2 major misconceptions about menopause—from the experts, for the experts
Key Takeaways
Industry Buzz
“[Patients] are afraid that if they take hormones, it will give them breast cancer or a stroke or a heart attack. And so it's a tragedy that only a small fraction of women who would be candidates for menopausal hormone therapy are actually on it." — Karen Adams, MD, clinical professor of OB/GYN at Stanford and Menopause Society-certified menopause specialist
“You would be amazed how menopausal women, I put them on hormone replacement therapy, and we get the dose right, how much better they feel.” — G Thomas Ruiz, MD, lead OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA
Menopause may be a universal experience, but the confusion surrounding it—especially in clinical settings—is anything but rare. Despite decades of research, many physicians still carry outdated or inaccurate beliefs about it.
Experts say that misinformation is not only widespread but also harmful, leaving many women to unnecessarily suffer through this life transition.
“This is not just aging,” says Karen Adams, MD, clinical professor of OB/GYN at Stanford and a Menopause Society-certified menopause specialist. “The suffering is not a given... and we as providers have a huge opportunity to really relieve [it], which is what we all went into medicine to do."
Whether it’s confusion over treatment options or misconceptions over symptom management, mistaken beliefs about menopause are common. Here are the top-two biggest myths about menopause, busted.
1. Suffering is inevitable
“I would say that, number one is that you have to just tough it out. You know, get a fan and tough it out. That is just absolutely not true," Dr. Adams tells MDLinx.
“It is so validating for a patient to be heard by their provider. So many patients feel dismissed: ‘You're just getting older, get used to it,’" Dr. Adams says. "That is the worst message to give a woman who is suffering [with] perimenopause. This is not just aging. Menopause and perimenopause are inevitable... But the suffering is not a given, and no woman should suffer through this stage of transition of her life.”
2. Treatment is too risky
Many patients are still hesitant to consider hormone therapy—and some providers are, too—but Dr. Adams says this is due to a number of misconceptions. Hormone therapy can help relieve symptoms of perimenopause and menopause and help women with hot flashes, night sweats, vaginal dryness, bone loss, and prevention of osteoporosis.
"People fear hormones."
— Karen Adams, MD
“[Patients] are afraid that if they take hormones, it will give them breast cancer or a stroke or a heart attack. And so it's a tragedy that only a small fraction of women who would be candidates for menopausal hormone therapy are actually on it. Part of the reason is because providers are not very well informed, and so they don't offer it to the patients,” she says.
Related: Doc's comments spark heated debate: Have we been giving bad advice to patients with breast cancer?“People are afraid because there were some big studies that came out decades ago that said, ‘Oh, hormone therapy causes heart attacks and strokes and breast cancer and all these things,’" Dr. Adams says.
"However, what we know now, several decades later, is that younger women respond differently to hormones than older women. And in those big trials, they had women between the ages of 50 and 79, and it was the older women that had all those events,” she adds.
The truth about potential treatment options
“When people start on hormones under age 60 or less than 10 years out from that last menstrual period, they get tremendous benefits. They get heart health. They get bone health as well, and mood stabilization, as well as symptom management,” Dr. Adams tells MDLinx.
Dr. Adams says only about 3% of patients who are good candidates for hormone therapy actually use it. "And that's just a tragedy, because so many people could benefit from it.”
G Thomas Ruiz, MD, lead OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, has seen the benefits of hormonal therapy for his patients first hand. “You would be amazed how menopausal women, I put them on hormone replacement therapy, and we get the dose right, how much better they feel,” he says.
“They feel better about themselves, but they're also sleeping," Dr. Ruiz continues. "Their life is not being disrupted by vasomotor symptoms. Their joints and their body don't hurt as much. Their memory seems to improve, and this brain fog seems to disappear.”
Read Next: Halle Berry's 'menopause party' offers a wake-up call for docsNon-hormonal options
Hormone therapy isn't for everyone. Non-hormonal treatments for menopause are gaining attention, especially for individuals who cannot or prefer not to take hormone therapy.
One FDA-approved option is fezolinetant (Veozah), a neurokinin 3 receptor (NK3R) antagonist that targets the brain’s thermoregulatory center to reduce vasomotor symptoms like hot flashes. Clinical trials have shown it significantly decreases the frequency and severity of these symptoms without affecting estrogen levels, making it a promising alternative for patients with hormone-sensitive conditions such as breast cancer.[][]
Other nonhormonal strategies include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)—such as paroxetine and venlafaxine—which have demonstrated efficacy in reducing hot flashes.[]
Additionally, gabapentin, typically used for neuropathic pain, and clonidine, an antihypertensive, are sometimes prescribed off-label to manage vasomotor symptoms, though side effects like dizziness and fatigue may limit their use.[]
Lifestyle interventions—such as regular exercise a healthy diet, and deep-breathing exercises or massages to relieve stress—can also offer symptom relief, particularly for mood and sleep disturbances.[]
Read Next: Could a new non-hormonal treatment reduce menopause’s hot flashes?