6 Myths About Menopause

Whether women experience menopause anxious or carefree also depends on how well they know about it. There are still a lot of rumors going around

Do you know everything about menopause? Those who know are better armed

© Strandperle / Urbanlip

From a biological point of view, menopause is definitely a major turning point in life, because it is the end of a woman's fertile years. This challenge is best mastered by those who are properly prepared for it. But the information many women give is based on reports from others. What is wrong with well-intentioned advice and what is really true? Six myths about menopause in check.

1. Menopause begins around 50

Not correct. As a rule, menopause actually begins in your 40s. The ovaries then gradually produce fewer sex hormones, menstrual bleeding becomes less regular and eventually stops. After that, pregnancy is no longer possible. The so-called menopause is usually reached when there has been no menstrual period for twelve months. For women in this country, this is the case on average at the age of 51. However, the individual range is large. Some women do not enter menopause until they are 55, others at 45 - in rare cases even at 40 or even 35 years of age. Certain operations - such as removing or switching off the ovaries in the case of cancer - can immediately trigger menopause. This can put a lot of strain on women who want to have children. If you want to know exactly whether the menopause has already begun, you may be able to have certain hormones - FSH, LH and estrogens such as estradiol - examined by your gynecologist. However, this is only possible at the expense of the health insurance company in special cases, for example when diagnosing premature menopause. Otherwise, it is a so-called hedgehog service that you have to pay for yourself and that is generally not considered necessary. In order to be meaningful, it must also be repeated several times.

2. Menopausal symptoms are all hormone-related

Not correct. The role of hormones is often overestimated. It is true that the decrease in the level of estrogen is responsible for the typical hot flashes and sweats in menopause. Many other physical and psychological changes increase in men as well as women from middle age for very different reasons, including, for example, sexual problems or mood swings. The risk of cardiovascular disease and osteoporosis increases with menopause, but the loss of hormones is just one of several reasons.

Not to be underestimated: in these years there are often upheavals in private and professional life. The children leave the house, there is more time for partnership and career. The change harbors opportunities. For some people, however, it means increased stress and emotional strain. Thus, living conditions can also have a major impact on individual wellbeing.

3. Menopause has no effect on teeth

Not correct. Women should be aware that hormonal changes, such as those during the menopause, can also affect dental and oral health: inflammation occurs more frequently, the gums become softer, and bacteria can attack more easily. In addition, the saliva production decreases. The best antidote is therefore, especially after the 40th birthday, very good dental hygiene, whereby careful brushing twice a day is more effective than more often superficial.

4. Special diet, exercise, herbal remedies: There are many things that can help against menopausal symptoms

Yes and no, because hardly any recommendation has been adequately proven by studies. The uncertainty begins with nutrition. Eat more nuts and soy products, less salt and chocolate; Herbal tea instead of strong coffee and alcohol: There is a lot of advice circulating about what to consume during menopause or not to reduce hot flashes. From a scientific point of view, there is little to be said for avoiding valuable foods and the enjoyment associated with them as a precaution. Recommendations to keep salt or alcohol in moderation make sense regardless of the menopause. The same applies to sport and exercise: activity does not help directly against hot flashes, but generally serves the health and mental well-being.

Many women take herbal and homeopathic remedies such as red clover, black cohosh, ginseng and kava kava, or they rely on alternative medicine approaches such as acupuncture and chiropractic. But there is no hard evidence of effectiveness for these means and methods either. There are slight indications, for example, for some soy preparations that contain so-called isoflavones. Conversely, herbal remedies can also have serious side effects. Kava Kava was temporarily withdrawn from the Federal Institute for Drugs and Medical Devices (BfArM) because it caused liver damage in individual cases. It is now back on the market, but only under strict conditions, which are coupled with a prescription.

5. Hormone replacement therapy prevents symptoms

Attention! Hormones are not harmless drugs, and menopause, like aging, is not a disease that can be prevented simply by raising hormone levels. The hope of keeping women young for longer by giving them early and long-term hormones without menopausal symptoms fell through a few years ago: Large, long-term studies have shown that long-term use of hormones can have serious side effects. In these studies, the risk of thrombosis, cardiovascular disease and, depending on the composition, possibly also of breast cancer and ovarian cancer increased. In addition, the risk of dementia increased if women only started hormone therapy at an older age, over 65 years of age. However, in the most important study, a special American study, two-thirds of women did not start hormone treatment until they were over 63 years of age. In addition, it was largely women with many other risk factors, such as high blood pressure, obesity, lipid metabolism disorders or diabetes. The authors of this study recently pointed out that their results should not be extrapolated to younger women without risk factors. Furthermore, recent studies indicate that the risk of such effects can also be reduced if the body's own hormones estradiol and progesterone are taken and treatment starts earlier - at the onset of the menopause. Most experts advise against taking preventive hormones, unless a woman has a greatly increased risk of osteoporosis.

However, treatment with estrogen and progestin preparations is considered to be the most effective therapy for typical acute complaints such as hot flashes and sweating, sleep disorders or urogenital complaints, if those affected are severely suffering from the symptoms. While the prevention of osteoporosis using hormones should take longer, such therapy usually only lasts a few years. Even then, it should be remembered that for many women, hot flashes will go away on their own after a few years. So if you want to swallow hormones, you should first find out about the opportunities and risks from a specialist. If the decision is made, the treatment and, above all, its duration must be individually tailored and regularly monitored.

6. Sex becomes a problem during menopause

It doesn't have to be. Sexuality has many dimensions, including during menopause. In about 30 percent of women, a direct consequence of the hormonal changes is that the vaginal mucosa becomes drier and more sensitive, and even when aroused it no longer becomes properly moist, which can lead to pain during sex. However, this can easily be remedied with a lubricant or an estrogen treatment that only works locally in the vagina. Often, a bigger problem is that many women lose their sexual desire. For others, however, it rises.

Hormones are probably less responsible for decreasing desire than couple problems, psychological stress or drugs, which many women take more often with increasing age. Some women don't mind the decrease in lust at all. However, anyone who suffers from it or fears negative effects on the partnership should seek advice without shame: the gynecologist is usually a good first point of contact and is used to talking about sexual problems. If it is more about the psychological and social dimension, a visit to the psychologist or couple therapist could also be called for.

This article was created with the expert advice of Prof. Dr. Dr. Alfred O. Mueck from the Women's Clinic at the University of Tübingen, President of the German Menopause Society.