Women's HealthPending review

Menopause and HRT

Depletion of the finite ovarian follicle pool causes oestradiol production to fail despite rising pituitary drive, and the resulting oestrogen withdrawal produces effects across every tissue that depends on it, which HRT works by directly replacing.

First principles

Ovarian follicle depletion is the root cause

Women are born with a finite, non-renewable pool of ovarian follicles that declines throughout life. Menopause occurs once this reserve is exhausted to the point that the ovary can no longer reliably produce mature follicles or the oestradiol they secrete. Every downstream feature of the menopause follows from this single fact: the ovary is running out of raw material, not malfunctioning in some reversible way.

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Educational content pending clinical review. Not medical advice.