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Truths and Myths About Menopause

Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical Officer
Updated12/09/24
Article Content

Myth

Reality

Taking hormones increases the risk of cancer, clots, or strokes.

False. Studies have shown that women receiving bioidentical hormone replacement therapy (HRT) do not have any apparent increased risks for cancer, clots, or strokes.

Bioidentical hormones cause lots of scary diseases.

False. The very old studies that tried to state the harmful effects of hormones were not using bioidentical hormones. The hormones that they were using were from pregnant horse urine! Those are not the bioidentical hormones we use today.

Synthetic hormones are the same as bioidentical hormones.

False. Myths and misinformation about synthetic non-bioidentical hormones (Premarin and Provera) as compared to natural bioidentical hormones abound. Some people promote this confusion to sell their own products. This causes unfortunate confusion about the importance of hormone therapy. Bioidentical hormones have the same chemical structure as the hormones produced naturally by the body. The literature that states the harmful effects of HRT used non-bioidentical hormones which are not comparable to what we use today.

Hormones shouldn’t be messed with, it’s not natural.

False. Our bodies make 50 different hormones that serve as a chemical communications system. Hormones circulate in the blood looking for the right place to land and do their job. Hormones have complex jobs like coordinating fertility, sleep, wellness, mood, metabolism, and organ functions. Replacing hormones to appropriate levels allows the complex interactions to function correctly.

There are so many things going on during perimenopause and menopause, they can’t all be due to hormones!

Mostly False. Menopausal symptoms are related to decreasing levels of hormones. Those symptoms include depression, irritability, short-term memory loss, hot flashes, night sweats, insomnia, low libido, fatigue, and weight gain. HRT is the most effective treatment for menopausal symptoms.

Taking HRT is just a convenience, it won’t help my long-term health.

False. Using bioidentical hormones decreases the risk of breast and colon cancer, diabetes, heart attacks, strokes, osteoporosis, and more. HRT has been shown to support heart and bone health and decrease cancer risk for the rest of your life.

Hormone replacement is unhealthy.

False. HRT, using bio-identical hormones, for menopause symptoms has significantly reduced the risk of mortality, heart failure, and heart attacks. Hormones can make you feel better, give you more energy, live longer and help you sleep.

I tried birth control pills, and I didn’t like the way they made me feel. HRT will be the same.

Likely False. There are many different variations of hormone replacement therapy, and it’s about finding the right preparation for your body. Winona specialists can help you try different preparations to find one that suits you. HRT is give at much lower doses than oral contraceptives that you may have tried before. Effective doses of HRT are much lower than oral contraceptive prescriptions.

Menopause is natural, all animals go through it.

False. Only a few species are known to experience menopause: humans, rhesus monkeys, pilot whales, and killer whales. Biologically speaking, menopause is a bizarre concept, and very few species have a prolonged period of their life span where they no longer reproduce. The good news is that we have over 60 years of research that supports the use of hormone replacement therapy to ensure that the second half of your life is fulfilling and healthy.

If there are other products that are more ‘natural,’ and sold in the US, I know I can trust them to be safe.

False. The Food and Drug Administration (FDA) is responsible for ensuring the safety of the US food supply, cosmetics, and products BUT the FDA does not oversee the ‘natural’ products. This leaves it up to companies that sell the product to decide what their safety guidelines are. What may be ‘safe’ to the retailer isn’t necessarily safe at all. Winona hormones are prescription products and are fully FDA approved and produced in our licensed Winona Pharmacy.

Herbal supplements are safer than prescription medicines.

False. The FDA doesn’t regulate herbal supplements which means manufacturers can sell them without FDA approval! Herbal supplements, or botanicals, can not only be ineffective, but they can be dangerous, even life-threatening.

It is safer to take products made from plants, not those made in the lab.

False. Bioidentical hormones are made from plants. They are extracted in the lab and have the same exact structure as the hormones produced naturally by the body. They are also made to be easily absorbed so you can take less than ever before.

Taking hormones isn’t worth the risk.

That is up to you – but you can guard against major health risks like heart disease, diabetes, cancers, and osteoporosis by taking HRT.

Taking hormones can make me gain weight.

False. HRT can increase your lean muscle and energy level thereby increase your metabolism and interest in exercising, making weight loss easier.

