With decades of periods under your belt, you might be ready to wave goodbye to menstruation. After all, for many women, the idea of life without monthly cramps, cravings, and mood swings may sound nothing short of relieving. Before you can experience relief, however, you'll need to experience menopause—symptoms and all.
A quick refresher: Menopause is the time in a woman's life when menstruation ends—it occurs 12 months after her last period. It's marked by a natural drop in reproductive hormones (estrogen and progesterone) that are produced by the ovaries. Collectively, the years leading up to the point of menopause are known as perimenopause, or menopausal transition, according to the Office on Women's Health. The hormonal changes that happen during this time are responsible for irksome symptoms like hot flashes, anxiety, and trouble sleeping, just to name a few.
Menopause is completely normal and natural. But even still, it can be a confusing time for many women, especially if they've never spoken to female friends or relatives about it. Unfortunately, the conversation around menopause is pretty limited—which means there are a lot of myths and misconceptions floating around out there. To help you navigate this major (and inevitable!) life transition, we're debunking some of the most common menopause myths, with the help of doctors and health pros.
Myth: Menopause (and symptoms) always starts in your 50s.
While it is true that the average age of menopause is 51, the "normal" range for menopause is greater than you think—it lies between 45 to 55 years old, according to Jill Angelo, CEO and co-founder of Gennev, a digital menopause clinic. (This is independent of age at your first period and pregnancy, as well as birth control history.) What's more, "menstrual cycle changes and early symptoms may show up in a woman's late 30s, with each decade [causing different symptoms]," she explains. "Some factors, including smoking or prior hysterectomy (removal of the uterus) may lead to menopause at a younger age, [while] removal of the ovaries at any age results in immediate menopause." Otherwise, family history can play a role in the age of natural menopause or menopause without a specific cause.
Menopause symptoms last forever.
Thankfully, this is false. As mentioned earlier, menopause is characterized by a drop in estrogen levels. During this time, you'll experience menopause symptoms as your body slowly attempts to regain balance. However, because this transition happens slowly, symptoms often linger for some time—but not forever. On average, symptoms last for four and a half years after a person's last period (and about seven years in total), according to a study in JAMA Internal Medicine. Additionally, the most "problematic symptoms tend to be most noticeable during the first few years of the transition, [eventually] tapering off over time," explains Angelo, adding that everyone is different, so it's impossible to predict how long menopause symptoms will last for any particular individual.
But take note: Your lifestyle habits can play a role. According to a 2020 study, regular physical activity can minimize the severity of menopausal symptoms. On the flipside, habits like smoking cigarettes and drinking alcohol can actually increase the frequency and severity of symptoms. Emotional stress has also been found to exacerbate menopausal symptoms, according to a 2021 study. That said, it's never too late to fine-tune your habits in the name of managing menopause.
Myth: If you've missed a few periods, you're in menopause.
In order to be considered in menopause, you need to go without a period for one full year, says Lisa Savage, MD, FACOG, obstetrician/gynecologist at Gennev. That said, during perimenopause, it's common to experience skipped or irregular periods for a few months or years, she adds. The cycle irregularity in this phase, Dr. Savage says, "is due to the variability and inconsistency [of] ovarian function."
Myth: Menopause is an illness.
Nope, nope, and nope. It's not uncommon for menopause to be discusesed as if it's a disorder or ailment. And while the typical symptoms can disrupt everyday life, it's anything but an illness. "It's a natural transition that every woman will go through, just like puberty," Angelo says. "[The medical professionals at Gennev] view menopause as the start of the second half of life, which we expect to be fulfilling and vibrant with the right outlook and support."
Myth: Women have to just deal with menopause symptoms.
"Society has taught many [women] to grin and bear it," Angelo says. However, with more prescription and natural solutions available, it's possible to minimize the impact of symptoms and thrive during the menopause transition. "Women do not need to wait to treat their menopause symptoms until they become unbearable," she urges. That's why it's crucial to routinely visit your gynecologist, regardless of your age or phase of menopause. And don't be shy: Ask about the best options for managing your personal set of symptoms.
Myth: Menopause only causes hot flashes.
False. While hot flashes are "classic" symptoms, menopause can affect your body's temperature in myriad ways, Dr. Savage says. After a hot flash, you may feel cold as sweat evaporates. This can snowball into alternating sensations of hot and cold, resulting in a "covers on, covers off" phenomenon at night. In other cases, some women experience cold flashes without any hot flashes first. All of this stems from the hypothalamus, a part of the brain that, because of hormonal alterations, reacts inappropriately to small changes in core body temperature. To manage these symptoms, Dr. Savage recommends dressing in layers, like wearing a scarf and cardigan over a tank top. This way, you can easily remove layers (or bundle up) depending on how you're feeling.
Myth: No periods means no cramps.
This isn't the best news, but it's helpful to know what you're getting into. During perimenopause, it's possible to experience pelvic cramping even if you don't have periods, Dr. Savage says, explaining that the uterus is made of strong muscle tissue which might squeeze and contract. as ovarian function declines. However, if you continue experiencing cramping despite having no periods, she recommends visiting your doctor for a gynecologic evaluation, just in case. If all looks well, you can use the usual cramp remedies (think: ibuprofen, heating pads, etc.) to get relief.
Myth: You can't get pregnant right before menopause.
Although fertility declines as you get older, it doesn't necessarily mean that pregnancy is out of the question. That's because you can still ovulate during perimenopause, even if you're experiencing skipped or irregular periods, Dr. Savage says. So an unplanned pregnancy is a real possibility, even if you're nearing menopause. In order to prevent an unintended pregnancy, you'll still need to use birth control until you've gone one year without a period—which, again, is the official definition of menopause. This may be especially important for anyone with chronic conditions like heart disease, hypertension, or diabetes, which can pose serious health risks in pregnant women. On that note…
Myth: You can't use the pill after age 35.
"This is a myth!" Dr. Savage says. Unless you smoke cigarettes or have certain medical conditions, you can use a low-dose birth control pill to manage symptoms during perimenopause, she adds. Additionally, you can continue taking the pill until age 55, as it "contains estrogen and progestin, which can balance hormones, control cycles, and provide contraception," Dr. Savage says. But always, always talk to your doctor, who can confirm if this is the right move for you.