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8 Myths About Menopause We Can All Stop Believing Right Now

Eva Selhub, M.D.
By Eva Selhub, M.D.
Dr. Eva Selhub is a resiliency expert, physician, author, speaker, scientist, and consultant. She studied medicine at Boston University and is board certified in Internal Medicine.
Photo by Jonathan Caramanus

I’ve been in practice as a doctor for over 20 years, and I can tell you this: No two women are alike, and no two women will experience menopause in the same way. Interestingly, in my experience, women tended to fall into two camps: One group is looking forward to menopause since their "mom breezed right through it" and they're tired of getting their periods. The second group is dreading it, believing they will suffer; these same people often fear the whole aging process altogether.

The truth of the matter is that menopause is experienced differently by each woman, and it really doesn’t need to be a bad or scary thing. In fact, menopause can be a time of liberation and opportunity to be healthy, fearless, and happy. So let’s look at what is fact, what is fiction, and discover ways you, too, can look forward to aging happily.

Myth 1: Menopause only happens when you're 50 years old.

Menopause happens at whatever age ovarian function starts to wane. The average age of menopause is about 51; however, many women experience the change in their 40s, while others go through it in their late 50s. Often, you can gauge when you may go through menopause according to your mother or grandmother, as it seems to be hereditary. Menopause is official when periods cease for one year, and early menopause may happen because of smoking, chemotherapy, radiation therapy, or surgical removal of the ovaries.

Myth 2: It doesn't take very long; it just happens.

Actually, it can take quite a bit of time for menopause to happen. In fact, the transition can take years, and during this time periods come and go at irregular intervals, and their consistency is widely varied (heavy or light, for several or few days). During this transition time, the function of the ovaries fluctuates, which leads to fluctuations in the sex hormone levels or estrogen and progesterone. It is this hormone variability that leads to the variability of the periods as well as symptoms like hot flashes, night sweats, vaginal dryness, irritability, and mood changes. In other words, you can experience symptoms of perimenopause for many years before your period actually stops for good.

Myth 3: Everyone will have hot flashes, and all hot flashes are the same.

Though 70 to 75 percent of women do get hot flashes and night sweats, the rest do not. Within this range of women who do experience hot flashes, some experience extremely agitating ones while others experience only minor symptoms.

According to a study published in the journal Menopause in 2016, some women are "early onset" hot flashers who experience these symptoms starting up to 11 years before their last period until shortly after menopause, while others are "late onset" hot flashers that experience the symptoms at the end, near the time of their last period. Of course there are the "lucky few" who never get hot flashes and the "not-so-lucky few" who begin to experience hot flashes early in life.

This study also found that several factors such as race, weight, health habits, and education played a role in these patterns. For instance, heavy alcohol use was associated with experiencing negative symptoms longer, while obesity, depression, and anxiety were associated with an earlier onset of symptoms.

Myth 4: The only symptoms associated with menopause are hot flashes.

During the transition period and in menopause, a wide variety of symptoms can be experienced that may affect quality of life including sleep problems, mood changes, low energy, vaginal dryness, bloating, breast tenderness, joint pain, and irritability. In addition, in some cases, individuals who have pre-existing conditions may find that symptoms related to those conditions worsen. A recent study, for example, showed that women with rheumatoid arthritis suffer a larger decline in physical functioning with menopause. Similar to hot flashes, these symptoms can be influenced by lifestyle factors, weight, smoking, alcohol use, education, and socioeconomic status.

Myth 5: Only hormone replacement therapy can fix menopausal symptoms.

Although hormone replacement therapy can help relieve some of the symptoms of menopause, there are other ways to reduce the frequency and intensity of symptoms. For example, research shows1 that regular exercise can control hot flashes, improve mood and sleep, control weight, and lessen fatigue.

Other ways to reduce symptoms include addressing factors that have been associated with worsening symptoms, like obesity, depression and anxiety, alcohol use, a poor diet, and smoking. Stress reduction techniques, a plant-based diet, and an increased intake of phytoestrogens, more exercise, less alcohol, and working with a therapist are therefore some modalities that can be used to feel better.

There are also several herbs that one can take, though best to check with your doctor to ensure you're taking the type and best dosage for you.

Myth 6: You'll have no sex drive.

It's true that declining sex hormones can cause a shift in libido, but it seems that it is not really all due to hormonal fluctuation. Rather, it is more likely due to mindset (depression, irritability), energy levels, and lifestyle factors (being busy and stressed). If you enjoyed having sex before menopause, it's likely that you will continue to enjoy it. The only drawback may be vaginal dryness that can occur with the drop in estrogen levels, which can lead to painful intercourse. In this case, small doses of estrogen creams and lubricants can fix the problem.

Myth 7: You will gain weight.

Any time hormones fluctuate in your body, your metabolism can be affected, and this means if it slows down, weight gain is possible. Having said that, there is no evidence that menopause actually causes weight gain although researchers have found that due to the drop in estrogen levels, fat storage may shift from the hips and thighs to the abdomen, thus causing many women to gain more belly fat.

With the combination of fat shifting and a slowed metabolism, along with a sedentary lifestyle that many people tend to move toward as they age, the propensity to gain weight may increase. However, when eating healthy and exercising regularly—about 30 minutes a day of moderate aerobic activity five times a week and some weight training—weight gain will not only be avoided, but muscle mass and bone health will improve.

Myth 8: It will be awful; no one escapes it.

As I mentioned previously, this statement really isn’t true. Though some women experience a myriad of symptoms, many women experience little to none. What we do know is that women who tend to take care of themselves better—exercise, eat healthy, keep a positive attitude, meditate, socialize, and so forth—do better, often coasting through menopause happily and effortlessly.

Eva Selhub, M.D. author page.
Eva Selhub, M.D.

Dr. Eva Selhub is an expert in the fields of stress, resilience and mind-body medicine. She studied medicine at Boston University and is board certified in Internal Medicine. She has been a lecturer in medicine at Harvard Medical School, a clinical associate at Massachusetts General Hospital, and was medical director and senior physician at the Benson-Henry Institute for Mind/Body Medicine at the Massachusetts General Hospital. She now runs a private practice as a comprehensive medical specialist and transformation consultant and is the author of Your Health Destiny: How to Unlock Your Natural Ability to Overcome Illness, Feel Better, and Live Longer.