We struggled for many years before we realized we were in perimenopause. And when we did, we had a lot of things wrong. A lot. This is part 2 of the list we started compiling of common menopause myths. We hope these lists help make your journey a little smoother than our experiences. Part 1, which includes myths 1 through 6, can be found here.
Myth 7. Everyone Should Take Hormone Therapy
As per our previous post, sensationalized and overblown results from the Women’s Health Initiative (WHI) study in the early 2000s made the majority of women stop taking hormone therapy overnight. The pendulum swung hard.
Some 20 years later, hormone therapy is now recognized as the most effective treatment for hot flashes and night sweats, as well as the genitourinary syndrome of menopause (GSM) – formerly known as vaginal atrophy. Hormone therapy is also considered preventative when it comes to bone loss and facture.
The pendulum seems to be swinging again.
There are providers and clinics that have been accused of prescribing hormone therapy for uses, and in doses, that are not supported by strong evidence or current guidelines. In some cases hormone therapy is being touted as the silver bullet for all menopausal symptoms and all manner of prevention.
But there are no silver bullets.
Hormone therapy is an important tool, but it’s not right for everyone or for every symptom. Beyond osteoporosis, there is no consensus on the preventative capabilities of hormone therapy.
As per the North American Menopause Society (NAMS), the risks of hormone therapy differ depending on type, does, duration of use, route of administration, timing of initiation, and whether a progestogen* is used. Treatment options should be individualized to maximize benefits and minimize risks.
Treatment options should also be fully explained to the patient. Once the patient understands the potential benefits and the potential risks, then they can make the best decision for their health and wellbeing.
Myth 8. There Is One Solution for Your Symptoms
There is no one thing that is going to address all of the changes and potential symptoms associated with perimenopause and postmenopause. This time in our lives is about change and renewal. And our habits and lifestyle will need to change as well. For the better.
Some of us will need medication, which may or may not include hormone therapy. With few exceptions, we all can use more exercise. Our diets will likely need more fiber, protein, and healthy fat. Few people can say they are getting enough vegetables. Many of us need to change our love/hate relationship with carbs. You may need to cut back or stop drinking. Most of us will need help learning how to sleep again.
There is no one hormone, drug, supplement, diet or special tea that is going to make it all better. You’re going to need to build your own personalized toolkit to help you seize the incredible opportunities that come with this phase of life.
Sound daunting? We get it. Get sound advice from your doctor, nurse practitioner, dietitian, cognitive behavioral therapist, or naturopath. Take is slow. Start with small changes to build healthy habits that will last. If prioritizing your health seems impossible, this post may help.
Myth 9. Every Symptom In Your 40s is Perimenopause
Once I learned what perimenopause was, and got over the shock of just how many symptoms can be caused by fluctuating and declining hormones, I blamed everything on perimenopause. And I shared that view with anyone who would listen, not just menopausal women, but postmenopausal women as well.
It’s important to know your body. Have your doctor perform an exam to get a baseline. Learn about the symptoms of menopause, both peri and post. Track you cycles and your symptoms. See your doctor regularly and provide them with the information you are tracking.
Are these symptoms of menopause?
There are many health conditions with similar symptoms as those that happen in perimenopause. Low thyroid or hypothyroidism as well as low iron or iron deficiency anemia are two of many examples where common symptoms could be mistaken as symptoms of menopause.
It’s always important for a qualified medical provider to rule out other causes when symptoms present that are interfering with your quality of life. It is also important that once other causes have been ruled out, you are presented with options to to manage your symptoms of menopause.
Myth 10. You Just Have To Go Through It
I had a doctor once tell me ‘you’ll just have to go through it’ when I asked about menopause. I had two words. And they weren’t ‘menopause myths’. I have a new doctor.
According to the Menopause Foundation of Canada 3 our of 4 women experience menopausal symptoms that interfere with their daily lives. And not one of them should ‘just have to go through it.’
There are safe and effective treatment options, preventative care, and lifestyle choices to be considered. Everyone should have the opportunity to build their own personalized toolkit to support their menopausal journey. It should never be about ‘just getting through it’. It should be about thriving and excitement for this next phase life. A phase that will span up to half of the average woman’s life.
Myth 11. No Symptoms? Don’t Worry
From emotional symptoms to heart palpitations, up to 95% of women experience a range menopause symptoms. For some these will be severe, for others they may not really notice much of a change. If you don’t have any symptoms, you don’t need to worry, right? Well, no. While you’re very fortunate to not experience symptoms that can interfere with your daily life, there are risks you need to understand. Here are two of those risks:
Osteoporosis is when loss of bone mass over time makes the bones weak and more susceptible to breaking or fracture. Fractures from osteoporosis are more common than heart attack, stroke, and breast cancer combined and at least 1 in 3 Canadian women will break a bone related to osteoporosis during their lifetime.
Bone density peaks by about thirty years old. After that, there is a slow and steady decline in bone mass over time, for everyone. However women face the harsh reality that for them bone loss accelerates during the menopause transition.
Cardiovascular diseases, like heart attack and stroke, are the leading cause of death for both men and women. Our risk is impacted by our lifestyle choices and it’s well established that eating well, exercising, avoiding smoking, limiting alcohol intake, and getting enough sleep lowers our risk.
What many women don’t realize is that our risk for heart disease dramatically increases after, and because of, menopause.
The Risks We Face
As women, we have to understand just how much our changing biology during menopause impacts our risk for future health conditions. Then we need to appreciate that our health choices matter.
Early healthy interventions and prevention can lower our risk in a meaningful way. We need to start conversations with our doctors, ask for screening, ask about prevention and if needed, treatment. We also need to raise awareness among women about the risks we face.
Sharing our blog post about some of these risks is a good start.
Myth 12. It’s The End
We all have a deeply held notion that menopause signifies the end. This must stop. This is indeed the worst of the menopause myths. We are so much more than our reproductive capabilities. And we need to change this paradigm.
Sure. I might trade in my current body for the one I had in my early thirties. But not if it meant losing the knowledge and experience I have gained in my almost 50 years on this planet. I wouldn’t trade a single memory. Nor would I trade any of the joy, or any of the pain. I have finally started to embrace my perfectly, imperfect self.
I feel stronger, confident, and excited about the opportunities before me. And I didn’t always feel this way. Some days I still don’t. But the good days outnumber the bad. What has been important for me is to become informed. Equally important: understanding the power of my perception and perspective.
That’s why we started thisisperimenopause.com. We’re hoping you’ll join us in redefining midlife.
Both progesterone and progestins are classified as progestogens. To be classified as a progestogen, the drug must act on the lining of the uterus to enable the implantation of a fertilized egg and support early pregnancy.
When it come to menopausal hormone therapy, progestogens are used to protect the endometrium. The endometrium is the mucous membrane lining the uterus, which thickens during the menstrual cycle in preparation for the possible implantation of an embryo.
Left unopposed, estrogen therapy can cause cancer to grow in the endometrium. Endometrial cancer is also sometimes called uterine cancer.
For more detail on progestogens, check out this post.