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Myths About The Menopause

The menopause can be tough, so it's important to know fact from fiction. We unravel some of the myths and establish the menopause facts.

Image of a lit up question mark sign

For women across the world, the menopause is an inevitable fact of life and a normal part of the ageing process.

But the menopause is still a bit of a taboo topic and, as a result, a lot of myths and misinformation still surround the menopause. Here, we look at some of the common myths about the menopause and attempt to debunk them once and for all.

1. The Menopause Happens Suddenly At The Age Of 50!

This is not true.  The menopause is a gradual process that lasts 4 to 8 years, starting with the perimenopause phase where most of the symptoms are experienced.

Next comes the menopause which is when a woman hasn't had a natural period for 12 months.

And finally, postmenopause where the symptoms can continue for an average of 4 to 5 years as hormones finally settle down - however, the symptoms are far less severe.

2. It's the menopause that causes the symptoms

This is factually incorrect. Even though a lot of women use the term 'menopause' to describe the phase in their life when they experience all the symptoms, it is the perimenopause phase which causes all the unpleasant symptoms.

The perimenopause is a phase that lasts several years leading up to the menopause.  It's the transition phase where FSH, LH and oestrogen levels begin to fluctuate and it's these hormone fluctuations and gradual decline in oestrogen levels that cause the symptoms.

The term 'menopause' is the term used to describe the point in time when a woman's periods have stopped for 12 months.

3. Symptoms are the only way to diagnose the perimenopause

The symptoms of the perimenopause, such as irregular periods, hot flushes and mood swings are used to diagnose whether a woman has started the menopause. However, the symptoms experienced in the early stages of the menopause can cause concern and confusion for many women.  This is especially true if a woman hasn't noticed her periods have become irregular.

Symptoms such as brain fog, memory loss and poor concentration can be experienced by women during the perimenopause.  These symptoms, along with increased anxiety, and feeling unable to cope with everyday situations can often leave women feeling scared, confused and no longer feeling like themselves.

This is further exasperated by the lack of conversation and education around the menopause. Some women don't realise how soon the perimenopause can begin and that the symptoms they feel are related to hormone fluctuations.

It is possible to get confirmation that your symptoms are related to hormone changes with a blood test that measures the key hormones involved in the menopause - oestrogen, FSH and LH.  These hormones fluctuate during the perimenopause and cause the varied symptoms women experience.  Therefore, a blood test would need to be taken over time to establish changes in hormone levels.

As the chart below shows, oestrogen begins to decline as you enter perimenopause and FSH and LH begin to increase more sharply:

 

chart showing how female hormones fluctuate over time

As a woman progresses through the transition to menopause, FSH and LH continue to rise as oestrogen slowly declines over time.

Our perimenopause home blood test is a simple finger prick blood test that measures these 3 key hormones. Tracking these hormones over time provides insight into how your hormones are changing and is, therefore, a good indicator of perimenopause.

Read our Guide To Menopause Symptoms.

4. The menopause always happens after a woman reaches 50

Broadly, this is true, the average age of a woman reaching the menopause is 51 - this is when a woman hasn't had a period for 12 months. Yet, it is important to remember that this is just an average and in fact, the menopause may happen much earlier or even later.

5. Early 40s is too young to start the menopause!

Unfortunately, this is not true. Women may begin to experience symptoms of the perimenopause in their early 40s.  This is when hormones will begin to fluctuate and cause a variety of symptoms.

The misunderstanding and misuse of the term 'menopause' combined with the fact that menopause happens when a woman is in her 50s (on average, although it can happen between the ages of 45 and 55), has lead many women to think that they are too young to be going through the perimenopause in their early 40s.

This causes additional confusion when they begin to experience some of the less obvious symptoms such as anxiety, disturbed sleep and brain fog.  In addition, if a woman is not keeping track of her periods, she may not realise that they have become irregular.

In addition, around 1 in 100 women will experience the menopause before the age of 40, known as premature menopause. Premature or early menopause (before the age of 45) can occur spontaneously because the ovaries stop working or it can be induced because of chemotherapy or surgery.

It is important for women of all ages to know the signs and symptoms of the menopause and premature ovarian failure (POF). POF can occur at any age and in younger women, it can lead to serious conditions such as osteoporosis.

6. The Menopause Only Lasts A Few Years

This may be the case for some women, but in others, the symptoms may last for up to 10 years. Often, it’s easy to get bogged down in the law of averages, but each female is individual and one person’s experience may be completely different to someone else’s.

“Menopause symptoms last, on average, for between 4 - 8 years, but for a small percentage of women they may continue for longer”, explains Diane Danzebrink, The Menopause Counsellor, a psychotherapist and menopause expert. “Approximately 25% of women will experience very few or no symptoms”. Women are officially postmenopausal when 12 months have passed and no period has occurred. In fact, most women spend one-third of their life postmenopausal.

7. You Can't Get Pregnant

This is not true, while a woman is still having periods, regardless of how irregular they are, she should continue to take some form of contraception.

A woman should continue with her usual contraception routine until she hasn't had a natural period for 12 months if over the age of 50.  By this time, a woman is considered to have reached the menopause. If a woman reaches menopause before the age of 50, then she should continue to use contraception for two years without a natural period.

