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. So we’ve started compiling a list of common menopause myths in the hopes that we can make your journey a little smoother than our experiences.
Myth 1. Someone Is Coming
No one is coming to explain perimenopause, menopause, or postmenopause to you. We had always assumed that when the time came our doctors would guide us into this next chapter of our lives. We were even a little excited at the prospect of no longer having a period. Then our hormonal changes started wreaking havoc on our bodies and minds.
We Were Dismissed
Turns out our doctors weren’t as helpful as we had hoped. The information available was sparse and often inaccurate. We were being dismissed for symptoms and concerns that were not only valid, but needed to be addressed.
We eventually realized that we were going to need to take charge of our own health. And that we needed to become tenacious and demanding (yes demanding) to get the care we deserve. This can be daunting and exhausting. Being able to rely on each other has been so important to our well-being. We know not everyone has that kind of support. That’s why we started This Is Perimenopause.
Myth 2. There Is A Test To Confirm Menopause
I can remember naively asking my doctor during an annual physical if he could run a test to confirm I was in perimenopause. He stared at me blankly. He then asked if I was having irregular periods or hot flashes. I said, no. He said, then you aren’t in perimenopause. Oh.
According to the North American Menopause Society (NAMS), there is no simple test to predict or confirm when perimenopause has started or menopause occurs. In fact, hormone tests are generally not helpful because your hormone levels change significantly day to day. Some doctors may test follicle-stimulating hormone (FSH) levels, but both FSH and estrogen can swing significantly during perimenopause.
The Only Way To Confirm Menopause
The only way to confirm menopause is once you have gone one year without a period.
Think you are experiencing symptoms of perimenopause? An experienced medical practitioner can help you confirm by reviewing your symptoms. Tracking your symptoms in the context of your menstrual cycle will help significantly with diagnosis. Your doctor may also need to rule out medical conditions depending on the nature of your symptoms and your medical history. For example, if you are experiencing heart palpitations your doctor will likely want to rule out other causes like arrhythmias.
Myth 3. Irregular Periods Are Required
While some of the most common symptoms women experience in the menopause transition are irregular periods and hot flashes, they are not required to confirm perimenopause. Unfortunately many practitioners still use these two symptoms as screening questions to determine if someone is in perimenopause.
Some May Never Get Hot Flashes
There are a a wide range of symptoms that signal perimenopause. And some women may never experience hot flashes.
Everyone’s journey is unique and there is no ‘typical’ menopausal transition. If you suspect you might be in perimenopause and you are dismissed, find a provider with experience treating menopausal women. NAMS has a tool where you can search for menopause practitioners by geography.
Myth 4. There Are Only A Handful of Menopausal Symptoms
We were so wrong on this one.
On average each of us will experience seven different symptoms during the menopause transition. But there are far more than seven symptoms. It is broadly recognized that there are over 30 symptoms of menopause and perimenopause.
It’s important to feel prepared and be on the lookout for menopause symptoms that may significantly impact your well-being and quality of life. We struggled to find a comprehensive and straightforward list. So we pulled together a researched list of recognized symptoms based on current reliable resources. Our detailed list has over 60 symptoms. Seriously.
Myth 5. Perimenopause Doesn’t Start Until Your Late 40s or Early 50s
Turns out that when I had asked my doctor to run a test to see if I was in perimenopause, it had likely being going on for quite some time. According to the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) perimenopause can begin as early as age 35 and end as late as age 59.
I had my children late in life. Looking back I suspect some of my physical and emotional symptoms were the beginning of my perimenopause. At the time I attributed everything to the trauma and stress of bearing and raising tiny humans. But I now think my estrogen levels were already starting to become erratic when my kids were babies.
It is said that perimenopause lasts on average 6 to 8 years. I’m pretty sure I’ve been in perimenopause now for at least 10. Any day now. Any day.
Myth 6. Hormone Therapy Is Bad
I took birth control for years and didn’t give it a second thought. But when it came to hormone therapy for menopause, I thought it was extremely dangerous.
I, like many women, had internalized the news in the early 2000s that hormone replacement therapy will give you breast cancer. It turns out, that the results from the study making those claims were overblown and sensationalized. And it caused up to 80% of women to stop taking their hormone therapy for symptoms of menopause overnight.
Women’s Health Initiative
The Women’s Health Initiative (WHI) clinical trial was undertaken to evaluate hormone replacement therapy and it’s impact on cardiovascular disease, osteoporosis, blood clots, dementia, endometrial cancer, and breast cancer. Five years into the study it was abruptly stopped. Initial findings showed that the women in the study taking hormone therapy were at an increased risk of breast cancer.
Relative vs Absolute Risk
Except that the risk of breast cancer with hormone replacement therapy vs the placebo group in the study was in fact rare and not statistically significant. According to a paper published in the journal of Nuclear Receptor Signaling, one of the major problems with the interpretation of the WHI study was that it emphasized the use of relative risks rather than absolute risks.
Unfortunately, none of the published critiques of the WHI study have had the same level of media attention as the initial headlines. The messaging that hormone therapy will give you breast cancer stuck.
Breast Cancer Risk In Context
The Menopause Manifesto does an excellent job of putting the WHI risks into context. Here are the highlights:
- The WHI said there was a 26% increase in risk of invasive breast cancer. Sounds scary. That percentage translates to 6 women for every 10,000 who took hormone replacement therapy, or 0.06% of women a year as compared to the placebo. Not quite as scary.
- Other factors that increase your risk of breast cancer include consuming 2-3 glasses of alcohol a day. That increases your risk by 20%. Giving birth after the age of 35 vs before the age of 20 increases your breast cancer risk by 40%.
- There are many different types of estrogen and progestogen, all with different risk/benefit profiles. The women taking hormones in the WHI study took Premarin, which is estrogen created with horse urine. If they had a uterus they also took Provera, which is a progestin. But the WHI findings were applied to all types of hormones, not just the two used in the study. (Progesterone and progestins, although structurally different, are both classified as progestogens.)
- The average age of the women in the WHI trial when it started was 63. Their risk was extrapolated to all women.
Yes. There are risks associated with taking hormone replacement therapy. Taking any medication comes with risks that must be understood. There are also benefits that should be considered, including quality of life.
What is important is that the person who will be assuming the risk is provided with accurate information. Then they can decide whether the potential benefits outweigh the potential risks. Hormone therapy is an important tool to help women with symptoms like hot flashes and genitourinary syndrome of menopause (GSM). If your provider isn’t willing to discuss the risks and the benefits of hormone therapy, find one that is.
The Biggest Myth of All
It’s important to get accurate information so that you can make the best decisions for your health and well-being. It’s taken us a while to sort out many common menopause myths. And we’re still learning. One of the biggest things we’ve learned is that you don’t want to experience the menopause transition alone.
Perimenopause can be overwhelming. We highly recommend you don’t go it alone. Being dismissed? Find another medical provider. Talk to your friends. Get a good pharmacist. Follow us;).
We’ve struggled. We still have bad days. We work hard at our health. And through all of this we’ve busted the biggest myth of all. We used to think menopause signaled the end. It is not. It’s actually the beginning, of what is shaping up to the best time in our lives.
Want to keep reading? Check out Menopause Myths Part 2.