanied by hot flashes and flushing. The physician diagnosed estrogen deficiency.
【Expert Insight】Estrogen is fundamental to maintaining female physiological functions and cannot be replaced by other hormones. Its deficiency leads to amenorrhea and infertility. While advertisements for infertility treatments are ubiquitous, estrogen plays a pivotal role in fertility.
An ancient Chinese saying holds that among the three forms of filial disobedience, failing to produce an heir is the gravest. If a woman cannot bear children, it becomes the most significant issue for a family—spousal affection may fracture, and marriages may dissolve. Ultimately, a major contributing factor could be estrogen deficiency.First, the female reproductive organs cannot develop without estrogen. Many women report having a particularly small uterus or irregular menstruation. Why? Because estrogen is absent. For a woman to menstruate, estrogen is essential for the development of the uterus and endometrium, ensuring regular growth cycles and timely menstruation. Without estrogen, it's as if the soil for a child's growth has vanished.Therefore, it is recommended that women experiencing estrogen deficiency due to diminished ovarian function or disease supplement with exogenous estrogen under specialist medical guidance. When appropriate levels of estrogen enter the body, it can slow the rate of reproductive tract atrophy, thicken the vaginal mucosal epithelium, increase elasticity, and improve lubrication.It also increases blood flow to pelvic tissues and organs, thereby enhancing sensitivity to touch and sexual responsiveness in female reproductive organs. However, exogenous estrogen must never be abused lightly; strict adherence to medical advice is essential to avoid uterine bleeding or even uterine cancer.【Clinical Case】
Patient 3, 44 years old. Presented to the hospital with irregular menstruation for over two years and vaginal bleeding lasting 10 days. The patient had previously been in good health. Over the past two years, she experienced unexplained menstrual cycle irregularities, ranging from 25 to 45 days in length. Occasionally, her menstrual cycle occurred only once every two months. The physician suspected early menopausal symptoms.
【Expert Insight】Why do some women experience unexplained menopause as early as age 36 or 39?
Multiple factors contribute. Modern women experience menarche earlier, averaging 12.5 years old, compared to 19 years in primitive societies. The age of menopause is indeed closely linked to fertility.The older a woman is at her first pregnancy or first childbirth, the earlier menopause typically occurs; conversely, more pregnancies tend to delay menopause. It is well known that during pregnancy and lactation, the ovaries suspend ovulation. Ovulation resumes only 4 to 6 months after breastfeeding begins. During this period, the ovaries defer the release of nearly 20 eggs. Consequently, women who have given birth may experience a delayed onset of menopause.Similarly, ovulation is suppressed during lactation. Therefore, the longer the breastfeeding period, the fewer ovulations occur, and the later menopause occurs.
Secondly, accelerated lifestyles, high stress levels, vitamin and trace element deficiencies, reduced physical activity, coupled with obesity and chronic diseases, diminish the sensitivity of primordial follicles to pituitary hormones, leading to insufficient estrogen levels. Additionally, being underweight and prolonged absence of sexual activity can also contribute to early menopause.
To address this, women should proactively adopt menopause-focused health practices. By modifying environmental factors—such as increasing exercise, improving nutrition, enhancing marital quality, maintaining psychological balance, quitting smoking, improving occupational conditions, strengthening physical fitness, and losing weight—the onset of menopause can be delayed. Additionally, it is recommended to measure estrogen levels twice annually, typically via fasting blood tests on the third day of menstruation.