••• CHAPTER 33^ Menopause^317
❍ Which hormones decline as a result of menopause?
Estrogen, androstenedione, and progesterone.
❍ Which hormones decline as a result of age?
Dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and testosterone.
❍ What is the level of DHEA-S in a 70-year-old compared with peak levels in a 25-year-old?
10% to 20% of peak.
❍ Where is most of the postmenopausal androstenedione produced?
The adrenal gland.
❍ How much estradiol (E 2 ) is produced each day in postmenopausal women?
6 μg/day, decreased from 80 to 500 μg/day in reproductive age women.
❍ How much estrone (E 1 ) is produced each day in postmenopausal women?
40 μg/day, decreased from 80 to 300 μg/day in reproductive age women.
❍ What is the circulating estradiol (E 2 ) level in women after menopause?
10 to 20 pg/mL (40 to 70 pmol/L).
❍ What is the primary source of estrogen in postmenopausal women?
Peripheral conversion of adrenal and ovarian androgens by extraglandular aromatase in adipose.
❍ What is the predominant estrogen of the postmenopausal woman?
Estrone (E 1 ).
❍ What is the biological potency of estrone compared with estradiol?
It is only one third as potent as estradiol.
❍ What happens to progesterone production in menopause?
Progesterone is no longer produced.
❍ What hormone is secreted more by the postmenopausal ovary than the premenopausal ovary?
Testosterone; prior to menopause the ovary contributes 25% of circulating testosterone and in menopause the
ovary contributes 40% of circulating testosterone.
❍ Why does the postmenopausal ovary produce more testosterone than the premenopausal ovary?
Elevated gonadotropins stimulate the stromal tissue to secrete testosterone.