Menopause affects more than half the population, but many people don’t know much about it.
In one survey of postmenopausal women, 94 percent said they hadn’t learned about menopause at school, and 49 percent didn’t feel informed about it at all.
To make matters worse, myths and misconceptions permeate the internet and social circles — where many women turn for information — while stigma and shame often shroud the topic in silence.
“Often, women enter perimenopause and menopause without a clear understanding of what’s happening in their bodies,” says Corinne Bazella, MD, an ob-gyn and assistant professor at Case Western Reserve University in Cleveland. “This lack of knowledge can lead to confusion, anxiety, and missed chances to get relief or prevent long-term health problems.”
To clear up some of these common misconceptions, here is the truth behind six common menopause myths, to help you feel more empowered and prepared.
Myth: Menopause Only Affects Women in Their Fifties
Menopause is the point at which your periods have stopped for good, and it’s been at least 12 consecutive months since your last cycle.
“Because the average age for the last menstrual period in U.S. women is 51, most people assume that is when symptoms begin,” says
Sameena Rahman, MD, an ob-gyn and founder of GSM Collective, a medical concierge service in Chicago.
However, perimenopause, the transitional phase before menopause, may start between your mid-thirties to mid-fifties. Most women experience symptoms during this period, which can last up to eight years.
Additionally, about 5 percent of women experience menopause early (before age 45) and about 1 percent experience premature menopause (before age 40).
Sometimes surgery (such as a hysterectomy or oophorectomy) can cause premature or
early menopause, but it can also happen with no explanation.
Having autoimmune diseases, smoking, having received cancer treatment, or having a family history of early menopause can also increase the risk of early menopause. “Women of color are more likely to experience menopause earlier,” Dr. Rahman adds, noting that Black, Latina, and South Asian women often also experience more significant, prolonged symptoms.
And menopause symptoms don’t stop after the transition. Rather, they can persist for months or years during the postmenopausal period (the rest of your life).
“The duration, type and severity of symptoms vary widely,” says
Robin Noble, MD, a gynecologist and the chief medical officer at Let’s Talk Menopause, a national menopause nonprofit, based in Portland, Maine. “Some people have almost none and others can have intensely bothersome symptoms for 20 years or more.”
Myth: You Can’t Get Pregnant During Perimenopause
It’s a common misconception that you can’t get pregnant during perimenopause, says
Deepali Kothary, MD, an ob-gyn at Kaiser Permanente in Burke, Virginia. In fact, while your fertility declines during this time, your ovaries can still release eggs until you’ve gone 12 consecutive months without a period.
“That means pregnancy is still possible, even if your cycles are irregular,” she says.
If you’re not planning a pregnancy, Dr. Kothary recommends continuing to use birth control until your ob-gyn confirms that you’ve reached menopause. “And if you are trying to conceive, your doctor can evaluate your hormone levels and discuss options to support a healthy pregnancy later in life,” she says.
Myth: It’s Just Hot Flashes and Night Sweats
Hot flashes and night sweats are just two of more than 30 potential menopause symptoms, which range from anxiety and insomnia to headaches and heart palpitations.
“Many women also notice
sleep problems, mood swings, brain fog, weight gain, hair and skin changes, bone changes, bladder problems, decreased libido, and vaginal dryness,” Kothary says.
For example, research suggests that between 40 to 56 percent of women have sleep issues.
And about 44 to 62 percent report problems with memory or cognition.
“Menopause is a natural milestone, but the journey looks different for everyone,” Kothary says, noting that it can significantly impact various facets of health, well-being, and life in general.
If your symptoms are bothering you, talk to your ob-gyn to tailor a treatment plan that may involve lifestyle changes and medical interventions.
Myth: Menopausal Hormone Therapy Is Dangerous
Menopausal hormone therapy (MHT) involves taking estrogen, progesterone, or a combination of both.
Mixed messages about MHT’s safety exemplify health science’s constant evolution, where new knowledge often challenges existing beliefs, Dr. Bazella says.
