Let’s Talk Menopause: 6 Myths Every Woman Should Know

Menopause remains frightening to many women who lack basic facts about it. That’s why we’ve called on Dr. Robert Goldfarb, M.D., an OB/GYN and menopause expert at Henry Ford West Bloomfield Hospital, to lob a few truth bombs at common menopause myths. Despite what you may have heard, menopause doesn’t make you fat, sexless and crazy. Here’s how to navigate “the change.”

 When women talk about menopause, they usually mean perimenopause, the transition time leading up to   the last period. That’s because periods turn fickle as menopause approaches, sometimes happening more often than usual or skipping months. Scientifically, a woman has completed menopause when she hasn’t had a period for a year. The average age for menopause is 51.

Fluctuating hormones cause these irregular periods, as well as hot flashes, sleep problems, vaginal dryness and other symptoms. These can start years before menopause. The good news: Today’s doctors have better information and tools to offer individualized patient care, which is what you need because each woman’s experience is unique.

Thinning vaginal tissues and dryness can make intercourse uncomfortable or even painful. “You’re at a time in your life where your libido isn’t where it used to be, but at the same time, you don’t want to give up sex,” Dr. Goldfarb says. “No one wants to do something that’s painful. It’s difficult for relationships.”

Difficult but not impossible, he stresses. Dr. Goldfarb recommends women first try over-the-counter vaginal lubricants and moisturizers. If those don’t help, talk to your doctor about topical prescription remedies. “Vaginal estrogen works really well to help with the discomfort,” Dr. Goldfarb says.

    Get ready for weight gain.

“I’ve not seen any research that says, ‘You’re menopausal, so you’re going to gain weight,’ ” Dr. Goldfarb says. He encourages patients to “be reasonable” about regular exercise and diet and to track what you eat. “A lot of times, people eat more than they realize,” Dr. Goldfarb says. Watch out for stress eating, too, he says.

 Menopausal hormone therapy will change your life or kill you.

For decades, almost every woman took hormones (then called hormone replacement therapy) because it treats hot flashes and other symptoms, and doctors thought it had other benefits. “We were saying it should be in the drinking water,” Dr. Goldfarb jokes, “and then the Women’s Health Initiative came out, and they said, ‘It would be like drinking from the Love Canal.’ ” (For those too young to remember, Love Canal was one of the most toxic pollution disasters in U.S. history.)

As part of its Women’s Health Initiative, the U.S. government in 2002 stopped a hormone replacement study early after noting a link between taking a combination of estrogen and progestin and an increased risk of breast cancer and cardiovascular disease. Two years later, another study involving only estrogen was halted because of an increased risk of stroke.

However, menopausal hormone therapy can bring relief to women suffering severe symptoms, Dr. Goldfarb says. “Those who are on hormones really like their hormones,” he says. “The recommendation is to use as low a dose as possible for as short a time as possible.”

Patients should weigh the severity of their symptoms against MHT’s slightly increased risk of breast cancer, blood clots and strokes, Dr. Goldfarb says. Women who have had breast cancer and certain other conditions should not use MHT.

Some medications for depression, high blood pressure and seizures also can help calm hot flashes and menopause-related sleep problems, he says.

   Bioidentical hormones are best.

Bioidentical hormones are artificial hormones with the same chemical makeup as those produced by the body. They are available from regular pharmacies and custom-compounding pharmacies. However, the North American Menopause Society warns against using compounding pharmacies, saying their products aren’t FDA-tested and may not contain the correct dosage.

Dr. Goldfarb says he has patients on bioidentical hormones, adding, “I don’t necessarily think they’re better, but this is what some patients want.” he says. Ask your doctor about what’s right.

   Why wouldn’t you feel blue? Life as you know it is over.

Mood swings and brain fog affect many women during perimenopause. But this isn’t the time to turn your back on life. Taking care of yourself now is more important than ever, especially if you’re deep into a career, raising kids (who may be going through their own hormonal stuff) or caring for aging parents. “It can be a very stressful time of life,” Dr. Goldfarb says. “I think the hormonal changes definitely add to the stress.”

Depression, on the other hand, is a serious condition that calls for professional evaluation. Talk to your doctor if feelings of sadness or hopelessness don’t respond to your best efforts to keep them at bay.

Menopause can be a time to redefine yourself and embrace your evolving lifestyle. In other words, take charge of the change.

Menopause for men?

There’s no official diagnosis of male menopause. Many men can continue to reproduce, and often they don’t even notice the natural decline in testosterone that comes with middle age. Some men, however, suffer from a range of symptoms including fatigue, depression, weight gain and sexual problems.

In most cases, the “cure” for these issues is to follow the usual guidelines: eat healthy, work out often, get sleep and avoid stress. There are some medicines that can rev up your sex life if erectile dysfunction and low libido are issues, notes Dr. Robert Goldfarb.