The Many Myths of Menopause

Patient Expert

About as many myths surround this important rite of passage in a woman's life as the Loch Ness Monster. Separating fact from fiction can be tough. Once you let the cat out of the bag and tell your friends that you THINK you're in menopause, advice and old wives' tales come from every direction. Here are some common myths and the realities that go along with them:

MYTH: Menopause symptoms begin when a woman approaches age 50.

REALITY: In fact, hormonal changes start much earlier than that, usually around age 40 or even before. Perimenopause, the beginning stage of menopause, starts when a woman starts skipping periods because of these hormonal changes. Perimenopause can last between two and eight years. Menopause actually starts only after a woman has missed monthly periods for a year.

MYTH: Menopause causes women to be cranky and angry.

REALITY: It's actually the changing hormones' effect on the brain that causes the mood swings, and some changes affect parts of the brain that can trigger anger. It truly is a chemical reaction, and your mood swings won't last forever.

MYTH: A drop in a women's testosterone level during menopause is the reason she loses interest in sex.

REALITY: All women (and of course men) have some testosterone. In women and men, the level may drop as we age, but in some women at menopause, it actually increases. While some women think they can replace their "lost" libido by using testosterone supplements that are on the market, it is important that you have your hormonal levels tested first, to see if your testosterone is the problem, or perhaps another hormone.

MYTH: Menopause is nature's way of assuring that women don't have children when they are "too old."

REALITY: The first stirrings of menopause can start in a woman's 30s, while she is certainly of child-bearing age. She can get pregnant while going through menopause and only when she has stopped having periods for 12 months is she considered unable to produce an egg capable of being fertilized.

MYTH: Women who go through "artificial" menopause due to surgery or chemotherapy have a tougher time than women who go through more natural menopause.

REALITY: Women whose periods stop abruptly because they have had surgery on their reproductive system or who have had chemotherapy or other drugs for serious illnesses are dropped into menopause almost overnight, without any chance to ease into it. They go into menopause at an earlier age than they might have otherwise. Because of their other serious illness, they can be more stressed than the rest of us, and their symptoms can be magnified. Supplemental hormone therapy is almost always chosen to help them through what the rest of us have years to adjust and adapt.

MYTH: The risks of hormone replacement therapy outweigh the benefits for just about everyone.

REALITY: Twenty years ago, hormone replacement therapy (HRT) was touted as the fountain of youth and then later as the road to almost certain heart attack, stroke and breast cancer. Neither is totally true. Recent studies have shown that the age at which you begin HRT has an impact on whether it is potentially heart-protective or a contributor to your chance of heart attack and stroke. This data isn't fully understood. The fact is, there is no one-size-fits-all hormone replacement therapy. It can be beneficial for some and deadly for others, and you really have to be knowledgeable and talk honestly with your healthcare team to make an informed decision.

MYTH: Menopause causes depression.

REALITY: No study has shown that menopause alone is linked to mental illness, including depression. Menopause is a signal, to our brains and to our bodies, that life is changing. Denial of that fact can lead to some serious consequences, including depression. When kids move out, relationships falter, jobs lose our interest, we start to forget things or are told we have to take calcium supplements for our bones, medicine for our cholesterol, or have to do exercises so we won't pee our pants when we're older, it's no wonder we get depressed-we see a long slide into old age. But our outlook matters immensely. Those willing to face the changes and have faith that you can get through them-to control what you can (diet, exercise) and let go of what you can't (your child-bearing years are waning) are more likely to have less anxiety (and even depression) than those who feel helpless in the face of life's changing landscape.

The reason I've pointed out just some of the myths surrounding menopause is that it's important for you to get the facts and do your homework when making decisions about this new and exciting (yes, I said exciting) part of your life. Friends, mothers, mothers-in-law and sisters of all kinds can be wonderfully comforting during these changes. But they might not be the best source of data. Throw yourself into this research project like you've never done before, because the quality of your life depends on it.