“Science isn’t black and white; it’s full of gray areas where more study is needed,” Bazella says. “That’s why something seen as a myth today might have been considered new knowledge in the past — it’s all part of the process of learning and discovery.”
In 2002, a study by the Women’s Health Initiative suggested that the use of combination (estrogen and progestin) MHT increased the risk of heart disease and breast cancer. The study had many flaws, according to Mayo Clinic, including that it looked at older women who had not recently entered menopause, and who used a form of estrogen that’s not the norm in more modern treatments.
“In reevaluating this study, looking at patient ages when MHT was initiated and the hormone formulation used, we now understand that MHT’s risks and benefits depend heavily on timing of initiation, individual health profile, and the therapy formulation,” Bazella says.
Based on subsequent research, experts now consider MHT to be a safe, effective way for healthy women under age 60 or within 10 years of menopause onset to manage certain symptoms, including hot flashes and night sweats.
“It may also help prevent bone loss and improve quality of life,” Bazella says. “The key is choosing the right formulation, dose, and route of administration, based on each woman’s risk factors.”
The U.S. Food and Drug Administration has approved several MHT products, including systemic (full-body) and localized options (for issues like vaginal dryness).
However, MHT may not be safe for all women, including those who have a history of certain cancers, those who’ve had a stroke or heart attack, and those with liver disease or a history of blood clots.
“I routinely recommend MHT — but not universally,” Bazella says. “It isn’t a one-size-fits-all solution ... but with thoughtful evaluation, realistic expectations, and ongoing monitoring, it can be a powerful tool.”
If you have questions about MHT, Bazella recommends talking to your doctor, so that you can make a shared, informed decision based on your specific situation.
Myth: Hormone Therapy Is the Only Way to Manage Symptoms
If you’re not a candidate for MHT or feel that it isn’t right for you, there are plenty of other ways to find relief. “We can tailor the approach to the person’s symptoms, medical issues, goals, preferences, and philosophy,” Dr. Noble says.
Examples of other treatments include the following:
- Nonhormonal medications, such as fezolinetant (Veozah), elinzanetant (Lynkuet); antidepressants, gabapentin, and oxybutynin.
- Cognitive behavioral therapy, which may help with symptoms such as mood changes, sleep disturbances, and the impact of hot flashes and night sweats on quality of life.
- Vaginal treatments, including nonhormonal lubricants and moisturizers to relieve dryness and discomfort.
- Acupuncture and integrative therapies, which may offer symptom relief for some women, especially when combined with other approaches.
Additionally, Bazella says that a healthy lifestyle — including regular exercise, a balanced diet, stress reduction, not smoking, and good sleep hygiene — is crucial, even if these habits may not directly reduce symptoms. “All menopausal therapies should be in addition to these basics of health promotion,” she says.
Myth: There’s No (Good) Sex After Menopause
Hormonal changes can make intimacy feel different, but you can still have a vibrant sex life during and after menopause, Kothary says.
“As estrogen levels drop, some women experience vaginal dryness or discomfort that can make sex less enjoyable,” Kothary says. “The good news is that these symptoms are highly treatable with moisturizers, lubricants, and low-dose vaginal estrogen that restore comfort and elasticity.”
Rahman also suggests looking at additional factors — including medications, underlying health conditions, and stress — that may be affecting your sex life and relationships. “For example, treating depression and anxiety can help your sexual function, but some treatments, like selective serotonin reuptake inhibitors, can make it worse [by lowering libido], so it is important to understand all of this and get help from a sexual medicine expert.”
Open communication with your partner is also essential, Rahman says, noting that sex therapy can be a helpful tool. “Menopause can definitely [affect intimacy], but it is also a time for redefining your life and asking for what you want,” she says.
The Takeaway
- Menopause is a natural transition that usually begins in midlife as the ovaries stop producing reproductive hormones, such as estrogen and progesterone.
- Everyone’s experience is different, but many women experience an array of symptoms, such as hot flashes, night sweats, vaginal dryness, and sleep difficulties.
- If symptoms are bothering you, talk to your healthcare provider about your options, which may include a combination of lifestyle changes, medical treatments, and complementary interventions such as therapy or acupuncture.
