Our mothers and grandmothers used to talk about menopause in hushed tones in the kitchen or ladies’ room (if at all). During these whispered discussions, negative opinions and misconceptions were often passed around more than helpful, fact-based information.

Thankfully, women talk openly (and loudly) about menopause now. But some of the myths have survived and continue to make the rounds on social media, in family kitchens, and between friends. We’d like to dispel a few of the more common myths and share some truths about menopause.

Myth #1: Menopause lasts a long time

Truth: Nope, it does not. Menopause is actually a milestone in your life. It occurs when you’ve gone without a menstrual period for 12 consecutive months. About 6,000 women in the United States reach menopause every day, typically between the ages of 45 and 55.

So, you could say that menopause is more like the one-year anniversary of your last period. Although we often talk about menopause as a phase, it’s actually ONE DAY in a woman’s life.  

Just to clarify though, the phases before and after menopause ARE long. Perimenopause is the transitional phase before menopause when your periods often become irregular and you may have a variety of other symptoms. Perimenopause can last for many years. And postmenopause starts at menopause and lasts for the rest of your life.  

Myth #2: Menopause symptoms hit fast and furiously

Truth: Not usually. For most women, symptoms begin slowly as the natural perimenopause transition begins. A skipped period. Hot flashes here and there. Some brain fog or moodiness.  

There are a host of symptoms that may occur, and they might start slowly and happen in any order. You may have one or two symptoms or a whole slew of them, as each woman’s experience is unique.  

That said, there is one case where symptoms do hit fast and could be severe. It’s called “surgical menopause,” and it occurs after a procedure called a bilateral oophorectomy during which a woman’s ovaries are removed due to ovarian cysts, severe endometriosis, other gynecological issues, or as part of cancer treatment. Since the ovaries produce much of the circulating sex hormones, the abrupt drop in estrogen may bring on strong symptoms very quickly.

Myth #3: You can’t get pregnant once perimenopause symptoms begin

Truth: Oh, yes, you can get pregnant! As you go through perimenopause, especially toward the latter part of the transition, you may have irregular periods. Or you may skip your period for a month or two, or even longer. But you can still ovulate regularly or sporadically as your hormone levels fluctuate during perimenopause. So, it’s important to be mindful of the chance of pregnancy and use appropriate birth control if you prefer not to have a baby.  

When you’ve reached menopause—again, 12 consecutive months without a period—then you’re most likely past the point of worrying about an unplanned pregnancy.

Myth #4: Menopause affects mostly the reproductive organs

Truth: While irregular periods are a hallmark symptom of perimenopause, the decreasing estrogen levels can affect other parts of the body from head to toe.

Starting with the head, most women have some degree of scalp hair thinning. Then there’s brain fog, forgetfulness, mood swings, and migraines. Some women suffer from dry mouth or dry eyes and other vision problems. Facial skin develops wrinkles.  

Breasts may feel tender. Heart palpitations can crop up, and the risk of cardiovascular disease rises. Digestion may be affected, leading to heartburn or constipation. Changes in vaginal tissue can contribute to vaginal dryness, urinary tract infections, and incontinence. Joints may feel stiff or painful. And bones may lose density.

While this sounds like an overwhelming list, remember that you can take steps to minimize hormonal imbalances during perimenopause. One strategy is talking with your provider about bioidentical hormone replacement therapy (BHRT). Monitoring your heart health and getting bone density screenings are important too.

Myth #5: There’s no relief from hot flashes and night sweats

Truth: During a hot flash, you feel a sudden rush of heat in your face, neck, and upper body, along with possible sweating and skin flushing. Night sweats are just what they sound like—you wake up feeling overheated and soaked with sweat, then feel chilled as the warmth subsides, and you’re lying there in damp pajamas.

Hot flashes and night sweats are considered vasomotor symptoms that occur during perimenopause. Heart palpitations, anxiety, and sleep disturbances may accompany hot flashes.  

There are things you can do to deal with hot flashes, or you can try to lessen them. For some women, certain things—like alcohol, hot beverages, caffeine, or spicy foods—trigger hot flashes, so avoiding those may help decrease the frequency. To cool down quickly when hot flashes occur, keep a bottle of ice water handy to drink, and wear breathable fabrics in layers so you can peel them off.

To address the root cause of hot flashes, which is often estrogen fluctuations, ask your doctor about prescribing personalized BHRT.  

Myth #6: Hormone therapy is too risky

Truth: Hormone risks are considered minimal when prescribed properly. Bioidentical hormones, which are usually plant-derived compounds, have the same molecular structure as hormones made by the human body.

However, the widespread, long-standing fear about hormone therapy stems from the Women’s Health Initiative (WHI) study in 2002. When the study came out, many women and doctors stopped using hormone therapy because of the WHI study cited an increased risk of breast cancer, heart disease, and stroke.  

But the WHI used synthetic hormones on women who were mostly 10+ years past menopause. We now know that when patient-specific hormone therapy is started earlier in perimenopause, there are a number of potential health benefits. Many studies support its use to address symptoms stemming from hormonal imbalances and improve overall wellness.  

What actually may be unsafe for women is something else that’s happening when women go to the doctor with perimenopausal symptoms related to hormone deficiency, says Dr. Angela DeRosa, who is the medical director for Belmar Pharma Solutions, and an internationally recognized authority on women’s hormonal health.  

In her book, A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You, Dr. DeRosa notes that many women are being treated with multiple pharmaceutical drugs for several separate symptoms (like anxiety, insomnia, high cholesterol, migraines, and bone loss, for example) when the underlying cause of most of their issues is hormone deficiencies.

To target the root cause of perimenopausal symptoms, DeRosa uses compounded bioidentical hormones. When prescribed appropriately, bioidentical hormones benefit a women’s overall health in myriad ways, and may help them transition away from other prescription drugs being used to treat individual symptoms.

The truth about BHRT

Having hormonal support helps keep many parts of the body—like the heart, brain, bones, and urinary tract—functioning optimally. Studies show that starting BHRT early in perimenopause or within 10 years of the onset of menopause may be the best timeframe for reducing symptoms and protecting overall health.

To manage their menopausal symptoms, many women are choosing compounded BHRT. When your provider prescribes compounded BHRT like we make at Belmar Pharmacy, it’s created in a dose and form that’s personalized to your individual body and needs. If you’re having uncomfortable symptoms, ask your doctor about replenishing your hormones.