The impact of hormonal changes on a woman’s health throughout life – at 20, 30, 40, 50, 60 years old.

Currently, there are over 500 million women over 50 years old on Earth. In Russia, about 25% of the total population are women aged 40-69 years. Unfortunately, these years often come with health deterioration and unpleasant conditions.

Interesting Facts:

  • The aging of the world’s population has significantly accelerated compared to the past.
  • The share of the world’s population over 60 will almost double from 2015 to 2050 (from 12% to 22%).
  • In 2020, the population aged 60 and over exceeded the population of children under 5 years old.
  • 12.2% of women experience menopause before 40 due to certain chromosomal anomalies, autoimmune disorders, or other unknown reasons.
  • Throughout a woman’s life, egg cell loss occurs at a rate of approximately 25-150 cells per day: by the time of the first menstruation, they decrease by 50%, and by menopause, there are about 1000 left.

There are two types of aging: physiological and premature.

Physiological aging is a natural process characterized by age-related changes that gradually occur in the body, limiting its ability to adapt to the environment.

Premature aging, on the other hand, occurs most commonly after the age of 40-50 and involves either partial or overall acceleration of the aging process. This means a person ages faster compared to the average for their age group.

Aging affects nearly all body functions, including intellectual and reproductive abilities. It also increases the risk of common diseases like atherosclerosis and cancer.

Why does aging occur?

Aging at the biological level results from various molecular and cellular damages that accumulate over time in humans. This leads to a gradual decline in physical and mental abilities, an increased likelihood of diseases, and ultimately, death.

However, aging is not only caused by damages but also by genetically programmed factors. Some genetic abnormalities in humans are linked to premature aging and a shortened lifespan.

Several common factors influence life expectancy:

– Genetics:

 Inherited genes can predispose someone to various disorders. For instance, inheriting genes that increase cholesterol levels might lead to a shorter life. Conversely, having genes that protect against heart disease and cancer could result in a longer life.

– Lifestyle: 

Choices like quitting smoking, avoiding drugs and excessive alcohol, maintaining a healthy weight, eating well, exercising, and regularly getting recommended screenings and vaccinations can extend life expectancy.

– Environmental exposures:

Harmful substances in the environment can shorten life expectancy, even among those with good genetic makeup.

– Medical care:

 Preventive measures or treatments for disorders, especially treatable ones like infections and some cancers, can help increase life expectancy.

Features of Aging in the Female Reproductive System

The aging of a woman’s reproductive system is a genetically programmed process. It involves a gradual weakening of regulatory mechanisms, a loss of coordination in physiological processes, and a decline in compensatory reactions. A distinct feature of the female reproductive system is its gradual decline during life: reproductive functions start diminishing around 35 years old, while menstrual and hormonal functions decline around 45-50 years old.

Menopause (climacteric) marks the onset of aging, but it’s not aging itself; it’s a natural physiological process that can’t be stopped.

A woman’s lifespan is closely linked to her reproductive health. Factors influencing it include:

  • The age of first menstruation
  • The number and course of pregnancies
  • The number of deliveries
  • The number of induced and spontaneous abortions
  • Menopause

Stages of Aging in the Female Reproductive System

The stages of aging in a woman’s reproductive system are clinically and hormonally characterized based on numerous scientific studies. Three main stages are identified: reproductive period, menopausal transition, and postmenopause. Each stage is further subdivided into early, peak (only in the reproductive period), and late stages. In total, there are 10 separate stages labeled from -5 to +2.

Late Reproductive Period:

 Divided into 2 stages (-3b and -3a), characterized by low levels of anti-Müllerian hormone (AMH) and possibly inhibin B (a glycoprotein hormone synthesized in the granulosa cells of ovarian follicles) and the number of antral follicles (AFC):

  • Stage -3b: Regular menstruation with no significant fluctuations in follicle-stimulating hormone (FSH) levels during the early follicular phase.
  • Stage -3a: Minor changes in menstrual cycle patterns (often shortened cycles) alongside increased FSH levels and greater variability.

Transitional Period:

 Defined regardless of a woman’s age, starting from increased variability in menstrual cycles, where the longest and shortest cycles differ in duration by 7 days:

  •   Early stage of the transitional period (stage -2): Fluctuating FSH levels with a tendency towards elevation in the follicular phase.
  •   Late stage of the transitional period (stage -1): Onset of amenorrhea (absence or abnormal cessation of menstruation) lasting more than 60 days, lasting from 1 to 3 years, often accompanied by the emergence of vasomotor (hot flashes), psychological, urogenital estrogen-deficiency symptoms.

