MENOPAUSE MYTHS AND FACTS
The abundance of information on menopause can often cause confusion and misunderstandings. Below, we separate fact from fiction and provide evidence-based answers to the myths of menopause.
Menopausal hormone therapy (MHT) has been proven to be effective for treating menopausal symptoms and reducing the risk of long-term diseases, including osteoporosis and heart disease.
Fact: The benefits of taking MHT outweigh the risks (individual assessment necessary). There is a greater risk if you are overweight, do limited exercise and have increased alcohol consumption.
Oestrogen-only MHT causes little change or no change in the risk of breast cancer and MHT that contains oestrogen and progestogen may increase breast cancer risk if you take it for a prolonged period of time. It falls again when you stop taking MHT.
Fact: Whilst the average age of reaching menopause in Australia is 51, you can start to experience menopausal symptoms at any age. Premature and early menopause affects 12 out of 100 women under the age of 45.
Fact: Taking MHT before your periods stop helps to relieve symptoms and reduce the risk of long term conditions such as heart disease, osteoporosis, dementia and colon cancer. The main concern is the risk of abnormal uterine bleeding if the ovaries are still producing oestrogen as the endometrium thickens due to the oestrogen in the MHT and the ovarian contribution. Unlike the combined oral contraceptive pill (COCP), MHT does not ‘switch’ the ovaries off.
Fact: MHT is not a contraceptive, therefore, it is recommended to use contraception for two years if your last period was before the age of 50 or for one year if your last period was after the age of 50. Blood tests can help to determine if it is safe to cease contraception.
Fact: Symptoms of the menopause or perimenopause are usually enough to identify if you have started the menopausal transition. Symptoms combined with a 1 year gap with no periods equals the menopause. Blood tests are not necessarily required as the levels of FSH and LH start to rise several years before the last menstrual period. However, blood tests ARE important if early menopause or premature ovarian insufficiency (POI) is suspected.
Fact: Unlike MHT, complementary or natural therapies are not thoroughly researched and are not proven to be safe. The main issue is that of the exact dose and hence the effect is not accurately known.
Fact: Weight gain can simply be due to ageing. Women may find that they have more weight around their stomach, which is caused by hormonal changes that result in a redistribution of fat within the body.
Fact: Research has shown that MHT is both a safe and effective way to treat symptoms of menopause in women within 10 years of natural menopause. The need for continuing MHT should be individualised and reassessed annually.
Fact: Menopause is not an illness. It is just a phase of life for over half of the world’s population. Not everyone requires MHT. 20% of women have minimal symptoms, 60% mild to moderate and 20% severe.
Fact: Research has shown that healthy women younger than age 60 or within 10 years of the start of menopause can safely take MHT without significantly increasing their heart disease risk.