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Menopause and Perimenopause Myths Debunked

09/14/2017

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With countless resources available describing “magic fixes” for menopause symptoms, many women find themselves worrying about the dreaded change. What happens? Does every woman experience every symptom? When it comes down to it, many women don’t know all the facts, and some might have fallen prey to common menopause myths.

It’s time to put pre-menopausal minds at ease. Since September is Menopause Awareness Month, it’s a perfect time! We’ve brought in Courtney A. Seacat, M.D., an OB/GYN practicing women’s health at INTEGRIS Health Edmond, to explain exactly what menopause is and what pre-menopausal women should expect.

What is Menopause?

“The definition of menopause is one full year without a period,” Dr. Seacat says. “This marks the end of the reproductive years for women and when the ovaries stop making estrogen. This is the hormone that helps control the menstrual cycle.”

As a result, menopause can also come with hot flashes, vaginal dryness, thinning hair and the inability to have children. Other symptoms may include heart palpitations, irritability, urinary incontinence, facial hair growth and osteoporosis. Due to the lack of estrogen, many post-menopausal women are at an increased risk of heart disease, stroke and bone loss.

The Stages of Menopause:

Pre-menopause: The female body has not begun menopause.

Perimenopause: The female body slowly begins to reduce its estrogen production. This can occur in one year or gradually over several years. Menopause symptoms, such as hot flashes, may start to occur in the tail-end of this stage. The woman has periods and is still capable of becoming pregnant.

Menopause: The female body stops producing estrogen, and the woman has gone without a menstrual cycle for 12 consecutive months.

Post-menopause: The years following menopause.

Menopause Myths Debunked

Myth: Menopause always starts at age 50.

According to Dr. Seacat, “The average age of actual menopause is 51, but it all depends on genetics, lifestyle, smoking, etc. Some women enter menopause or perimenopause at an early age and some later.”

A woman is not officially in menopause until she has gone an entire year without a period. If she doesn’t have a period for nine months and has one in the tenth month, she is still in perimenopause and the clock resets.

Myth: It’s easy to tell if you are going through menopause.

Since perimenopause can last several years, it can be difficult to discern if you have transitioned into menopause. It’s even more difficult for women who have had a hysterectomy to tell if they are experiencing menopause. These women have had their uterus removed but still have ovaries. Some women, with or without a previous hysterectomy, only experience one symptom of menopause – the end of periods.

Tests can be performed to discern if someone is experiencing menopause. “There is a hormone level called Follicle Stimulating Hormone, or FSH, which can be checked to help decide if someone is in menopause or close,” Dr. Seacat says. “This is a hormone that talks to the ovaries. When the ovaries are not functioning anymore, this hormone level increases. Most of the time though, the diagnosis of perimenopause and menopause is based on symptoms and lack of or decrease in periods, and blood work is not needed. Periods typically become shorter and they may space out, but occasionally people have heavier or more frequent bleeding, as those hormones start to change. Regardless, you should report them to your doctor, as abnormal bleeding could be a sign of another problem.”

Myth: Every menopausal woman has hot flashes.

Each woman has a different menopause experience. Some have hot flashes. Some have insomnia. Some don’t experience any symptoms. The American Congress of Obstetricians and Gynecologists (ACAG) cites other common symptoms including vaginal changes and urinary tract inflammation. Due to the decrease in estrogen levels, the vaginal lining can become thinner, dryer and inflexible. These changes could cause pain during intercourse but can be prevented with lubrication. During menopause, the urethra can experience inflammation, dryness or irritation, causing an increased risk of UTIs or increased frequency of urination.

Myth: Women should take hormones after menopause.

“Many women ask if they need to be on hormones once they go through menopause,” Dr. Seacat says. “The answer is, ‘no’.  We do not automatically put women on hormone replacement (give them estrogen). The main reason to put women on hormones is to help manage hot flashes and night sweats, if they are bad enough to interfere with daily life. The recommendation is ‘the lowest dose of hormone, for the shortest period of time’, to get them through the symptoms of menopause. The dose on hormones and length of symptoms is different for everyone and should be a personal decision between the patient and her doctor and evaluated each year. There are certain women that may not be a candidate for hormones therapy because of such things as a history of blood clots, breast cancer, etc. Of note, if you still have a uterus and need to get on hormone therapy, you need a progesterone hormone with the estrogen to protect your uterus. Giving estrogen alone without a progesterone can increase the risk of developing uterine cancer.”

Myth: Hormones are the only cure for hot flashes.

Dr. Seacat explains that there are other methods for managing hot flashes. “There are antidepressants that can help decrease hot flashes. Plant and herbal supplements such as soy or black cohost may help some people, but these are not FDA regulated so there is not proven safety and efficacy. And bioidentical hormones, which are hormones from plant sources, are a popular topic these days. However, they are also not regulated by the FDA. Currently, there is no scientific evidence that these are safer or more effective than the standard hormone therapy. “

Menopause is not a one-size-fits-all condition. Women cannot predict when they will experience it, nor can they make it end more quickly. “Menopause and perimenopause are normal parts of being a woman,” Dr. Seacat says. “Everyone has a different experience with it.” Don’t fear the change.

Still curious? Read more from Dr. Seacat in What You Need to Know About Menopause.

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