During this period, many diseases and conditions manifest in a woman’s body, impacting both the quality and length of life: hormonal imbalances, cardiovascular diseases (CVD), osteoporosis and osteoarthritis, obesity, urogenital disorders, sexual dysfunction, increased gynecological diseases, cognitive function decline, depression, and others. The risk of oncological diseases increases, and sleep worsens.


Persistent cessation of menstruation, marking the end of reproductive and hormonal ovarian function due to age-related decline. Menopause, including early menopause, is always a lengthy process gradually unfolding over many months. The onset of menopause is a time for women to consider symptom management and preventive measures to enhance quality and length of life. Premature menopause (before 40 years), early (40–45 years), timely (46–54 years), and late menopause (after 55 years) are distinguished.

Late postmenopausal:

 Changes associated with somatic aging and manifestations of genitourinary syndrome, i.e., alterations occurring in external genitalia, perineum, vagina, urethra, and bladder. Vasomotor symptoms are less pronounced but may persist in 15% of cases for a prolonged period.

The risk of cardiovascular diseases in postmenopausal women

After menopause, 37.2% of women aged 40–59, 71.9% aged 60–79, and 86.7% over 80 years old face an increased risk of cardiovascular diseases (CVD). Moreover, women over 40 are more likely to develop CVD and suffer disability and mortality related to it compared to men. This is due to the loss of estrogenic “protection” post-menopause. Additionally, traditional risk factors for women are not as apparent as they are for men, and they don’t always accurately predict the likelihood of developing cardiovascular diseases. Hence, it’s crucial to anticipate potential CVD and detect irregularities during the peri- and early postmenopausal period (6–8 years) in women.

What tests does a woman need to undergo?

The required check-ups include visits to different doctors to know her personal and family medical history: like hysterectomy, cancer in reproductive organs, blood clots, osteoporosis, heart disease, digestive issues, dementia, thyroid problems, diabetes, smoking/alcohol habits, diet, and exercise. Collecting medical history thoroughly helps to find factors that might affect the decline of female reproductive function: age of first menstruation, smoking, obesity, complicated pregnancies, complicated gynecological history, and other health issues.

General check-up involves: calculating body mass index; measuring blood pressure; complete blood count; gynecological examination; Pap smear test; pelvic ultrasound scan; lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol); blood glucose and thyroid hormone analysis.

Additional tests may include liver ultrasound and liver enzymes test; blood test for clotting disorders, FSH, estradiol, prolactin, anti-Mullerian hormone, inhibin B (after hysterectomy or to check ovarian reserve); bone density scan; colonoscopy.

How to support reproductive system health during aging?

Exercise regularly. 

Doing physical activities lowers the risk of heart diseases and overall mortality. Active people have better metabolism, muscle strength, cognitive abilities, and quality of life. They also have fewer heart problems, strokes, fractures, breast cancer, and colon cancer. Optimal physical activity should include at least 150 minutes of moderate-intensity exercises per week, adjusted based on individual physical condition.

Maintain a healthy lifestyle. 

This involves having a balanced diet with fruits, vegetables (several servings a day), whole grains, fish (twice a week), and limited fat intake (preferably olive oil). Salt consumption should be limited, and alcohol intake should not exceed 20 grams per day. Dietary changes and regular exercises can ease hot flashes and improve mood. Losing weight and avoiding hot flash triggers (like caffeine or direct heat sources) can minimize their impact. Just a 5–10% weight reduction can help correct many issues associated with insulin resistance syndrome. Also, quitting smoking is essential.

Take care of mental well-being.

 Informal social interactions, physical and mental activities are beneficial. Meditation, relaxation, and cognitive-behavioral therapy can improve conditions for women experiencing hot flashes. It’s important to establish a new doctor-patient relationship style where the doctor acts as an advisor, and the patient takes responsibility for their own health.


During the transition to menopause, many chronic conditions in a woman’s body start to show up, affecting both the quality and duration of life. That’s why it’s crucial to take preventive measures on time to address the conditions accompanying this period. Doing so can enhance life quality and extend its duration.

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