Don’t Sweat It: Busting Six Menopause Myths

If you break out in a sweat just thinking about what menopause might mean for your mood, your relationships or your ability to sleep through the night, chill out. Women’s health experts Daniel Laury, MD, of UVM Health Network – Alice Hyde Medical Center in Malone, N.Y., and Mariah North, MD, of UVM Health Network – Porter Medical Center in Middlebury, Vt. offer some reassurance and guidance.

Myth #1: Menopause is the Same for Everyone

Menopause is medically defined as a year without a period. The age at which women in the United States reach natural menopause varies widely – between 40 and 58, with some women entering this phase while in their 30s, some in their 60s. Although 51 is the average age of menopause in the U.S., Dr. Laury says that for several years after menopause, the ovaries continue releasing hormones that affect each person’s body differently.

Perimenopause – also referred to as the menopause transition – is the time frame leading up to your last period, and for one year after. Signs you’re entering perimenopause can include irregular periods, hot flashes, sleep disturbances and mood swings resulting from erratically changing levels of ovarian hormones (estrogen) in your body. 

Many women assume they will experience all of the worst symptoms of menopause, but Dr. North says, “A good portion of people don’t have any problems, including hot flashes, and sail smoothly through this phase of their lives, so I don’t want everyone to be scared that it will be especially bad for them. And it’s important to know there are treatments available to help.” 

Myth #2: Your Symptoms Aren’t Bad Enough for a Doctor Visit

“Women usually wait and wait and wait before they decide they feel bad enough to consult their doctor,” Dr. Laury says. “They're having hot flashes and getting brain fog or poor sleep or they’re having problems with their partner and then they start showing up to our office.”

If you are experiencing uncomfortable symptoms, you should not hesitate to speak to your doctor about treatment options and strategies for minimizing their impact on your life, Dr. Laury advises. These include:

• Hot flashes and sweats, especially those that interrupt sleep. “Poor sleep can create its own set of problems, including poor concentration and irritability,” Dr. North says.
• Sexual health concerns.
• Irregular and/or especially heavy bleeding. “If you’re bleeding more than once a month, your provider will want to know about it,” say Dr. North.

Myth #3: Get Used to Mood Swings 

Many women going through menopause are also dealing with other challenging life transitions, such as empty nest or caring for elderly parents, or both. Meanwhile, society’s obsession with youth and beauty also may take a toll on women’s sense of well-being in midlife, as their bodies tend to lose muscle mass and gain fat mass around their midsection, Dr. North says. “We definitely see an increase in mood disorders – depression, anxiety and irritability – during this life stage.” 

Poor sleep resulting from hot flashes and night sweats can also cause mental and physical health problems, Dr. North adds. “Medications, such as antidepressants for mood, and hormone replacement therapy for hot flashes and sweats, can really help.” 

A focus on behavior change may also alleviate symptoms. Some suggestions:

• Do an intensive cardio workout.
• Avoid warm rooms, hot drinks, hot foods, alcohol, caffeine, excess stress and cigarette smoking. 
• Wear layers of clothing made from light, breathable fabrics. 
• Keep a fan near your bed. 
• When a hot flash is starting, try “paced respiration.” This involves slow, deep, abdominal breathing – in through your nose and out through your mouth. Breathe more slowly than usual, only five to seven times per minute.

Myth #4: Hormone Therapy Is Dangerous

The medical community’s approach to hormone replacement therapy (HRT) has seen a wide pendulum swing in recent decades. Where once there was a general hesitancy on behalf of physicians to prescribe HRT due to the associated risks, including breast cancer, heart attack, stroke and blood clots, now there is a more nuanced discussion that centers on risk vs. benefit. 

Both Drs. North and Laury agree that prescription hormone therapy is the most effective treatment for hot flashes. And reducing hot flashes can dramatically improve a woman’s life.

“If you are having problems with hot flashes, heavy or more frequent periods or vaginal pain/dryness with sex, get in touch with a women’s health provider to talk about evaluation and options,” advises Dr. North.

The North American Menopause Society reports that “Although using hormones can increase your risk of breast cancer and cardiovascular disease, studies show that benefits may outweigh risks for healthy women younger than age 60 with moderate to severe hot flashes. The goal is to use the lowest dose of hormone therapy that treats your symptoms for the shortest time necessary. Women with a uterus need to combine estrogen with a progestogen.”

Drs. North and Laury have successfully treated many patients with HRT with no adverse outcomes. Dr. North recommends that patients read this in-depth article from the North American Menopause Society to learn more about the risks and benefits of hormone replacement therapy.

Myth #5: Say Goodbye to Your Body 

Changes in your body often accompany the menopausal transition, but there are actions you can take to mitigate the effects and empower yourself, Dr. North says. Since muscle mass decreases as we age, it’s important to intensify strength training during workout routines – even before actual menopause. 

Dr. North also suggests seeking dietary advice from a nutritionist or other qualified member of your health care team. A nutritionist can help you identify medical factors contributing to weight gain, including high insulin or an underactive thyroid. They can also help develop strategies for improving your overall nutrition, such as:

• Incorporating more vegetables and healthy fats into your diet. 
• Limiting how much alcohol and caffeine you consume and reducing your consumption of sugar and processed foods. This can help improve your daytime energy and quality of sleep.  

Myth #6: Menopause Destroys Your Sex Life

“This is not the case at all,” says Dr. Laury, who wrote a book about seniors and sexuality called “SeniorSex.” “People in their 50s have completed only about 60 percent of the average life span—there’s a lot of life left to live and sex doesn’t just quit when you hit menopause.” In fact, he points out, “What's really interesting is that while sexual frequency decreases with age, sexual satisfaction goes up.” Dr. Laury talks to his patients about how to adapt to ensure a mutually satisfying experience as bodies age, including focus on foreplay and the use of a lubricant to combat vaginal dryness. 

Says Dr. North, who encourages women to speak openly not just with their gynecologist, women’s health nurse practitioner or midwife but also with their partners about their menopause concerns: “Finding support and understanding is key. Don’t we all need that?”