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 even if a million individuals are going by way of it at any given time, per the National Institute on Aging), menopause nonetheless is not nicely understood.

Actually, a July 2023 on-line survey performed within the U.Okay. and reported in BMC Women’s Health discovered solely 47 p.c of respondents at varied levels of menopause felt like that they had the data to handle their signs.

It is on this lack of awareness that menopause myths are sometimes fashioned. Under, specialists share six misconceptions they usually hear about this life stage, plus the details to know as a substitute.

Fantasy: 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 will be gentle for some individuals however downright debilitating for others.

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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 Girls’s Well being survey, 39 p.c of respondents did not attain out to a health care provider for assist with their signs, partly 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 scorching flashes, for instance. They’re a typical signal estrogen has dropped and might occur a number of instances per day or only some instances per thirty days, per the American College of Obstetricians and Gynecologists (ACOG). And so they’re hardly a minor inconvenience: Sizzling flashes could make every day actions uncomfortable and significantly intrude with sleep (once they occur at night time, they’re sometimes called night sweats).

“On common, sufferers get scorching 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 with regards to scorching flashes and some other signs. Dr. Patil sometimes recommends life-style methods to ease hot flashes, sure drugs, and/or cognitive behavioral remedy (CBT), which has been proven to make scorching flashes extra tolerable, in accordance with a September 2021 research within the British Journal of Health Psychology².

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

Fantasy: Hormone alternative remedy is harmful

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

Whereas HRT is not proper for everybody and there are issues about long-term use (particularly in individuals older than 60), HRT is usually a secure and efficient approach to enhance your high quality of life, so it is definitely value asking your physician about when you’re coping with uncomfortable signs.

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

For individuals at low-risk (that’s, those that do not have sure underlying well being situations), HRT can provide an a variety of benefits. It is top-of-the-line therapies accessible to ease scorching 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 defend in opposition to bone loss, which may occur to some individuals throughout menopause, in accordance with ACOG.

The objective is not to make use of HRT eternally, although. Lengthy-term use is the place the dangers can sometimes improve. Individuals who take HRT for greater than 10 years (or begin it after age 60) are at a larger threat for growing situations 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 underneath the steering of a menopausal specialist,” says Sherry Ross, MD, an OB/GYN, ladies’s sexual well being professional and creator of the books She-ology and She-ology: The She-quel. Collectively, you and your physician can talk about whether or not any type of HRT is sensible to attempt.

Fantasy: Hormones are your solely therapy possibility

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

“There are lots of different medical therapies [for menopause], and a few don’t even contain medicine,” says Dr. Patil. “There are different choices on the market.”

That may embrace antidepressants or elective estrogen receptor modulators (SERMs), each of which may enhance scorching flashes. Different drugs provide advantages for decent flashes and insomnia, just like the anti-seizure medicine Gabapentin and the blood stress medicine Clonidine, in accordance with ACOG.

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

In case you 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.

Fantasy: “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 blended and offered at compounding pharmacies, which often promote different natural and pure drugs. “There’s this notion that it is more practical than what’s provided at retail pharmacies, or that it is being ‘custom-made’ for them,” says Dr. Patil. “However this can be a very unsupported declare.”

Actually, 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. For that reason, ACOG solely recommends FDA-approved HRT, not compounded therapies.

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

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

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

Fantasy: 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, could cause vaginal dryness, which may contribute to uncomfortable or painful sex. It is a frequent menopause symptom, as a Might 2017 survey within the Journal of Sexual Medicine identified. It discovered that of the greater than 2,000 Australian ladies ages 45 to 60 surveyed, over 69 had low sexual want.

And it is sensible, seeing that “ladies 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 for this low libido is vaginal dryness—medically often known as genitourinary syndrome of menopause (GSM)—which will be significantly irritating. Based on Dr. Ross, GSM could 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 usually hesitant (and even embarrassed) to deliver them up in a medical setting. Actually, an older August 2009 research 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 just accept,” says Dr. Ross. “Vaginal dryness doesn’t need to destroy a sexual relationship together with your associate.”

Medicines like HRT may 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 attain throughout menopause. “Some, or all, of those therapy choices will enhance a girl’s intercourse drive,” says Dr. Ross.

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

Fantasy: 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 accordance with The North American Menopause Society.

This era irregularity could trigger individuals to mistakenly assume their childbearing years are behind them, and with it, their threat of unintended being pregnant. However it’s nonetheless doable to get pregnant throughout perimenopause, even when your durations are irregular, says Kelly Culwell, MD, an OB/GYN, ladies’s well being professional, and former medical officer for the World Well being Group.

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

That is why, when you 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 professional in Atlanta, Georgia. “There can be instances 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 desirous 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 accordance with Dr. Miller. Actually, 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.

In case you’re uncertain about the kind of contraception that is greatest for you—hormonal or non-hormonal—attain out to your OB/GYN. They may help you make an knowledgeable resolution about what’s greatest on your physique and deal with any issues you’ve.

The underside line

As a result of menopause is still largely misunderstood, individuals going by way of it usually really feel embarrassed or disempowered to deliver signs as much as their physician, and even speak about it with pals and family members. However menopause is a standard a part of life, and there are therapies on the market that present reduction.

One of the essential 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. Confide in them about your signs, even when they do not appear critical, and ask for assist with ones which are bothering you.

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

—medically reviewed by Andrea Braden, MD, OB/GYN