Menopause: Our Expert Sorts Fact from Fiction

If you’ve ever been told “you’re not 50 yet so it can’t be menopause” or “hormone therapy causes cancer” then you’d be forgiven for feeling a little daunted or confused. There is a lot of fake news out there, it is time to sort the menopause fact from fiction.

Menopause – almost every woman goes through it, yet this transitional stage remains shrouded in myth and misconception.

Perhaps you’re wondering what impact it’ll have on your libido? Maybe you want straight answers on potential body changes? Or do you just want to unpack all those weird and wonderful rumours you’ve heard?

To help you navigate this stage of life with confidence and ease, here, we debunk some of the most common menopause myths so you can make empowered decisions about your health and wellbeing during this time.

Myth: menopause starts at 50.
Truth: women can enter menopause from 40 to 55 years of age.

The average age of menopause for Australian women is 51. Nevertheless, women can enter menopause earlier or later, at any age between 40 and 55. Premature menopause between the ages of 40 and 45 is not uncommon, with one in twelve women experiencing an early onset.

Menopause is officially defined as a point in time 12 months after a woman’s last period. The perimenopause transition to menopause differs for each woman and can last between four and seven years, on average. Known factors that can influence the duration of menopause include genetics, lifestyle factors like smoking, alcohol intake, and weight.

No matter when your menopause journey starts or how long it lasts, it doesn’t have to be a negative experience. Treatment is available to help you manage symptoms and make this transitional period the best time of your life.

Myth: almost everyone goes through symptoms therefore medical support is not necessary.
Truth: uncomfortable symptoms don’t need to be endured; treatment is available.

Just because menopause is a natural and normal part of every woman’s life, it doesn’t mean to say symptoms should simply be shrugged off or endured. Menopause is not a taboo subject. Medical support and personalised treatment can help you manage both mental and physical symptoms, whether mild or severe.

From hot flushes and vaginal dryness to mood swings, sleep disturbances and irregular periods, menopause symptoms come in various forms. The most common and effective medical treatment for symptoms of menopause is menopausal hormone therapy (MHT). Formerly known as hormone replacement therapy (HRT), MHT works by replacing oestrogen and/or progesterone, which declines during menopause. Available by prescription in a tablet, patch, gel, cream or pessary form, MHT can be effective in relieving hot flushes, night sweats and sleep disturbances.

In terms of menopause without MHT, SNRI and SSRI antidepressants in low doses have been shown to be efficacious, non-hormonal treatments that may be prescribed by your doctor.

Meet with your healthcare provider to discuss which medical support best aligns with your menopause needs.

Myth: hormone replacement therapy causes cancer.
Truth: Australian experts disproved a previous study linking hormone therapy to cancer.

If you are deciding whether to take MHT/HRT, you may be curious as to its cancer-causing effects. MHT/HRT has many benefits for women experiencing menopause symptoms like hot flushes, night sweats, mood swings, vaginal dryness and reduced sex drive.

After the announcement of the first results of the Women’s Health Initiative (WHI) in 2002, which showed that HRT had more detrimental than beneficial effects, HRT use dropped. In the following years, a reanalysis of the WHI trial was performed, and new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality. Furthermore, it’s been proven in studies to prevent bone loss and reduce fractures in postmenopausal women.

The breast cancer risks associated with using MHT depends on your age, the type of MHT you choose and other non-hormonal risk factors. For some people the increased risk is as low as three in 1000 or 0.3%.

Like with any medical treatment, MRT/HRT can come with side effects. Reported side effects may include nausea, fluid retention, bloating, breast tenderness, or irregular bleeding. Speak to your healthcare provider to discuss the right dose and delivery system for your menopausal needs.

Although effective, MRT/HRT is not the only option for managing menopause symptoms. The Australasian Menopause Society cites Mindful Mediation, Yoga and Cognitive Behavioural Therapy can be helpful. Complementary Medicines such as Black Cohosh and Phytoestrogens can improve symptom control for some women, however have the evidence has shown limited benefit. The long term studies are lacking and safety should be discussed with your health professional.

Myth: I can’t get pregnant during perimenopause.
Truth: getting pregnant can still be possible even if periods have slowed significantly.

