There’s considerable conflicting information out there about menopause, especially when it comes to the risks and benefits of hormone therapy. Some sources warn of increased risks for conditions like cancer or heart disease, while others emphasize the transformative relief hormone therapy can offer. With so many mixed messages, it’s understandable if you’re unsure about what’s true and what isn’t.
The key takeaway is that menopause is a natural phase of life. While treatment isn’t always necessary, you don’t need to simply accept symptoms like hot flashes, mood swings, or fatigue as inevitable. Safe and effective options are available to manage these changes to help you feel more like yourself during this transition.
To bring clarity to this topic, we’ll address some of the most common myths about menopause and hormone therapy and debunk them with evidence-based scientific insights. By separating fact from fiction, you can make informed choices about your health and well-being.
Top 12 Myths About Menopause
Here are some of the most common myths about menopause and their corresponding facts.
1. Taking hormones increases the risk of cancer, clots, or strokes.
The myth that HRT significantly increases the risk of heart disease and stroke stems from the Women’s Health Initiative (WHI) trial. The WHI trial initially suggested that HRT was associated with higher risks of coronary heart disease and stroke. The WHI data were frequently reported without the necessary nuance, overlooking critical distinctions in HRT formulations, dosages, and patient demographics. This oversimplification fueled widespread fear of HRT, leading to its reduced use, even for women who may have benefited from it.
However, subsequent reanalysis and new studies have clarified that these risks are context-dependent, particularly influenced by the timing of HRT initiation. Women under 60 or those who begin HRT within 10 years of menopause may actually experience cardiovascular protection rather than harm.(1)
2. Bioidentical hormones cause many harmful diseases.
The claim that bioidentical hormones cause many harmful diseases is not supported by scientific evidence. Researchers suggest that bioidentical hormones may be safer and more effective for managing menopausal symptoms than their synthetic counterparts. Unlike synthetic options, bioidentical hormones have a molecular structure that closely resembles the natural hormones produced by the body, allowing them to work more harmoniously and with fewer side effects.(2)
3. Synthetic hormones are the same as bioidentical hormones.
The idea that synthetic hormones are the same as bioidentical hormones is a common misconception. While both are used in hormone therapy, they differ in structure and how they interact with the body.
Synthetic hormones, such as those found in medications like conjugated estrogens (Premarin) and medroxyprogesterone acetate (Provera), are chemically altered versions of natural hormones. Because of these structural differences, synthetic hormones may interact with the body unpredictably, leading to potential side effects or risks.
Bioidentical hormones, on the other hand, have the same molecular structure as the body’s own hormones. This similarity allows them to work more naturally and effectively.(3)
4. Hormones shouldn’t be replaced or supplemented as it’s unnatural.
Restoring hormones to optimal levels is actually not an unnatural intervention because it helps your body function as it’s meant to. Hormones do more than regulate the reproductive system; they also support the brain, skin, and other organs and processes. When levels fluctuate during the menopausal transition, symptoms like mood swings, hot flashes, and vaginal dryness can develop. Bringing hormones back to a healthy range helps address these symptoms and allow body systems to work properly. Rather than interfering with your body, hormone therapy works in harmony to maintain balance and overall well-being.
5. Perimenopause and menopause symptoms can’t all be caused by hormones.
Some believe that perimenopause and menopause symptoms aren’t entirely caused by hormones, but research shows otherwise. Hormonal fluctuations play a major role in many of the changes women experience during this transition.
Shifts in hormone levels, alongside age-related changes, are well-documented causes of issues like depression, irritability, hot flashes, night sweats, insomnia, and weight changes. Dismissing the role of hormones overlooks the profound impact these changes have on the body and mind.(4)
6. Taking HRT is merely a convenience and doesn’t support long-term health.
HRT is far more than a convenience—it’s a scientifically backed approach to improving long-term health and quality of life during menopause. Research shows that HRT helps maintain critical aspects of health, such as preserving bone density and supporting skin elasticity. It also significantly reduces the severity and frequency of debilitating symptoms like hot flashes and night sweats, allowing individuals to regain comfort and control in their daily lives. Long-term use of HRT has been associated with reduced risks of osteoporosis and improved cardiovascular health, making it a valuable tool for supporting overall well-being during and after menopause. (4)
7. HRT has the same effects as birth control pills.
Both HRT and birth control pills contain hormones, but they serve different purposes. HRT cannot be used as a contraceptive because it delivers much lower doses of hormones than oral contraceptives. Birth control pills provide higher hormone levels to stop ovulation and prevent pregnancy, while HRT works to restore hormonal balance during menopause. Specialists can tailor the treatment to meet individual needs, ensuring the best outcomes.
