Menopause Myths Doctors Want You to Stop Believing

Menopause—and the years main as much as it—can include some fairly irritating signs. Nevertheless 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 effectively understood.

In actual fact, a July 2023 on-line survey carried out within the U.Ok. and reported in BMC Women’s Health discovered solely 47 % of respondents at varied phases of menopause felt like that they had the information to handle their signs.

It is on this lack of understanding that menopause myths are sometimes fashioned. Beneath, specialists share six misconceptions they usually hear about this life stage, plus the details to know as an alternative.

Fantasy: Solely extreme menopause signs require therapy

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

Irrespective of the severity, many individuals with bodily menopause signs do not all the time really feel empowered to hunt therapy. In keeping with the identical BMC Ladies’s Well being survey, 39 % of respondents did not attain out to a physician for assist with their signs, partly as a result of they did not suppose menopause was a legitimate sufficient cause 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 occasions per day or only some occasions 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 severely intervene with sleep (once they occur at night time, they’re also known as 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 in the case of scorching flashes and another signs. Dr. Patil usually recommends way of life methods to ease hot flashes, sure medicines, and/or cognitive behavioral remedy (CBT), which has been proven to make scorching flashes extra tolerable, in keeping with 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

Fantasy: Hormone substitute remedy is harmful

Most of the specialists we spoke to mentioned one of the crucial pervasive misconceptions about menopause they hear is that hormone substitute remedy (HRT)—a kind of medicine that replaces misplaced estrogen and probably additionally progestin—is inherently dangerous and needs to be averted.

Whereas HRT is not proper for everybody and there are considerations about long-term use (particularly in folks older than 60), HRT generally is a protected and efficient manner 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 substitute 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 folks at low-risk (that’s, those that haven’t got sure underlying well being situations), HRT can provide an a variety of benefits. It is top-of-the-line therapies obtainable 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 tablet, pores and skin patch, gel, ring, cream, or spray) has additionally been discovered to assist defend in opposition to bone loss, which might occur to some folks throughout menopause, in keeping with ACOG.

The objective is not to make use of HRT endlessly, although. Lengthy-term use is the place the dangers can usually improve. Individuals who take HRT for greater than 10 years (or begin it after age 60) are at a larger threat for creating 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 steerage of a menopausal specialist,” says Sherry Ross, MD, an OB/GYN, girls’s sexual well being knowledgeable and writer 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, folks in menopause also needs to know that different therapy choices exist in the event that they want to go a unique route. That is particularly necessary 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 numerous 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 might enhance scorching flashes. Different medicines provide advantages for decent flashes and insomnia, just like the anti-seizure medicine Gabapentin and the blood stress medicine Clonidine, in keeping with 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 scorching 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 focuses on 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

In keeping with specialists, there is a harmful perception that hormones derived from plant merchandise—referred to 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 bought at compounding pharmacies, which normally promote different natural and pure medicines. “There’s this notion that it is more practical than what’s provided 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, which 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 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 usually costlier. “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 getting in them, and that they are protected and efficient,” she provides.

Fantasy: Your intercourse drive will disappear when you enter menopause

Sadly, there is a little bit of fact to this one. Plummeting estrogen and testosterone ranges can have an effect on your sexual need. And decrease ranges of estrogen, specifically, could cause vaginal dryness, which might 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 girls ages 45 to 60 surveyed, over 69 had low sexual need.

And it is sensible, seeing that “girls are being bombarded with bodily and emotional signs that immediately 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 could be significantly irritating. In keeping with 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. In actual fact, an older August 2009 examine in Maturitas discovered that solely about 25 % of girls with GSM signs talked about them to their physician.

However “these aren’t modifications you merely have to just accept,” says Dr. Ross. “Vaginal dryness doesn’t need to break a sexual relationship along with your associate.”

Medicines like HRT will help enhance vaginal dryness and painful intercourse, for instance, as can non-medicinal methods like vaginal dilators and lubricants. Vibrators also can 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 will not be a change you merely have to just accept. It doesn’t need to break a sexual relationship along 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 referred to 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 keeping with The North American Menopause Society.

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

“One of the vital frequent 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, 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 knowledgeable in Atlanta, Georgia. “There shall be occasions in the course of the transition [to menopause] when ovulation does happen,” she says. “The common 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 tablet, patch, or ring, in keeping with 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 greatest for you—hormonal or non-hormonal—attain out to your OB/GYN. They will help you make an knowledgeable resolution about what’s greatest in your physique and deal with any considerations you’ve got.

The underside line

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

One of the vital 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 severe, and ask for assist with ones which might be bothering you.

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