Not your mother’s menopause: 3 menopause myths debunked by a doctor

This piece is sponsored by Sanford Health.

Over the past few decades, there has been a shift in the way we talk about menopause. More research has led to more treatments, and more conversations have led to less shame about the topic.

As a new generation makes their way through this transition, it’s important to know that treatment methods – or lack thereof – of their mothers’ and grandmothers’ times have changed. And while the online health and wellness influencers showing up in the algorithm with “advice” may be convincing, they aren’t necessarily acting with a viewer’s best interest in mind.

Dr. Elizabeth Hultgren, an OB/GYN at Sanford Health, sat to down to clear up some confusion around menopause and to encourage women to turn to a trusted health care provider with any questions about this phase of life.

Myth No. 1: Menopause happens overnight

Put simply, menopause is the process of a woman phasing out of her reproductive years. The average age of menopause is 51, but it can happen for women in their early 40s to upper 50s.

“Your ovaries are slowly producing less hormones,” Hultgren said. “So there’s going to be a gradual decrease in estrogen and progesterone production.”

Menopause is a process that typically takes years, and it’s divided into three stages: perimenopause, menopause and postmenopause.

Perimenopause is the transitional time when symptoms like irregular periods, hot flashes, sleep troubles or mood changes begin.

“Women are coming to me with some of these symptoms five to seven years before the onset of menopause,” Hultgren said. “So this is a gradual process. It’s all on a continuum.”

While the term menopause is often used to describe the entire process, it’s also used to define the middle phase when menstrual periods have stopped permanently. This signals the end of a woman’s ability to have children, and hormone levels change.

Postmenopause is the time after menstrual periods have stopped for a year and indicates that a woman is in a new phase of life.

Myth No. 2: You have to suffer through the symptoms

There may have been a time when women were expected to try to ignore their menopause symptoms, but that is no longer the case. There are many treatment options to help.

One of the most popular treatments for menopause is hormone therapy. Hormone therapy is a broad category of treatments used for many things, including contraception and menstruation management. During menopause, it’s used to address multiple symptoms like hot flashes or mood swings.

It’s natural for hormone levels to decrease with aging, so the goal with hormone therapy isn’t to keep a woman’s hormones at the same place they were before menopause. Instead, the goal is to prescribe enough to help someone get to a point where symptoms are manageable.

“We start with a low dose and work our way up until we have relief,” Hultgren said. “We’re not treating towards a number. We’re treating symptoms.”

The change in hormones also can affect sexual and vaginal health during menopause. There’s decreased elasticity, collagen and blood flow to the area. Along with thinning skin, it can make having sex uncomfortable or even painful.

“This is one of those topics in women’s health that I feel is very underrepresented,” Hultgren said. “People can be uncomfortable talking about more intimate issues with not only providers but friends or family members too.”

Still, sexual health remains an important part of overall women’s health, even through menopause. For vaginal dryness, vaginal irritation or pain during intercourse, Hultgren suggests using vaginal estrogen, which comes in a tablet or cream.

“It’s one of those things that I think should be recommended to all women as they age,” she said. “It can be life-changing for a lot of women.”

There are also nonhormonal options to treat many menopause symptoms.

Simple lifestyle changes, like adjusting the way you dress, changing the weight of your blankets on your bed or putting a fan in your bedroom can help with hot flashes or disruptions to your sleep.

Additionally, stress levels and hot flashes are directly connected as they both originate in the same area of the brain. That’s why SSRIs or SNRIs, medications typically used to treat anxiety and depression, can be effective for controlling hot flashes.

For nonhormonal ways to address vaginal dryness during intercourse, Hultgren suggests using over-the-counter vaginal moisturizers or a silicone-based lubricant.

No matter the preferred approach, a woman interested in finding treatment options for menopause symptoms should talk with her health care provider.

“For that first conversation, we’ll look at hormonal and nonhormonal options,” she said. “And then we’ll break it down from there to find the best option to treat the symptoms you’re currently having.”

Myth No. 3: Weight gain is inevitable and uncontrollable

It’s important to be mindful of weight changes during menopause. As hormones shift, so can dietary and exercise requirements.

 “As women age, estrogen and progesterone levels drop, and we tend to lose muscle mass,” Hultgren said.

This loss of muscle mass is the main contributor to weight gain, so women should be thinking about how to build their muscle mass back up.

“There’s nothing that makes me happier than when I hear a woman is lifting weights two to three times a week,” Hultgren said.

Lifting weights can help combat weight gain, but it also will positively impact cardiovascular and functional health. Women should be doing about 150 minutes of exercise per week.

Additionally, as people age, their metabolism slows down, which means they need to eat differently from what they might be used to.

“For most women, we’re talking about 100 grams of protein a day,” Hultgren said. “Most women do not get that.”

It may feel unrealistic to consume that much protein, but Hultgren encourages women to be intentional about it. Protein is what makes building muscle possible.

“I really like to meet women where they are,” she said. “No one’s going to make a huge dietary shift overnight and have it be sustainable.”

Hultgren suggests keeping some easy options on hand like protein shakes, hard-boiled eggs or protein bars. She also recommends adding lean meats or plant-based proteins like beans and legumes at mealtimes.

Menopause is not just an ending

Menopause is a natural part of the life cycle. It has its challenges, but with a plan, you can get through it without letting it control your life.

While menopause marks the end of a woman’s reproductive years, it’s far from the end of life as she knows it. It’s just the beginning of a new chapter.

“For some women, this can be really empowering,” Hultgren said.

Find care to match the moment you’re in at Sanford Health.