Common Myths, Misconceptions, and Misinformation About Menopause:
The most common misperception is that menopause is "the beginning of the end."
The opposite myth is nearly as prevailing- that it just isn't a big deal. Upon
hearing about it, many women who are not affected react with nonchalance saying,
"I wish I could get out of having my periods!" Yet menopause is about much
more than losing your periods. For many women the end of fertility may be welcome,
but in some women, the end of childbearing potential can represent a major loss.
Many women struggle with the emotional burden of suddenly feeling "old". The
confusion of the numerous but sometimes vague physical and emotional symptoms
can be overwhelming, especially when many physicians don't consider menopause
as the diagnosis; too often women are treated with antidepressants or anxiolytics
(anti-anxiety medications) as a panacea. Some women report that when they asked
their doctors if their symptoms could be related to menopause, they are simply
told to come back when they haven't had a period in a year. Patients fear that
they are exaggerating real symptoms; they fear telling their physician, and
they fear being misunderstood.
Another myth is that menopause is associated with "empty nest syndrome" and
causes depression. Research has shown that the incidence of depression in women
actually peaks in the 30's; on the contrary, many women in their 50's experience
what Margaret Mead termed "postmenopausal zest". Menopause is a risk
factor for depression in certain women: women who have had a previous history
of depression (including postpartum depression), women with any other psychiatric
illness, women with a family history of menopausal depression, and women with
a history of premenstrual dysphoric disorder (PMDD, otherwise known as "PMS").
Depression can also be a symptom of numerous other medical disorders, from heart
disease to infectious conditions. Menopausal women with depression should consult
their physician, rather than assume it's "normal" to become depressed when one
enters menopause. What if your doctor's diagnosis is depression? Remember- it
Don't assume that your doctor thinks you have depression if s/he recommends
an antidepressant (e.g. Prozac, Zoloft, Effexor, Paxil) to treat your menopausal
symptoms such as hot flashes and mood swings. As we'll discuss later, these
medicines have been shown to be an effective alternative therapy to HRT from
menopausal or perimenopausal symptoms in some women whether or not they also
The most dangerous myth is that menopause is just a "natural" phase of life
and doesn't have any serious consequences. This simply is not true. Losing
estrogen puts women at increased risk for osteoporosis, heart disease, colon
cancer, Alzheimer's disease, tooth loss, impaired vision, vaginal and urethral
atrophy, Parkinson's disease, and diabetes. The longer women are without the
protection of their own estrogen, the greater their risk for the serious health
consequences from these conditions. Likewise, just because menopause is "natural"
doesn't mean there aren't interventions we can use to improve our quality of
life- many of the consequences of menopause can be successfully treated and
managed. The good news about menopause is that with prompt intervention and
proper management, many of the long-term consequences can be prevented, reduced
in frequency, or delayed.
Another way to view this issue of "it's natural, why interfere?" is that all
diseases and medical disorders are natural too, yet we "interfere". For example,
diabetes is caused by a shortage or lack of insulin; we replace insulin to treat
it. While menopause itself is certainly not a disease or a disorder, its consequences
are. They are either caused by or exacerbated by a lack of estrogen; we can
replace estrogen in many patients in order to treat them. Of course, hormone
replacement therapy (HRT) has its own list of consequences and side effects,
so the decision to chose this therapy should not be made lightly. The good news
is that there are many alternatives depending on a woman's individual circumstances,
risks and symptoms.