Menopause Myths Doctors Want You to Stop Believing

Menopause—and the years main as much as it—can include some fairly irritating signs. However it’s not a illness that must be cured; it is a regular a part of life. Regardless of that (and although a million individuals are going by it at any given time, per the National Institute on Aging), menopause nonetheless is not nicely understood.

In actual fact, a July 2023 on-line survey performed within the U.Ok. and reported in BMC Women’s Health discovered solely 47 p.c of respondents at numerous phases of menopause felt like they’d the information to handle their signs.

It is on this lack of awareness that menopause myths are sometimes shaped. Under, specialists share six misconceptions they typically hear about this life stage, plus the info to know as an alternative.

Delusion: Solely extreme menopause signs require therapy

When your ovaries make much less estrogen, you could have a spread of signs like night time sweats, sleeping problems, and vaginal dryness. These signs may be gentle for some folks however downright debilitating for others.

Associated Tales

Regardless of the severity, many individuals with bodily menopause signs do not at all times really feel empowered to hunt therapy. Based on the identical BMC Ladies’s Well being survey, 39 p.c of respondents did not attain out to a health care provider for assist with their signs, partially as a result of they did not assume menopause was a legitimate sufficient motive to get care.

However this should not be the case, says Rajita Patil, MD, an OB/GYN and director of the brand new Complete Menopause Care program at UCLA Well being. “Not all menopause signs need to be extreme to warrant therapy,” she says.

Take sizzling flashes, for instance. They’re a typical signal estrogen has dropped and may occur a number of occasions per day or just a few occasions per thirty days, per the American College of Obstetricians and Gynecologists (ACOG). They usually’re hardly a minor inconvenience: Sizzling flashes could make each day actions uncomfortable and severely intrude with sleep (once they occur at night time, they’re also known as night sweats).

“On common, sufferers get sizzling flashes for seven to 10 years,” says Dr. Patil. “That’s a very long time to attend it out to really feel higher.”

So do not low cost your physician’s help on the subject of sizzling flashes and some other signs. Dr. Patil usually recommends life-style methods to ease hot flashes, sure drugs, and/or cognitive behavioral remedy (CBT), which has been proven to make sizzling flashes extra tolerable, in response to a September 2021 examine within the British Journal of Health Psychology².

“Not all menopause signs need to be extreme to warrant therapy.”—Rajita Patil, MD, OB/GYN

Delusion: Hormone substitute remedy is harmful

Lots of the specialists we spoke to mentioned probably the most pervasive misconceptions about menopause they hear is that hormone substitute remedy (HRT)—a sort of remedy that replaces misplaced estrogen and doubtlessly additionally progestin—is inherently dangerous and needs to be prevented.

Whereas HRT is not proper for everybody and there are considerations about long-term use (particularly in folks older than 60), HRT is usually a secure and efficient manner to enhance your high quality of life, so it is actually value asking your physician about for those who’re coping with uncomfortable signs.

“Fears surrounding hormone substitute remedy can maintain sufferers again from therapy and aid,” says Banafsheh Bayati, MD, an OB/GYN in Santa Monica, California, and the medical co-founder of Perelel.

For folks at low-risk (that’s, those that do not have sure underlying well being circumstances), HRT can supply an a variety of benefits. It is probably the greatest remedies obtainable to ease sizzling flashes and night time sweats and enhance vaginal dryness. Systemic estrogen remedy (a better dose of estrogen within the type of a capsule, pores and skin patch, gel, ring, cream, or spray) has additionally been discovered to assist shield in opposition to bone loss, which might occur to some folks throughout menopause, in response to ACOG.

The aim is not to make use of HRT without end, although. Lengthy-term use is the place the dangers can usually enhance. Individuals who take HRT for greater than 10 years (or begin it after age 60) are at a higher danger for growing circumstances like coronary heart illness, breast most cancers, stroke, and blood clots, per the Mayo Clinic.

“Ideally, it is best to make use of HRT for the shortest period of time on the lowest dose beneath the steering of a menopausal specialist,” says Sherry Ross, MD, an OB/GYN, girls’s sexual well being skilled and writer of the books She-ology and She-ology: The She-quel. Collectively, you and your physician can focus on whether or not any type of HRT is smart to attempt.

Delusion: Hormones are your solely therapy choice

Whereas the dangers and advantages of HRT are sometimes misunderstood, folks in menopause must also know that different therapy choices exist in the event that they want to go a special route. That is particularly necessary information for many who should not take HRT—like anybody with a private or robust household historical past of breast, ovarian, or endometrial most cancers, says Dr. Ross.

“There are numerous different medical remedies [for menopause], and a few don’t even contain remedy,” says Dr. Patil. “There are different choices on the market.”

That may embody antidepressants or elective estrogen receptor modulators (SERMs), each of which might enhance sizzling flashes. Different drugs supply advantages for warm flashes and insomnia, just like the anti-seizure remedy Gabapentin and the blood strain remedy Clonidine, in response to ACOG.

And do not underestimate the ability of discuss remedy. CBT “has been discovered to be extraordinarily useful for folks going by menopause,” says Dr. Patil. As talked about above, the British Journal of Well being Psychology discovered CBT helpful to ease sizzling flashes, and likewise depression symptoms related to menopause. The North American Menopause Society additionally recommends it as an efficient non-hormone therapy.

If you happen to need assistance finding a therapist that makes a speciality of menopause, ask your OB/GYN for a referral, or search on-line for top-rated menopause specialists in your space.

Delusion: “Pure” hormone remedy is superior

Based on specialists, there is a harmful perception that hormones derived from plant merchandise—known as compounded bioidentical estrogen and progesterone hormones—are safer or higher than conventional HRT,  as a result of they’re marketed as being extra “pure.” However this isn’t true.

