How does menopause change the ovaries?

During menopause, the ovaries undergo significant physiological changes as they reach the end of their reproductive life. These changes include:1

• Structural Shrinkage: The ovaries decrease in size and typically come to consist primarily of fibrous tissue, some interstitial cells, and atretic (shrunken) follicles.21
• Follicular Depletion: By the time of menopause, the ovaries contain very few follicles. The remaining follicles, which contain immature eggs, degenerate as reproductive function ceases.13
• Hormonal Decline: The production of estrogen drops by 80 percent or more, though it does not cease entirely. This reduction in estrogen, combined with the loss of follicles, triggers a marked increase in the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary gland as the body attempts to stimulate the quiescent ovaries.21

These changes represent the natural conclusion of the ovaries' approximately 35-year lifespan, marking the permanent cessation of menstruation.1