How to Menopause

Content Warning: This section of the guide includes discussion of sexual content.

AMH is another marker sometimes used to assess ovarian reserve. It reflects the number of remaining follicles and can help predict menopause, but it is still considered an imperfect tool. Fadal mentions AMH as one of many fluctuating hormones and advocates for symptom tracking and self-awareness over lab results alone.

DHEA is a hormone produced by the adrenal glands that serves as a precursor to both estrogen and testosterone. Levels decline with age, and low DHEA can contribute to fatigue and decreased libido. Fadal includes DHEA among the key hormones worth tracking during menopause and sometimes recommends supplementation under a doctor’s guidance.

Estrogen is a primary female sex hormone involved in regulating the menstrual cycle and supporting reproductive health, but it also affects the brain, heart, bones, skin, and more. There are three types of estrogen: estradiol (the most prevalent during reproductive years), estrone (which becomes dominant after menopause), and estriol (produced during pregnancy). Estrogen levels begin to drop during perimenopause, which leads to a wide range of symptoms including hot flashes, sleep disturbances, and brain fog. Fadal explains that declining estrogen is one of the key drivers of menopausal symptoms, and that hormone therapy (HT) can help replace what the body no longer produces.