By the time they hit their 40s, most women have experienced it: the menagerie of symptoms that crop up during the march to menopause, which begins after 1 year without a menstrual period. More than one million women in the United States hit this milestone each year. But misconceptions about menopause abound.
“Women get information about menopause online and from their friends and family. Some of it is accurate, but some of it needs tweaking,” says Samantha M. Dunham, MD, co-director at the Center for Midlife Health and Menopause, part of obstetrics and gynecology services at NYU Langone.
It’s the myths about menopause that Dr. Dunham and her colleague and co-director, Laurie S. Jeffers, NP, DNP, are out to dispel. Here are menopause myths they recommend people stop believing—and truths to start passing along.
Myth: There’s No Such Thing as a Menopause Doctor
There are doctors and nurse practitioners who specialize in menopause treatment, and they have the training to prove it. Look for menopause practitioners credentialed by the North American Menopause Society (NAMS). These providers, including those at the Center for Midlife Health and Menopause, have the specialty training to manage menopausal health and the symptoms that affect about 80 percent of women during this pivotal life phase.
“When I first meet with a patient, we look at overall hormonal health and focus on the most bothersome menopause symptoms,” says Jeffers, who, like Dr. Dunham, is a NAMS-credentialed menopause practitioner.
Among those symptoms are hot flashes, difficulty sleeping, diminished sex drive, trouble concentrating, mood changes, anxiety, bladder problems, heart discomfort, physical and mental exhaustion, and vaginal dryness. To best understand how menopause is affecting your entire body, your provider will review your blood pressure and cholesterol along with other risks factors you may have for heart disease or breast cancer and talk with you about your lifestyle and medical history, and may order additional testing, such as bone density testing.
To optimize your health at this stage in life, “follow-up visits are an important part of our commitment to having an ongoing relationship with our patients,” Jeffers says. In-person visits take place at NYU Langone Obstetrics and Gynecology Associates, and video doctor visits are also available.
Myth: Menopause Symptoms Don’t Last Long
“This is one of the biggest myths I hear from patients—they heard that their menopause symptoms would only last about a year, and then everything would go back to normal,” Dr. Dunham says. “The truth is, the course of symptoms is unpredictable and will likely be much longer than a year.”
In fact, studies show menopause symptoms last an average of 7.4 years. “Most women really feel symptomatic for about four years, which if you think about it is as long as you go to high school or college. It’s a substantial chunk of life, at a time when you may be juggling your career with family demands, and perhaps caring for your parents,” Dr. Dunham points out.
Myth: Only Severe Menopause Symptoms Need Treatment
Even if your symptoms are mild to moderate, if they’re bothersome it’s worth seeking out the expertise of a menopause practitioner. “Some of my patients just come in to see me to learn about what’s going on with their bodies at this stage of their lives,” Jeffers says. It can be a good strategy. After all, some menopausal changes, such as a loss of bone mass and early symptoms of heart disease, may only be detected through preventive screenings. “This is a great time to take stock of your health and make important changes,” Jeffers says.
If you experience depression or anxiety, difficulty sleeping, or painful intercourse, which can peak during perimenopause or in the year or two directly following menopause, which generally happens around age 51, know that you do not have to go it alone. “There are lifestyle modifications and complementary therapies that can help,” Dr. Dunham says.
“Medical treatment is available to help you get over the hurdle,” Dr. Dunham says. It may include hormone therapy (HT), a low-dose contraceptive, or nonhormonal medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), to help reduce symptoms of menopause-related depression or anxiety. Over-the-counter treatments, such as a vaginal moisturizer, can ease dryness. “There are so many options for symptom relief,” Dr. Dunham says.
Myth: Hormone Therapy Isn’t an Option
For some women, HT, including prescription pills or patches, progesterone with estrogen for women with a uterus, and low-dose vaginal estrogen, can be safe and effective. They can help alleviate many symptoms of menopause. The 2022 hormone therapy guidelines from NAMS state that the lowest dose of HT for menopause symptom relief in women before age 60 or who are within 10 years of menopause can be safe and can provide significant relief.
“If you’re within 10 years of menopause and healthy and don’t have any contraindications for hormone therapy, such as having a history of stroke, blood clot, or a known or suspected history of breast cancer, the benefits of hormone therapy will very likely outweigh the risks for women with menopause symptoms,” Jeffers says.
“Dosing is dependent on symptoms and adjusted according to the individual,” Dr. Dunham says. Vaginal (or local) hormonal medication is an option for most women unless they are taking estrogen-blocking medications.
Myth: Once You’re in Menopause, It’s All Downhill
On the contrary, menopause can be among the best times in life, says Jeffers. Just think: you don’t have to worry about contraception anymore, and if you were troubled by heavy periods or PMS, menopause cures it. “Women can emerge healthy and empowered, with a freedom and spaciousness in their lives they’ve probably never had before,” says Jeffers.