8. Supplements marketed as “natural” in the U.S. are safe and effective for hormone balance and menopause support.
This isn’t necessarily true. Unlike prescription medications, supplements are not regulated by the FDA, meaning their safety, effectiveness, and ingredient accuracy depend entirely on the manufacturer. Without FDA oversight, these products can vary in quality, potency, and purity.
Prescription bioidentical hormones, on the other hand, are FDA-approved and must meet stringent safety standards. Bioidentical hormones that have the same molecular structure as the body’s natural hormones are often considered a more natural alternative. As discussed earlier, this structural match allows them to interact with the body in a way that more closely mimics naturally occurring hormones, potentially reducing side effects and improving effectiveness.
9. Herbal supplements are safer than prescription medicines.
Many assume herbal supplements are safer than prescription medicines, but without FDA regulation, their safety, effectiveness, and quality are not guaranteed. While they may seem like a more natural alternative, they can be ineffective, interact with other medications, or even cause adverse side effects in some individuals.
Conversely, prescription medicines are thoroughly tested and monitored for safety and effectiveness, ensuring a higher standard of care and predictability.
10. Plant-based products are safer than lab-made ones.
While plant-based products might seem safer because they’re “natural,” the way they’re processed matters. Bioidentical hormones, for example, come from plants but are carefully refined in labs to match the exact structure of the body’s natural hormones. This process ensures they are both safe and effective. On the other hand, unregulated plant-based products can vary in quality and potency, making them less reliable.
11. Hormones aren’t worth the risk.
This is a personal choice, however, it’s important to understand the significant benefits it can offer. Hormone therapy has been shown to lower the risk of serious health conditions like heart disease, diabetes, and osteoporosis. It also helps manage common menopause symptoms, such as hot flashes, mood swings, and sleep disturbances, improving overall quality of life. When used under medical supervision, hormone therapy offers a safe and proactive way to support long-term health and vitality.
12. HRT causes weight gain.
The idea that hormone replacement therapy (HRT) causes weight gain has been widely circulated in articles and discussions, but research tells a different story. Fluctuating hormone levels during menopause can alter fat distribution and slow metabolism, often leading to increased belly fat.
Since estrogen plays a key role in regulating fat storage and metabolic function, declining levels can shift fat accumulation to the abdomen. By supplying the body with balanced hormone levels, HRT helps counteract these changes, supporting a healthier metabolism and fat distribution.
A study involving over 1,000 postmenopausal women aged 50 to 80 found that women who were taking hormones had significantly lower levels of belly fat compared to women who had never used them.(5) Researchers also found that women using HRT had a BMI that was almost one point lower and carried about three pounds less fat than women who did not use HRT.(5)
The Truth About Menopause and HRT
The Women’s Health Initiative (WHI) study once caused widespread concern by suggesting that HRT might increase the risk of heart conditions or breast cancer. These findings led many women to stop using HRT, fearing the potential risks.
However, the study painted an incomplete picture. It didn’t account for factors like age or pre-existing health conditions and relied on synthetic hormones for its analysis. Later reanalysis revealed that when HRT is started within 10 years of menopause or before age 60, it can actually support heart health and offer significant benefits.(6)
Despite these updated insights, many women still hesitate to explore HRT due to lingering misconceptions, and some healthcare providers remain cautious, influenced by outdated data. As a result, countless women miss out on effective treatments for severe menopause symptoms.
It’s important to understand that menopause management isn’t one-size-fits-all. What works best for you may not be what works for someone else. While HRT can be life-changing for some, others may benefit from a combination of strategies, including medications, exercise, and lifestyle changes, with or without HRT. Staying informed about the latest research allows you and your healthcare providers to make the best choices for your unique needs, ensuring a healthier and more comfortable transition through menopause.
Interesting Facts About Menopause
Here are a few surprising facts about menopause:
Pregnancy is possible during perimenopause: During perimenopause, women may still ovulate occasionally, meaning pregnancy is still a possibility. Using contraception is essential for those who wish to avoid pregnancy during this transitional phase.(7)
Pregnancy is still possible during menopause with assistance: While natural conception is no longer possible once menopause is complete, women can still become pregnant using assisted reproductive technologies, such as in vitro fertilization (IVF).(8)
Not all animals go through menopause: Only a few species experience menopause, including humans, rhesus monkeys, pilot whales, and killer whales.(9)