I can get through menopause ‘naturally.’

True. You can indeed push through menopause without any treatments, but there is nothing more natural than the bioidentical hormones in HRT. Bioidentical HRT is all about returning what time and nature take away.

I can replace the decreased hormones by exercise and eating right.

False. While yoga can help with some menopause symptoms (like stress), and we always suggest eating well, the hormonal decrease is due to your ovaries slowing down over time and can only be replaced with treatment.

With enough yoga, healthy foods, and supplements, I can beat menopause.

False. Menopause is not a disease, it is a stage of life just like puberty was. We don’t ‘beat’ menopause, we work with it. Replacing those hormones is what your body desires. The huge drop in hormones at perimenopause and menopause can affect just about every part of your body – maybe that’s why they call it “the change of life.”

Menopause for me will start at the same age as my mom/ aunts.

False. There is no proven way to predict menopause age.

Menopause is something you deal with when you are in your 50s.

False. The transition to menopause is called “perimenopause” and often starts in your late 30's or early 40's.

I can wait until it’s really bad, or I’m older, to treat menopause symptoms.

False. The transition into menopause can sometimes take up to 10 years before recognizing you are in menopause. Women can experience mood disorders, sleep disturbances, and joint and muscle issues. Sadly, perimenopausal women often underestimate the impact that their undiagnosed menopause symptoms have on so many aspects of their lives and the long-term repercussions of not treating perimenopause. Waiting too long to seek treatment can adversely impact long-term health. Guard against major health risks like heart disease, diabetes, cancers, and osteoporosis by taking HRT. If HRT isn’t started before 60 years of age, the opportunity to take HRT will be lost.

I have high cholesterol, so I shouldn’t take HRT.

Likely False. Bioidentical hormone progesterone increases good cholesterol (HDL) and can decrease high blood pressure, total cholesterol, and triglycerides. Always check with your Winona provider or physician before trying any new medications.

My depression and/or anxiety isn’t related to menopause.

Likely false. Depression and anxiety can result from many various factors including life events, but depression and anxiety during your perimenopause and menopause years are likely partially due to hormone imbalances. Always check with your Winona provider or physician before trying any new medications.

HRT can’t help with brain fog and memory problems.

False. Not only is hormone replacement proven to help with these issues, but it is also really important to protect your brain function for the long-term by taking HRT. Always check with your Winona provider or physician before trying any new medications. Always check with your Winona provider or physician before trying any new medications.

Heart disease runs in my family, I don’t think HRT is for me.

Likely False. HRT has also been shown to support heart health by decreasing high blood pressure, total cholesterol, and triglycerides, and increasing good cholesterol (HDL).

Weight gain with menopause is inevitable

False. You can reverse course or prevent the gain by paying attention to the hormonal changes of menopause that may make you more likely to gain weight around your abdomen and back. Midlife women often gain up to 1.5 pounds per year. From perimenopause to the end of menopause that’s 15 lbs or more in your belly if you don’t prevent it.

My body is adding a layer of fat and it is landing in weird places – that’s okay – it’s a natural part of aging.

False. This kind of fat deposition can increase the risk of heart disease, cancer, and strokes. HRT can actually increase your metabolism and lean muscle mass which will help you avoid gaining weight and/or lose that perimenopause/menopausal weight deposit around your belly and back.

Gaining weight at middle age is an inevitable part of aging.

False. Reasons for weight gain may include increased hunger due to changes in the hormones that control hunger, as well as changes in metabolism due to decreased hormones that reduce lean muscle and increase appetite.

I won’t be able to lose weight after 40.

False. Fortunately, preventing weight gain and redistribution, or getting those sticky pounds to finally go away, is possible with HRT.

Sure, I’ve gained some weight around the middle, but that’s okay.

False. It’s not okay. Even if you are not obese but have excessive abdominal fat, you have a heightened risk of cardiovascular disease, asthma, sleep problems, osteoporosis, cancer, and death.

Hot flashes are something we must endure. I’m strong!

