Does menopause cause decreased ovarian estrogen and increased FSH and LH due to loss of negative feedback?

The physiological transition of menopause is fundamentally defined by the cessation of ovarian endocrine function and the subsequent restructuring of the hypothalamic-pituitary-gonadal (HPG) axis.

Clinical and Mechanistic Evidence

Research consistently demonstrates that menopause is characterized by the depletion of the ovarian follicular reserve, which serves as the primary source of circulating estradiol. This process leads to several documented hormonal shifts:

• Estrogen Decline: Serum estradiol levels drop sharply during the transition. While premenopausal levels average around 64.5 pg/mL, they typically plummet by approximately 67% to reach a stable postmenopausal range of 5–20 pg/mL. By age 61, ovarian estradiol secretion has ceased entirely, and the remaining low levels of circulating estrogen are derived from the peripheral aromatization of androgens rather than the ovaries.
• Gonadotropin Elevation: The depletion of follicles leads to a significant rise in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This elevation is a direct consequence of pituitary disinhibition.
• Loss of Negative Feedback: In a reproductive state, estradiol and inhibin B provide essential negative feedback to the hypothalamus and pituitary. Specifically, estradiol acts on kisspeptin neurons in the arcuate nucleus to inhibit the gonadotropin-releasing hormone (GnRH) pulse generator. As ovarian production fails, this "brake" is removed, resulting in increased GnRH pulse frequency and a subsequent hypersecretion of FSH and LH from the pituitary gland. FSH typically shows a more pronounced rise than LH due to the concurrent loss of inhibin-mediated suppression.

Bottom line

The claim is fully supported by established reproductive science. Menopause results in a profound decline in ovarian estrogen production due to follicular exhaustion, which removes the negative feedback signal to the brain, leading to the characteristic and sustained rise in FSH and LH levels.