As the medical director of one of the busiest menopause clinics in the country, I know what women are thinking about changes in their bodies, and I have a good idea of what informs their decisions. In general, my patients know a lot. But even smart, savvy women believe and perpetuate these menopause myths I hear again and again:
Myth 1: “I’m too young for menopause,” says a 45-year-old with hot flashes and irregular periods.
A woman in her 40s who is missing periods might have a thyroid issue or might just be stressed out — but she also might be in the throes of perimenopause. Age 52 is the average age of menopause, but any time after 40 is normal. So a 45-year-old, no matter how youthful she looks and feels, may well have ovaries that are winding down. But here’s the good news: While pregnancy is out of the question after menopause (unless a donor egg is in the picture), entering menopause is not the beginning of old age. It is the beginning of life without PMS, pads and periods!
Myth 2: “Hot flashes only last a few months,” says a 48-year-old who experiences hot flashes 15 to 20 times per day.
Until a few years ago, most doctors (including me) believed that hot flashes only lasted a couple of years. And while acknowledging that they seemed to go on much longer for some, we thought these women were outliers. Based on that premise, most women just tough it out under the misconception that the misery won’t last too long. A large study released in 2015, titled “The Study of Women's Health Across the Nation (SWAN),” completely debunked the myth that flashes are fleeting. We now know that hot flashes last an average of seven years. Up to 9 percent of women continue to flash for 20 years. While several factors determine the length of time someone is destined to live with an out-of-control internal furnace, genetics is a key determinant.
In the United States:
• Black American women average 10 years.
• Hispanic American women average 8.9 years.
• Caucasian American women average 6.5 years.
• Asian American women average five years.
Myth 3: “I’m done with menopause,” says a 56-year-old who accompanied her younger sister to my clinic.
Many women assume that once the hot flashes go away, menopause is officially over. That is not the case. While some symptoms of menopause are temporary, the inability to produce estrogen is permanent. Once you are done having hot flashes, the repercussion of your ovaries no longer producing estrogen continues to affect every cell in your body, which is part of the reason your postmenopause heart, vagina, bones, brain and bladder are not the same as when you were 20.
Many women develop vaginal dryness and painful intercourse years after their last period. But they have no idea this is a repercussion of menopause, since their perception is that they were “done with menopause.” You are done with menopause when you die.
Myth 4: “Hot flashes never killed anyone,” says a 51-year-old who decided to “tough it out.”
Even if you are willing to spend 10 or more years of your life dressing in layers, tossing and turning all night and carrying around a portable fan, the impact of hot flashes goes far beyond the misery of feeling like you are living in a sauna. There is now scientific evidence that hot flashes increase the risk of developing cardiovascular disease, osteoporosis, diabetes and other serious medical conditions. So, alleviating hot flashes is not just about quality of life. It is also about length of life.
Fortunately, there is an abundance of safe, effective hormonal and nonhormonal options to put out the fire.
Myth 5: Estrogen therapy? No way! It causes breast cancer!” says a 53-year-old, when asked to consider hormone therapy.
Estrogen does not cause breast cancer. Period. This is the one that will have a lot of you shaking your heads and thinking, “Is she kidding?”
This is not my opinion. The facts speak for themselves. Over 80 percent of women who have breast cancer have never taken hormones. And remember the 2002 Women’s Health Initiative (WHI) study, the one that made women across the nation flush their estrogen down the toilet? It was only the women that took estrogen and progestin together that had a slight increase in breast cancer. The news flash that didn’t make it to the news is that in the estrogen-only group, there was an 18 percent decrease in breast cancer. It is now clear that the modest increase in breast cancer in women who take hormone therapy is due to the progestin, not the estrogen. And for women who take estrogen together with a progestin, the culprit appears to be the specific progestin that was used in the WHI study: medroxyprogesterone acetate (brand name Provera).
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