Women's Health Texas – Austin


Hormone pearls through the decades

The primary hormones that I will be talking about are the ones that are produced by the ovary. Those are Estrogen, Progesterone, and Testosterone. There are additional hormones that affect our daily lives as well such as Thyroid Hormone, Adrenal Hormones (cortisol, DHEA, aldosterone).

First Decade:
Estrogen levels are very high at birth then decline rapidly. The source being the mother’s hormones from pregnancy. In our first decade, our estrogen, progesterone, and testosterone levels are all relatively low and stable until puberty. The primary hormone problem that can occur in this group is Precocious Puberty. This is defined as puberty beginning prior to the age of 6. In our country the age of puberty has declined over the years by about a year. Thelarche: 9-10 development of Breast Buds, Pubarche: The appearance of pubic hair, change in Body Shape where they acquire “baby fat” and deposition of fat about the middle is normal. Menstruation: takes place 1.5 years to 3 years from breast Development.


  1. Notify your doctor if your daughters’ development begins too early.
  2. Watch your reaction to the development of central body fat.
  3. Prepare your daughter for the changes they will be experiencing and normalize them.

Your attitudes contribute substantially to attitudes about changes.

Second Decade: The Teen Years
Teen years are years of growth and in general excellent health. It is characterized by boundless energy and incredible mood swings. Hormone levels are some of the highest in our lifetime. This is one of the most unpredictably unpredictable times of our lives: There are fluctuations that cause, Growth, Mood Instablity, Acne. It is characterized by the Fight and Flight. This is caused by stress. During this time the primary physiological activity is the synchronizing of the menstrual cycle. Dysynchronized cycles cause premenstrual mood swings, acne and dramatic responses to stress. In fact Adolescents are always experiencing stress. What Can We Do?


  1. Normalize their experiences and prepare them for the erratic development of their cycles and that unpredictability is normal.
  2. Help them by making sure they learn that the unpredictable nature of the hormones leads to and fight and flight affect may make them turn their moods on a dime. Help them learn better-coping skills and make sure they are sleeping and exercising. Remember this is the time in earlier times we were preparing for adulthood and to protect ourselves when leaving home.
  3. If they have fewer than 4 cycles per year or have not started menstruating by the age of 16, are flooding with their menses they need medical attention.

Third Decade: The 20’s
This decade is characterized by predictability of Cycle. This is a time of our lives when we enjoy some of our highest hormone levels, high libido, spot on cognitive ability and usually mood swings improve.


  1. Joint injury is greater in the second half of the cycle, with women having a higher incidence of anterior cruciate tearing. This is preventable by strengthening you thigh and hip muscles.
  2. The hormone levels of this decade are responsible for the most fertile time of our lives. Women’s Bodies are the most prepared for childbearing in this decade. During pregnancy women are at greater injury to their joints much like the second half of the menstrual cycle and have much more flexibility in the back with exaggerated swayback and more pressure on the low back. It takes up to 6 months postpartum to sustain full recovery from the hormonal changes.
  3. In contrast to the erratic nature of the teens with our cycles are more consistent women will notice the changes premenstrual time and some develop PMS or PMDD.
  4. When consistency is absent and the cycles remain erratic Polycystic ovarian disease may have started in the teen years and continue. This is a condition dominated by androgens. Cycles are inconsistent, weight gain common, acne and excess hair growth are common. This is also characterized by insulin resistance and women often gain weight.
  5. The high levels of hormones in this decade help keep the arteries flexible and help protect us from heart disease.

Fourth Decade: The 30’s
Our hormones begin to decline in this decade. They are still high enough to provide us with regular and predictable cycles.


  1. If you always imagined being a parent start moving in that direction. Make sure you are supplementing with Folic Acid (.8mg)/ Vitamin D and Omega 3’s.
  2. The reduction in hormones starts to affect your weight. Women start gaining 3-5 pounds per decade. Fat begins to be deposited around the waist. (it might take years to notice)
  3. Your bone-building declines. Weight-bearing exercises become even more important.
  4. Your skin begins to lose the hyaluronic acid and you are more susceptible to the development of acne.

Fifth Decade: The 40’s
By far the most unpredictably unpredictable time of a women’s life. The Perimenopause of the time prior to and leading up to the menopause. There is a much steeper decline in hormone levels, in general they are much more erratic. This time is characterized by a change in cycle length, heavier and missed periods. We experience a higher incidence of PMS symptoms, mood instability, hot flushes, insomnia, more fatigue and for some women a decline in libido. Weight redistribution continues and becomes noticeable.


  1. The physiologic instability of this time of our lives is real and you are not crazy!
  2. There are many approaches to managing this time. It is essential to make sure you are doing self-care, exercising, developing a mindfulness practice. Dietary modifications are essential as our basal metabolic rate declines and there is also a reduction in thyroid hormone production.
  3. Many women have been running on empty after completing childbearing and parenting and chronic stress has many consequences especially fatigue.

Sixth Decade: The 50’s
Menopause is a normal and natural event. Defined by your last menstrual period and confirmed when you have stopped menstruating for 12 consecutive months. It is characterized by lower levels of estrogen and progesterone resulting in symptoms in about 70% of women. The primary symptoms are hot flushes, sleep disruption and vaginal dryness. You may also continue to have mood instability and exacerbation of headaches or migraines. Estrogen deficiency increases the risk of osteoporosis and vaginal dryness.


  1. Average Age 51-52
  2. Duration of Symptoms months to years
  3. Treatments are tailored to the individual. They range from non-hormonal to hormonal. I have found that many patients wait and observe symptoms prior to jumping in and treating them. The current medical recommendations are to treat symptoms for the shortest length of time.

Seventh Decade: The 60’s
Many of the symptoms of menopause resolve and for a majority of women this time of their life is comparably modulated and stable.


  1. Loss of bone density: this needs to be checked by the age of 65 unless you have additional risk factors. Family history, smoking, alcohol, over-treated thyroid disease.
  2. Spinal Column: becomes compressed and curved
  3. Foot arches become flatter
  4. Joints are much stiffer and less flexible due to calcium deposition and osteoarthritis. The shoulder is the most often injured.
  5. Hip/Knee/and finger’s loose cartilage
  6. Lean Body mass continues to decline and there is up to a 30% loss in muscle mass between the ages of 50-70. Muscle fibers shrink and become stiffer as well.
  7. These all lead to fatigue and a decrease in activity tolerance, stiff joints, and pain. There is an increased risk of injury due to balance instability.
  8. Cardiovascular changes include a reduction of heart rate, increase in blood pressure resulting in an enlarging heart.
  9. GastroIntestinal changes include constipation
  10. Bladder changes primarily incontinence both stress and urge incontinence. Kegel exercises.
  11. Memory changes are common it is essential to exercise, a diet high in fruit and vegetables, maintain a social network and treat hypertension.
  12. Eyes become more sensitive to glare, cataracts increase. Ear’s demonstrate a decline in hearing
  13. Skin loss of the fatty layer under and a reduction of natural oils cause an increase in wrinkles and bruising. Sunscreen is essential.


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