False. Hot flashes are a sign that your body is struggling to deal with the changes in estrogen levels and it needs some help. We know why hot flashes happen. As the estrogen in our body declines, our internal thermostat resets and our body tries to cool itself when we are stressed, have spicy foods, caffeine, or you name the trigger. While hot flashes (or hot flushes) are common, they are not necessary. If not treated, you can continue to experience hot flashes for 10 years or longer which can lead to disrupted sleep, fatigue, weight gain, depression, and so much more.

Hot flashes are no big deal. What’s the problem?

False. While you may not have problems, for some, a hot flash may last 30 seconds, and for others as long as 10 minutes! You may have one flash a week or 15 in a day. It is incredibly variable. There is also an “ember flash” – a hot flash that isn’t as intense and lingers for 25 minutes or longer. Whether ember, hot, or a flush – the solution is clear HRT is the most effective treatment for hot flashes.

My weight doesn’t influence the severity of menopause symptoms

False. People that are overweight before or during menopause are more likely to experience hot flashes and other menopause symptoms.

Menopause has nothing to do with my urinary tract and vaginal issues.

False. HRT enhances sexual and urinary health. We know that 1 in 2 women experience vaginal symptoms with menopause. Thinning, dry vaginal walls and difficulty with urination can be a clear symptom of menopause.

It’s to be expected – your sex life disappears as you age.

False. Hormone replacement can improve your sex life! Lowering levels of estrogen can make the vaginal canal less stretchy and can lead to vaginal dryness, itching, and irritation. These symptoms may make intercourse uncomfortable or painful– don’t settle for a so-so sex life. Decreased hormone levels can also lower your desire and make it harder to become aroused. HRT can get you interested all over again!

My face is sagging – it’s too late to start HRT.

False. As your estrogen levels drop, so does the collagen in your skin. Collagen gives your skin its youthful plumpness and keeps your skin tight. HRT can return youthfulness to the skin. HRT returns what time and nature take away.

I haven’t had any hot flashes, so I’m not in menopause.

False. Hot flashes are not always the first sign of menopause. Your first sign of menopause could be fatigue, anxiety, irregular periods, irritability, mood swings, depression, weight gain, hair loss, cravings, fuzzy thinking, low libido, forgetfulness, heavy menses, and loss of sexuality… this is all perimenopause or menopause.

Sex is painful, so I shouldn’t have it as often.

Likely False. Regular vaginal sexual activity is important for vaginal health because it stimulates blood flow, helps keep your vaginal muscles toned, and maintains your vagina’s length and stretchiness to say nothing about nurturing your intimate relationships. HRT can help relieve painful sex and make it enjoyable again.

I’m just emotional, it isn’t menopause.

Likely False. Women are more prone to mood disorders in the perimenopausal period. Fluctuating hormone levels during menopause can contribute to stress, anxiety, irritability, and depression. HRT can be the beginning of breaking free of this rollercoaster of emotions.

Wrinkles and age spots are from too much sun damage over the years, not menopause.

Partially False. While sun exposure in your 20’s and 30’s can make a huge impact on long-term skin appearance, the hormonal changes of peri – and menopause greatly impact your skin and its youthfulness. The decreases in estrogen, progesterone, collagen, and testosterone related to menopause make you prone to thinning, sagging, wrinkling, and older-looking skin.

How well I age is hereditary, not because of hormones.

False. Menopause causes many changes to your skin: a. Your body stops making as much collagen. b. You lose some fat under your skin, and c. Your skin’s elasticity drops. Combined with dryness caused by hormonal changes, your face starts sagging — especially around the neck, jawline, and cheeks — and fine lines and wrinkles get deeper.

I’m not sleeping well, but that’s normal.

False. Lack of sleep can decrease your already reduced hormone levels and metabolism even more, which accelerates the aging process. Getting enough sleep helps your skin look fresh. Sleep can help prevent dark circles under your eyes, and it also gives the rest of your body a chance to recharge. We know clearly that with decreased sleep, weight gain often follows, and so do mental health problems.

My menopause experience will be like my mom’s and sisters’.

False. Menopause isn’t a one-size-fits-all event. It affects each woman differently. Even if you are related to them.

My best years are in the rearview mirror.

False. Instead of looking back mournfully, view menopause as a time to redefine yourself with positive thoughts, love yourself, explore what brings you pleasure, and revive (not retire) your sex life. With HRT you can start to take control of what might feel like a life that is spinning out of control. Take control, you can with HRT.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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