DEBUNKING MENOPAUSE MYTHS: WHAT’S TRUE AND WHAT’S NOT

Many women approach menopause with anxiety, having heard family members lament about “the change” as a stressful time full of hot flashes, weight gain, and decreased sex drive.

These life changes due to menopause and its precursor, perimenopause, can indeed disrupt sleep, relationships, and overall health during a woman’s prime years.

Unfortunately, myths and misconceptions about what’s normal and how to safely manage symptoms like night sweats and mood changes abound.

The good news is that menopause is currently receiving increased awareness, with more resources dedicated to women’s health and open discussions ensuring women get the information they need.

Today, there are more options than ever for treating disruptive menopause symptoms. With the right self-care and planning with a doctor, women can lead healthy, energetic lives well into their 60s, 70s, and beyond.

Given the average life expectancy of a woman is around 80.2 years, many will spend approximately half their lives post-menopausal. It’s time society takes women’s health care in menopause more seriously, reducing stigma and raising awareness of treatment options.

Myth: Menopause Means You Are Getting Old

Perimenopause and menopause are natural stages of aging, but they do not mean you are becoming frail or fragile.

Perimenopause is the period of eight to ten years leading up to menopause. For most women, this begins in their 40s, but it can start as early as the late 20s or 30s in some cases. During perimenopause:

1. Estrogen production begins to fluctuate. This hormone regulates the menstrual cycle and affects bones, breasts, heart, pelvic muscles, and more. Low estrogen levels can cause body alterations such as weakening bones, thinning skin, wrinkles, and mood changes. Fluctuations from high to low levels can produce night sweats and hot flashes.

2. Ovary function gradually slows down. The ovarian follicles—small, fluid-filled sacs in the ovaries, each containing an egg—lose function and stop releasing eggs. This means no more periods.

Menopause is defined as the cessation of menstrual periods for at least 12 months, most commonly occurring between the ages of 45 and 55.

Myth: Hormone Therapy is Unsafe

Hormone therapy, when administered under the care of a board-certified women’s health provider, is one of the safest and most effective treatments for a wide range of menopause symptoms, including:

– Hot flashes

– Mood changes

– Vaginal dryness

– Bone loss (osteoporosis)

– Urinary incontinence

– Weight gain and slowed metabolism

– Night sweats

– Chills

– Insomnia

– Thinning hair and dry skin

– Changes in libido

Research shows that hormone therapy can increase lifespan, reduce the risk of colon cancer and diabetes, alleviate vaginal dryness and hot flashes, and lower the risk of osteoporosis.

Estrogen plays a crucial role in promoting the growth of beneficial bacteria in the vagina. Without sufficient estrogen, the vaginal pH increases, leading to inflammation and bacterial overgrowth, which can raise the risk of urinary tract infections (UTIs) and bacterial vaginosis.

However, be cautious of med spas and standalone, self-proclaimed hormone clinics. These providers may not have access to safe, personalized medications approved by the U.S. Food and Drug Administration (FDA).

While hormone therapy is not a fountain of youth, it can significantly alleviate menopause symptoms. Typically, hormone therapy involves either estrogen alone or a combination of estrogen and progesterone, and in some cases, testosterone. There are two primary ways to administer hormone therapy:

1. Systemic Hormone Therapy: This type circulates hormones throughout the body and can be administered as pills, skin patches, gels, or sprays.

2. Vaginal Hormone Therapy: This type is applied directly to vaginal tissues to relieve dryness, itching, and discomfort during sex. It can also help with urinary urgency and reduce the risk of urinary tract infections. It can be administered as a cream, tablet, ring, or suppository.

Typicall recommended systemic hormone therapy for women who are perimenopausal or within 10 years of the onset of menopause is recommended. Certain risk factors associated with hormone therapy, such as an elevated chance of stroke, are higher in women over age 60. However, vaginal hormone therapy is safe to use at any age and offers many benefits.

Menopause and hormonal therapy are not one-size-fits-all solutions. Hormone therapy is a safe and effective option for most women. Depending on a woman’s preexisting conditions, family history, and the type of treatment, hormone therapy can carry a slightly higher risk of:

– Blood clots, particularly with oral estrogen.

– Breast cancer, influenced by factors such as breast density, family history, alcohol use, smoking history, and lifestyle. In some cases, a specific type of estrogen can decrease breast cancer risk.

– Stroke, which is also highly dependent on personal health history and lifestyle.

Myth: Hot Flashes and Moodiness Are Unavoidable

It’s a common misconception that you have to “just live with” uncomfortable symptoms like poor sleep, low libido, or emotional changes during menopause. Many symptoms can be effectively treated and managed with the help of your healthcare provider. Here’s a look at some of the most frequent concerns and proven methods to address them:

Hot Flashes and Night Sweats: Hot flashes are a hallmark symptom of menopause and perimenopause. They involve a sudden sensation of warmth and sweating, often affecting the face, chest, and neck. Approximately 75% of women experience hot flashes during perimenopause.

When these episodes occur at night, they are known as night sweats. This excessive sweating can soak your nightclothes and bedding, leading to disrupted sleep and subsequent daytime irritability and fatigue.

