For women across the world, the menopause is an inevitable fact of life and a normal part of the ageing process.
But myths and legends still surround it and, in many cases, the menopause is often regarded as a taboo topic. Here, we look at some of the common myths about the menopause and attempt to debunk them once and for all.
1. The menopause always happens after a woman reaches 50
In the UK, 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. Women may begin the to experience symptoms of the perimenopause in the 40s. This is the time when a woman's hormones begin to fluctuate as she heads towards the menopause.
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.
2. The menopause only lasts a few years
Does it? It may be the case for some, 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.
3. To HRT or not to HRT?
The HRT debate is massive and the adverse health claims are constant. First, what is HRT?
HRT stands for hormone replacement therapy. When a woman approaches the menopause, she stops having periods and is no longer able to conceive naturally. The menopause occurs because the female sex hormone balance is changed. The ovaries stop producing the hormone oestrogen, which is needed for an egg to be released every month, also known as ovulation. Oestrogen is also responsible for many of the female characteristics and keeps our menstrual cycle in check. So, when the production of oestrogen slows and eventually stops, the female body behaves differently. Of course, the body doesn’t just stop producing the hormone overnight, instead, it is a gradual process which can take place over several years with symptoms gradually occurring during this time.
One of the most common symptoms associated with the menopause is hot flushes. Other symptoms include:
- Night Sweats
- Vaginal dryness
- Difficulty sleeping
- Low or depressed mood
- Loss of libido
- Recurrent urinary tract infections (UTI)
Another effect of the loss of oestrogen is bone density. After the menopause, the risk of a woman developing osteoporosis is increased. HRT, therefore, is the most widely used treatment to combat the symptoms of the menopause and many women find it helps to relieve many of the associated symptoms.
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 great for oral HRT than transdermal HRT
- 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.”
4. You lose your sex drive
Diane explains, “the change in oestrogen levels can result in both psychological and vaginal symptoms which can also have an impact on libido”. A common symptom of the menopause is vaginal dryness which can make sexual intercourse uncomfortable and is a reason for a reduced sexual appetite. Equally, some women do lose their libido during the menopause while others claim it actually enhanced it.
The menopause is a personal and individual life stage, although all women experience it their individual experiences can differ dramatically. However, 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.
“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.
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. www.dianedanzebrink.com
Our menopause health check is designed for women who believe they are transitioning through the menopause or are at the post-menopause stage.
Faubion, S, S et al. (2017). Genitourinary Syndrome of Menopause: Management Strategies for the Clinician. Mayo Clin Proc: 92(12), pp 1842-1849.
National Health Service. (2018). Menopause. Available at: https://www.nhs.uk/conditions/menopause/
Newson, L. (2016). Myths and Misconceptions of the Menopause. British Journal of Family Medicine: 4(6).
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
Shuster, L, T et al. (2010). Premature Menopause or Early Menopause: Long-Term Health Consequences. Maturitas: 65(2).