A Straight Dope Classic from Cecil's Storehouse of Human Knowledge

Does use of The Pill delay menopause?

December 5, 1986

Dear Cecil:

Something's been bothering me about this whole birth control pill thing. If they taught me right back in sex ed, the pill "tells" the ovaries (through the hormonal code) that there's a pregnancy down in the uterus. The ovaries, not wanting to cause a uterine traffic jam, don't send another egg down the fallopian tubes. No egg, no pregnancy. Does this mean that a woman who takes the pill for three years will experience menopause three years later than she naturally would, due to the backlog of unreleased eggs?

Cecil replies:

Lord, give me strength. Pardon the expression, B., but you're laboring under several misconceptions. First, the pill doesn't "tell" the ovaries anything. It tells the brain, and the brain tells the ovaries. Next, what the pill says (via the hormones) is not that there's a pregnancy in the uterus. Rather, the pill tells the brain that ovulation has recently occurred, causing the brain to hold off sending another egg down the pipe.

Finally, you seem to have the idea that the ovaries are like gum ball machines, containing a relatively small number of eggs, all of which eventually get sent down the fallopian tubes; and that once the last egg is gone, some kind of "empty" light comes on and menstruation abruptly stops. The truth is that the ovaries contain the makings of several hundred thousand eggs, of which only one in a thousand or so ever makes it down to the uterus. Menstruation stops not because the proto-eggs get used up, but because they die off.

Only three or four hundred would-be eggs, which are called primary oocytes, develop into full-fledged ova. The rest wither away gradually during the woman's childbearing years. Exactly why this happens nobody knows; one guess is that the oocytes' life span is genetically predetermined. In any case, by the time the woman is in her forties, she's down to a few thousand. The ones that are left become insensitive to incoming hormones, and don't secrete enough outgoing hormones, disrupting the delicate chemical balance of the menstrual cycle, and menstruation eventually stops. So far as can be determined, using the pill has no effect on the age at which menopause occurs.

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