There are few topics my girlfriends and I won’t broach. Men, children, sex — anything is fair game. But one subject my 40-something-year-old friends and I haven’t touched with a 10-foot pole: the looming specter of menopause.
Turns out we’re no different from a lot of women our age, says Denise Pines, founder of the WisePause Lifestyle Summit, a conference that brings together experts to provide information to women about menopause, the period of life after you’ve gone 12 months without a menstrual cycle, and perimenopause, the period of time when your body transitions to menopause.
The way Pines sees it, menopause gets a bad rap. Women like my friends and me who are approaching that life stage often have preconceived notions about menopause making us less desirable or leaving us no longer wanting to have sex, so we avoid talking about it altogether. “When you have a word that equates with such negativity … you're not trying to identify with that,” Pines says.
But ignorance is not bliss. With so many of us staying mum on the topic, we often don’t know what to expect during perimenopause and menopause when our bodies stop producing as many hormones. “If you had the information, you'd start getting prepared,” Pines says. “You would go, ‘Oh, this is my hormones. Let me go to the right doctor … to help me get balanced.’”
Many symptoms can be alleviated if we know our options. Here are some common myths — and truths — about menopause to continue our education.
Myth: Hot flashes are the main thing I have to plan for.
Fact: While hot flashes, weight gain and vaginal dryness are among the most commonly known symptoms of menopause and perimenopause, according to a recent AARP study, there are other symptoms that many women don’t know about. For example, lesser-known symptoms include itchy skin, heart palpitations and acne. When shown a list of 28 conditions that could accompany menopause, roughly 1 in 6 women age 35 and over didn’t know any of them were symptoms associated with that stage of life, according to the AARP survey.
However, Black women are more likely to suffer from hot flashes than other races, according to the Study of Women’s Health Across the Nation (SWAN), a report that tracked the menopausal experience of 3,198 women between 1996 and 2002.
Myth: Menopause symptoms are just something I have to deal with.
Fact: Many of our mothers and grandmothers suffered in silence. “I remember my grandma walked around in her bra and none of us thought that was crazy — she was hot,” Pines recalls. The AARP study found that nearly half of women 35 and over, 46 percent, had taken no steps to do anything about the symptoms of perimenopause or menopause that they were experiencing.
However, there are solutions that can make us feel better, and there’s good reason for us to explore our options. Black women were found to have symptoms for a longer period of time than other women, the SWAN study found. While the median duration of menopause symptoms for all women is 7.4 years, for Black women it is 10.1 years.
Hormone replacement therapy (HRT) is medication that replaces the hormone estrogen, which is produced in smaller amounts by the ovaries during menopause. “HRT has been around for years and has been shown to be effective against symptoms of menopause,” says Dr. Jessica Shepherd, an ob-gyn who practices at the University of Illinois at Chicago.
Not only might certain medications bring about relief, but lifestyle changes can also make a difference. “Maintaining a healthy diet and weight can definitely help with the effects of menopause,” says Shepherd. For example, osteoporosis is a disease that weakens the bones and is often seen in women who are approaching or in menopause, Shepherd points out. Though Black women have a lower risk of osteoporosis than other groups, we can reduce our risk even more, she says. “Ensuring you eat foods with a great amount of calcium can help reduce unexpected fractures due to osteoporosis.”
Myth: Once I’m in menopause, my sex life will go downhill.
Fact: It’s true that during menopause, changes to the body can decrease your enjoyment of sex. Studies show that menopause can contribute to the development of vaginal dryness, which can make sex painful if untreated. But you can do something about it. Vaginal moisturizers, lubricants and estrogen-based HRT options can all help, according to the Mayo Clinic.
More good news: Researchers in Brazil found that other factors can influence how enjoyable sex is during menopause, including your general health and the relationship you have with your partner.
But perhaps the biggest boost to your sex life postmenopause: You can no longer get pregnant! Not having to think about contraception can usher in a new world of freedom and experimentation to your sex life.
Myth: Hormone replacement therapy comes with too many risks.
Fact: As with any treatment method, there are pros and cons to HRT, says Shepherd. Some women may be more at risk of certain health conditions if they take HRT, so “I strongly recommend discussing your symptoms with your primary care physician and ob-gyn to help determine if HRT is the right treatment method for you,” she advises.
Overall, “HRT’s advantages have outweighed its disadvantages,” Shepherd notes. It’s been found to alleviate hot flashes and night sweats. On top of that, it may help with mood swings, and according to the Mayo Clinic, it may reduce your risk of certain conditions such as heart disease and dementia.
Your doctor can help you determine a regimen that is safe for you, as experts advise using hormone therapy at the lowest dose that’s effective and for as short a period of time as possible.
Myth: All HRT options are the same.
Fact: Hormone replacement therapy comes in a variety of options to meet the many different needs of women in menopause. Not only can you take HRT orally in the form of a pill every day, but you can receive the hormones through vaginal creams, gels, rings and skin patches.
Some options add more estrogen to the body than others. Systemic hormone therapy contains high doses of estrogen that is absorbed throughout the entire body. Low-dose vaginal products produce less estrogen in the body and are primarily used for vaginal symptoms of menopause such as vaginal dryness.
Bottom line: Menopause and perimenopause need to become part of our sister-circle conversations. “Menopause is not a disease; menopause is a normal cycle, and we need to celebrate that cycle,” Pines says.
Loris Lora