Hot flashes are thought to result from low estrogen levels affecting the hypothalamus, the part of the brain that regulates temperature. They can happen spontaneously and last from a few seconds to several minutes.

To manage hot flashes and night sweats, lifestyle adjustments such as avoiding alcohol and maintaining a healthy weight can be helpful. Hormone therapy, which may include estrogen, progesterone, and/or testosterone, is a highly effective treatment available in various forms, including pills, gels, patches, and sprays. For those seeking a non-hormonal option, the FDA-approved selective serotonin reuptake inhibitor (SSRI) paroxetine can also be prescribed. This medication, commonly used for depression, lowers central body temperature and reduces blood flow to the skin.

Vaginal Dryness and Low Libido: Declining estrogen levels can lead to reduced moisture in the vaginal area, causing discomfort, itching, irritation, and pain during intercourse. This can also contribute to a decrease in libido (sex drive), which may affect relationships and self-esteem.

Sexual desire is an important aspect of many women’s lives and can be influenced by a combination of biological, emotional, and social factors. While hormone replacement therapy can help restore some sexual desire, it’s not a guaranteed solution. Libido is complex and often affected by emotional challenges, changes in body image, and other life stressors. Your partner’s experiences and mood changes may also play a role.

If hormone therapy and lifestyle changes don’t fully address libido issues, exploring additional support through cognitive behavioral therapy (CBT) or other therapeutic options may be beneficial. Your healthcare provider can refer you to specialists in psychiatry and psychology to further explore these avenues.

Urinary Urgency and Incontinence

Urinary urgency is characterized by a sudden, intense need to urinate, which can sometimes lead to leakage, known as urge urinary incontinence. This condition is often caused by changes in the pelvic floor muscles and tissues during menopause.

Fortunately, there are several effective treatments for urinary urgency and incontinence:

1.Pessary: This device is inserted into the vagina to provide support to the bladder and alleviate symptoms of urinary incontinence.

2.Medication: Anticholinergics and beta-3 agonists can help reduce bladder spasms and manage urinary urgency.

3.Pelvic Floor Physical Therapy: This involves exercises and techniques designed to strengthen the muscles that support the bladder, improving overall bladder control.

4.Bulking Agents: Injections of collagen or water-based gels can narrow the urethra to reduce leakage.

5.Surgery: Surgical options are available to support the bladder and/or urethra, offering a more permanent solution for severe cases.

These treatments can help manage and alleviate symptoms, improving quality of life for those affected.

Mood Changes and Sleep Disruption

Insomnia, characterized by difficulty falling asleep or staying asleep, is a significant factor contributing to various mood and health issues throughout life. Chronic sleep deprivation can elevate your risk of developing heart problems, obesity, diabetes, and other serious conditions.

During menopause, hormonal changes and conditions such as chronic obstructive sleep apnea (OSA)—a disorder where breathing repeatedly stops and starts during sleep—can exacerbate insomnia. Additionally, night sweats can further disrupt sleep.

Just as PMS or emotional swings during pregnancy affect mood, perimenopause and menopause can lead to similar fluctuations. It’s common to experience rapid mood changes, from irritability to emotional outbursts to happiness, during this time.

To manage insomnia, treatments such as cognitive behavioral therapy (CBT) can help alter sleep-related thought patterns and behaviors. For those with sleep apnea, continuous positive airway pressure (CPAP) therapy can offer significant relief. Hormone therapy may also help by addressing menopause-related symptoms and hormonal imbalances, thus improving sleep quality and overall well-being.

If you encounter symptoms requiring urgent attention, such as vaginal bleeding after a long period without menstruation or thoughts of self-harm, contact your healthcare provider immediately. These could be signs of a serious health issue that needs prompt medical evaluation.

Myth: Menopause Leads to Muscle Loss and Weight Gain

As we age, it’s natural to experience sarcopenia, or the gradual loss of muscle mass. However, reaching your 50s and beyond doesn’t mean you have to accept becoming soft or weak.

You don’t need to be a fitness enthusiast to reap the benefits of exercise during menopause. Simple activities like yoga, Pilates, or following a stretching video on YouTube can be highly effective. Incorporating ankle weights during walks or using resistance bands for quick workouts can make a significant difference. Research shows that regular physical activity can help prevent dementia, alleviate pain, and reduce cardiovascular disease risk.

Nutrition also plays a vital role. Maintaining a balanced diet that includes lean proteins, fruits, vegetables, and whole grains supports muscle health and overall vitality. Staying hydrated is equally important, as it helps maintain muscle function and joint mobility. When combined with regular exercise, a nutritious diet can help mitigate sarcopenia and promote a healthy, active lifestyle.

Focusing on exercise and nutrition in your 40s, as you enter perimenopause and menopause, sets a strong foundation for preserving muscle mass, mobility, and agility in later years.

Embrace Menopause with Confidence

Menopause doesn’t have to be a time of fear. With the right treatment and care, women can live vibrant, active lives. Personalized care and breaking down myths can transform the narrative around menopause from anxiety to empowerment, ensuring women thrive through all stages of life.