Compounded hormone remedy is combined and bought at compounding pharmacies, which normally promote different natural and pure drugs. “There’s this notion that it is more practical than what’s supplied at retail pharmacies, or that it is being ‘personalized’ for them,” says Dr. Patil. “However this can be a very unsupported declare.”

In actual fact, compounded hormone remedy may very well be riskier than conventional HRT. That is as a result of the U.S. Meals and Drug Administration (FDA) doesn’t oversee the purity of compounded biodientical hormones prefer it does with conventional HRT, that means, we do not know precisely what’s in them. Because of this, ACOG solely recommends FDA-approved HRT, not compounded therapies.

Bioidentical hormone therapies additionally have not been examined in scientific trials in the identical manner conventional HRT has, provides Dr. Ross. “They’re marketed as being extra pure, safer, and higher in your physique, however no medical research help these claims,” she says.

What’s extra, these so-called “pure” hormones are typically dearer. “Most individuals [buying bioidentical hormone therapies] don’t even know there’s FDA-regulated HRT at conventional pharmacies that is manner cheaper than what they’re paying for,” says Dr. Patil.

With conventional HRT, “we all know precisely what’s stepping into them, and that they are secure and efficient,” she provides.

Delusion: Your intercourse drive will disappear when you enter menopause

Sadly, there is a little bit of reality to this one. Plummeting estrogen and testosterone ranges can have an effect on your sexual want. And decrease ranges of estrogen, particularly, may cause vaginal dryness, which might contribute to uncomfortable or painful sex. This can be a widespread menopause symptom, as a Could 2017 survey within the Journal of Sexual Medicine identified. It discovered that of the greater than 2,000 Australian girls ages 45 to 60 surveyed, over 69 had low sexual want.

And it is smart, seeing that “girls are being bombarded with bodily and emotional signs that instantly have an effect on their temper within the bed room,” says Dr. Ross.

A serious reason behind this low libido is vaginal dryness—medically generally known as genitourinary syndrome of menopause (GSM)—which may be significantly irritating. Based on Dr. Ross, GSM may cause different signs throughout perimenopause and menopause, together with the next:

• Burning and irritation throughout intercourse
• Lack of lubrication
• Discomfort or ache with intercourse
• Urinary ache or urgency

Regardless of these signs affecting on a regular basis life, menopausal individuals are typically hesitant (and even embarrassed) to carry them up in a medical setting. In actual fact, an older August 2009 examine in Maturitas discovered that solely about 25 p.c of girls with GSM signs talked about them to their physician.

However “these aren’t adjustments you merely have to simply accept,” says Dr. Ross. “Vaginal dryness doesn’t need to break a sexual relationship together with your companion.”

Drugs like HRT might help enhance vaginal dryness and painful intercourse, for instance, as can non-medicinal methods like vaginal dilators and lubricants. Vibrators may make orgasms simpler to realize throughout menopause. “Some, or all, of those therapy choices will enhance a lady’s intercourse drive,” says Dr. Ross.

“Vaginal dryness isn’t a change you merely have to simply accept. It doesn’t need to break a sexual relationship together with your companion.” —Sherry Ross, MD, OB/GYN

Delusion: You may’t get pregnant when you enter perimenopause

The transition to menopause is a gradual one. Within the years main as much as it (a part known as perimenopause), your estrogen ranges begin to fluctuate and your menstrual cycle begins to decelerate, per ACOG. Throughout this time, it is regular to often have shorter or longer periods, or miss a interval altogether some months. As soon as you’ve got missed 12 consecutive durations, you are formally “in menopause,” in response to The North American Menopause Society.

This era irregularity might trigger folks to mistakenly assume their childbearing years are behind them, and with it, their danger of unintentional being pregnant. However it’s nonetheless attainable to get pregnant throughout perimenopause, even when your durations are irregular, says Kelly Culwell, MD, an OB/GYN, girls’s well being skilled, and former medical officer for the World Well being Group.

“Some of the widespread age teams for unintended pregnancies are girls of their 40s, actually because they’re nonetheless ovulating, even when not each month,” she says.

That is why, for those who do not want to get pregnant, contraception ought to stay a precedence throughout this time, says Taniqua Miller, MD, an OB/GYN, empowerment coach, and midlife and menopause skilled in Atlanta, Georgia. “There can be occasions in the course of the transition [to menopause] when ovulation does happen,” she says. “The typical time to menopause is 4 years, so contraception is a should for these eager to keep away from being pregnant.”

You may nonetheless use hormonal contraception at this stage—together with mixed hormone choices which have each estrogen and progestin, just like the capsule, patch, or ring, in response to Dr. Miller. In actual fact, the Facilities for Illness Management and Prevention’s U.S. Medical Eligibility Criteria for Contraceptive Use clears the usage of mixed hormonal contraception as much as age 55.

If you happen to’re uncertain about the kind of contraception that is finest for you—hormonal or non-hormonal—attain out to your OB/GYN. They might help you make an knowledgeable choice about what’s finest in your physique and tackle any considerations you may have.

The underside line

As a result of menopause is still largely misunderstood, folks going by it typically really feel embarrassed or disempowered to carry signs as much as their physician, and even speak about it with buddies and family members. However menopause is a traditional a part of life, and there are remedies on the market that present aid.

Some of the necessary issues you are able to do for your self throughout this time is to discover a supportive, caring, and educated OB/GYN or menopause specialist that you just belief. Speak in confidence to them about your signs, even when they do not appear critical, and ask for assist with ones which can be bothering you.

Finally, regardless of the misconceptions, life can nonetheless really feel enjoyable, wholesome, and fulfilling throughout menopause.