The Menopause

Every female knows the physical and mental difficulty of menstruation, having to experience it once a month most commonly, starting during teenage years. Every child in the UK who sits GCSEs is taught basic reproduction and the 28-day reproductive cycle of a woman, including the roles of two key hormones; oestrogen and progesterone. However, only those going through or those who have already experienced the menopause are completely aware of what it is and its symptoms.

The menopause is ‘when a woman stops having periods and is no longer able to get pregnant naturally’, as described by the NHS and usually happens between the age of 45 and 55 but can happen prematurely, or after breast cancer treatment or an oophorectomy.

Low mood, sweats and vaginal dryness are all common symptoms of the menopause caused by significant fluctuation in release of oestrogen and progesterone, and the stopping of ovulationThe reduction of oestrogen and progesterone is due to the decreasing responsiveness of ovaries to the hormones FSH, which causes ova to mature in the ovary and controls release of oestrogen, and LH which stimulates release of the ovum. The menopause worsens quality of life as women sweat more so feel that they may not wear long sleeves, cannot wear makeup without it coming off and have to wear their hair up to be comfortable (as written in the Daily Telegraph on 10.4.17).

Both female and male gametes are required for reproduction in humans as we produce sexually, as opposed to asexually so once ovulation stops (the release of the female gamete), women are no longer able to have a child. Humans stop reproducing far sooner than other mammals and this is said to be an evolutionary advantage as reproducing late in life has various risks for the child, such as developing Down’s syndrome or a cleft palate, and for the mother, if they are in a less able physical state to give birth.

In the news lately there has been talk of a new drug called MLE4901which relieves the symptoms of the menopause – in particular sweats, with a lower risk than the most commonly used drug HRT which can lead to breast and ovarian cancer, and blood clots which can lead to strokes. The drug is said to improve many more lives as it would be available for far more people as HRT cannot be given to people who have previously had breast or ovarian cancer or high blood pressure for obvious reasons. MLE4901 does not increase oestrogen release like HRT, but works by preventing Neurokinin B (a hormone) being released. Neurokinin B is an important hormone shown by its increase in release during falling oestrogen levels so by decreasing Neurokinin B levels, decline in oestrogen level can be stopped. Neurokinin B also activates the metabolic pathway of thermoregulation, so by controlling its release, hot flushes are reduced.

A clinical trial was taken out by Imperial College London where people spoke about their moods during a four-week trial period of taking the drug and feedback was very successful. However, it is extremely hard to compare MLE4901 to HLE as emotion is a qualitative value so should be used with caution.


Emily Buchanan