Women should consult their GP to get more advice on contraception as they transition through the menopause.

8. You Shouldn't Take HRT

The HRT debate is massive and the adverse health claims are constant, but let's first take a look at what HRT is.

HRT stands for hormone replacement therapy and is a treatment prescribed to women going through the menopause to help alleviate some of the symptoms. There are two types of HRT:

  1. Combined HRT which includes oestrogen and progesterone
  2. Oestrogen-only HRT

Oestrogen on its own can increase the risk of womb cancer, which is why progesterone is often prescribed alongside oestrogen.

HRT can also help protect against long term health issues such as osteoporosis. The decrease of oestrogen in the body leads to a loss of bone density.  This is why it's important for women to eat a healthy, balanced diet, take vitamin D and ensure they continue to exercise - especially weight-bearing exercises.

HRT, therefore, is the most widely used treatment to combat the symptoms of the menopause.

Yet, there have been concerns raised about HRT including the fact it may increase the risk of breast cancer, ovarian cancer and heart disease.

“The disadvantages of HRT have been focused on the much-reported increased risk of breast cancer, however, it is important to put this into context. The increased risk is only related to some forms of HRT and Cancer Research UK state that the risk is small compared to many lifestyle risk factors including smoking, being overweight or drinking alcohol”, says Diane Danzebrink.

However, in 2016 NICE changed its guidelines to encourage doctors to prescribe HRT to their patients and relieve their symptoms. NICE states women should be told:

  • The risk of venous thromboembolism is greater for oral HRT than transdermal HRT (skin patches)
  • HRT doesn’t increase the risk of heart disease when it is begun in women under the age of 60
  • HRT doesn’t affect the risk of dying from cardiovascular disease
  • Oestrogen-only HRT is associated with little or no change in the risk of breast cancer
  • The risk of breast cancer related to HRT reduces once the treatment is stopped.

Diane continues, “the benefits of taking HRT are that it can help to improve menopause symptoms and offer protection for long term health. Many women are reluctant to try HRT due to the myths that have grown up out of the negative press, but once they start to use it and find the right preparation and dose for them many report being back to themselves and having their lives back.”

Read our guides to Hormone Replacement Therapy and natural alternatives to HRT.

9. You lose your sex drive

For some women, this is true. A common symptom of the menopause is vaginal dryness which can make sexual intercourse uncomfortable and is a reason for reduced sexual appetite. Equally, some women claim the menopause actually enhances their libido.

Diane explains, “the change in oestrogen levels can result in both psychological and vaginal symptoms which can also have an impact on libido”.

There are many treatments available to help combat the negative effects of the menopause on your sex life, including:

  • Pelvic floor therapy
  • Vaginal lubricants
  • Vaginal moisturisers
  • Sex therapy

Women experience the menopause in many ways. Your body may feel like it is changing dramatically, which is completely normal, or it may feel like it hasn’t changed at all which is equally normal.

10. You Gain Excessive Weight During The Menopause

This is not true.  It is common for some women to gain around 4-7lbs in weight, especially in underweight women.  However, the menopause does not cause excessive weight gain.

Women may find that they have more weight around their stomach which is caused by hormonal changes that result in a redistribution of fat within the body.

Learn more about menopause and weight gain.

Summary

The menopause can be a very confusing time in a woman's life, made worse by the lack of education women receive around the menopause and what to expect.

“When it comes to managing your menopause symptoms it is important to have factual, evidence-based advice upon which to make an informed decision. In November 2015, NICE produced menopause guidelines for clinicians but they are available for everyone to read. I would highly recommend having a look at them before you seek advice from your GP so that you know what information and choices should be on offer to you”, says Diane.

Thanks to an increased awareness of the menopause, and it being spoken about more openly by people like Louise Minchin from BBC Breakfast, more is being done to break down the barriers and prevent the menopause being a taboo subject.

Watch Louise Minchin talk about her experience of the menopause.

It is important that women educate themselves on the menopause and what to expect.  Women should try and talk to their mother, grandmother and friends to learn more about this natural part of life.

Perimenopause

Our perimenopause test is for women who believe they may be starting to transition through the menopause. It tests three key female hormones – FSH, LH and oestrogen which change when entering the menopause.
Perimenopause
£59
A test to confirm you are transitioning through the menopause.
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References

  1. Faubion, S, S et al. (2017). Genitourinary Syndrome of Menopause: Management Strategies for the Clinician. Mayo Clin Proc: 92(12), pp 1842-1849.
  2. National Health Service. (2018). Menopause. Available at: https://www.nhs.uk/conditions/menopause/
  3. Newson, L. (2016). Myths and Misconceptions of the Menopause. British Journal of Family Medicine: 4(6).
  4. NICE. (2015). Menopause: Diagnosis and Management. Available at: https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#long-term-benefits-and-risks-of-hormone-replacement-therapy
  5. Shuster, L, T et al. (2010). Premature Menopause or Early Menopause: Long-Term Health Consequences. Maturitas: 65(2).
  6. Diane Danzebrink is The Menopause Counsellor, a psychotherapist and menopause expert with professional nurse training in menopause she founded Menopause Support and launched the #MakeMenopauseMatter campaign in Parliament in October 2018. You can learn more by visiting www.dianedanzebrink.com.

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