As exciting as it may be finally ditching birth control, it is still possible to get pregnant during menopause. Menopause is a gradual process that can take several years, and you can still ovulate and become pregnant during this time. Hormonal changes that occur during perimenopause can cause fluctuations in the menstrual cycle, which can lead to occasional ovulation.

During the perimenopause transition, your periods start to become lighter or heavier than usual and may occur less frequently. For instance, if you’ve not had one for three months, you may think you are no longer fertile, but this is not necessarily the case. As menopause progresses, you can expect longer intervals between each period until they eventually stop altogether.

Menopause is only confirmed after a woman has gone 12 consecutive months without a menstrual period. The current recommendation is if you are under 50 you need to continue contraception for 2 years after your last period. For women over 50 that drops to 12 months. It is worth noting that MHT/HRT does not act as contraception. Please speak to your health care provider regarding the best options for you.

Myth: menopause means the death of my libido.
Truth: not always! Some women report increased libido.

Although it’s true that your sex drive may drop when you reach menopause, fortunately, it’s not a given that excitement between the sheets will vanish altogether.

As oestrogen levels lower, this can lead to a reduction in blood supply to the vagina, which can hinder arousal. 27%-60% of women report vaginal dryness and pain which may make intercourse uncomfortable, triggering a loss of libido. If weight gain is an issue, this may also affect body image and confidence when it comes to being intimate.

Many women, however, find that their sex life doesn’t drop off a cliff; moreover, improves! Some women cite the lack of fear surrounding pregnancy, while others feel liberated from child-rearing responsibilities. Remember, every woman’s menopause experience and libido are unique, so you are not necessarily destined to a sex-free future.

To help support intimacy around menopause, you could consider lubricants if dryness is an issue. Communication is everything, so explore with your partner what works for you and what doesn’t. Have fun and experiment, be it with massage, books, toys or whatever tickles your fancy.

Myth: menopause is causing my weight gain.
Truth: it could be, but other factors may be at play.

With 70% of midlife women experiencing weight gain, acquiring a ‘meno belly’ during menopause is a common occurrence. The body’s decline of oestrogen can reduce muscle mass, slow down the metabolism and redistribute fat from the hips and thighs to the abdomen. However, menopause is not necessarily the sole reason to blame for weight gain.

Genetic disposition plays a role, so if family members gained weight during midlife, then it may increase your chances of weight gain. General ageing and lifestyle factors also influence whether or not you may gain weight during menopause, too. At this period in your life, you may find yourself balancing work with a family and caring for elder relatives. The associated pressures of multiple responsibilities can be draining, leading to a lack of sleep, low energy and an increased appetite.

Learn more about the relationship between menopause and weight gain, and read our practical tips to manage a healthy weight during this time.

If you are looking to be the happiest, healthiest version of yourself throughout menopause, Metluma can help you navigate this transitional time with confidence. Schedule a free consultation to discuss creating a personal treatment plan and support your needs.

Summary

Here, we summarise the myths and misconceptions around menopause so you can make empowered decisions about your health and wellbeing during this time.

• The average age of menopause for Australian women is 51, however women can enter menopause earlier or later, at any age between 45 and 55. Genetics, lifestyle factors like smoking and weight, stress and auto immune issues can influence the duration of menopause.
• Do not feel afraid to seek medical support such as MHT/HRT to help you manage both mental and physical symptoms of menopause.
• Declining oestrogen levels lower blood supply to the vagina, which may hinder libido during menopause, but it is still possible to maintain a healthy and happy sex life during this time.
• MHT/HRT is effective in improving menopause symptoms like hot flushes, night sweats, mood swings, vaginal dryness and reduced sex drive. The increase of risk of breast cancer is generally low and depends on other variables. Speak your health care practitioner about what is best for you.
• It is still possible to become pregnant during peri-menopause, menopausal transition and post-menopausal phase as fluctuations in the menstrual cycle may still lead to occasional ovulation.

Metluma provides evidence-based health and wellbeing support for women at all stages of life. Learn how to live longer, be healthier, and optimise your health during menopause.

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