The menopause years aren’t just hot flashes and irregular periods.
Yet, Tiffini Sarver, 44, of Lincoln Square, said growing up these were the only two menopause symptoms she’d heard about from school health classes and watching her mom’s “really bad” experience with hot flashes. The air conditioner was always on, Sarver remembered. Otherwise, she said, no one ever discussed it.
Sarver expected menopause to be one event ending when the periods stopped after a few years of hot flashes and menstrual cycle changes.
But in her late 30s, she started having seasonal allergies that got progressively worse. Anxiety and memory issues followed. Sarver said her doctor confirmed her suspicions of menopause-related brain fog and allergies: “It blew my mind but made sense.”
Across the U.S., Sarver is one of 75 million women in one of the three stages of menopause: perimenopause, menopause or postmenopause, with 6,000 women reaching the menopause milestone daily, according to the nonprofit Let’s Talk Menopause.
Women’s health experts attribute commonly held myths and misconceptions to the stigma of menopause, research gaps from inadequate funding and undervaluing women’s health.
“There’s not one menopause syndrome, or collection of symptoms, that every single person gets, that’s a myth,” said Dr. Monica Christmas, associate medical director of the The Menopause Society and director of the Menopause Program at the University of Chicago.
About 80% of people get hot flashes, she said. Even then, symptoms can vary in frequency and intensity, if experienced at all. Some women are more sensitive to hormonal fluctuations and grapple with debilitating hourly recurrences; others may experience less bothersome flashes twice a week, she said.
Sarver, a finance and billing specialist, has never had a hot flash. She expressed surprise that symptoms could be so varied. While data is limited, emerging research supports that lower estrogen levels occurring around menopause can make sinonasal symptoms, such as allergies, worse.
What’s behind menopause misinformation?
Lack of health care provider training, social media and inadequate research are core reasons for menopause misinformation, according to professor Pauline Maki, director of the Center for Health, Awareness and Research on Menopause (CHARM) at the University of Illinois Chicago.
Maki attributed the training shortfall to the legacy of the 1990s Women’s Health Initiative study, which linked hormone therapy to breast cancer and heart disease. In turn, she said, medical schools stopped teaching about menopause and developing a pipeline of knowledgeable providers.
Seeking answers, she said women often go online. Maki warned, though, most social media accounts are influencers not recognized as medical experts in the field of menopause medicine: “That doesn’t align with the practice of evidence-based medicine.”
Globally, menopause research is an underfunded and underprioritized area of public health, Maki and other experts agreed. Doctors only receive on average two hours of perimenopause and menopause education, one study reported.
In March, actress Halle Berry joined Maki in Chicago to promote menopause awareness through public education and policy. At the event, hosted by the University of Illinois Chicago, Berry shared the story of her doctor misdiagnosing her perimenopause symptoms of pain from vaginal dryness as herpes.
The experience spurred the actress to be an on-the-ground advocate for greater menopause research funding, quality of care and health care access for women navigating midlife — and the changes that come with it.
The menopause conversation remains stigmatized. “Periods are a taboo topic,” Christmas said, while Maki noted women are especially reluctant to discuss sexual symptoms with doctors, who frequently cannot answer their questions.
Illinois Senate Majority Leader Kimberly A. Lightford and Lt. Gov. Juliana Stratton are aiming to change that through policy: They backed state Senate Joint Resolution 25, which both chambers recently adopted, designating October 12-18 as Menopause Awareness Week.
Myths unraveled
Still, there’s much to unpack about the menopause years.
Perimenopause is the transitional phase that women’s health experts say can start up to 10 years before natural menopause, which happens after a year without a period, typically around age 51.
The hormone fluctuations that begin during this transition can cause a constellation of symptoms including night sweats, sleep disruptions, heart palpitations and anxiety. Despite most every woman experiencing menopause if she reaches midlife, there’s frequent misconceptions surrounding what to expect — and when.
Here, leading health experts and women at different life stages weigh in on common menopause myths and share their personal journeys.
Myth: Hot flashes, or night sweats, disappear after a couple years
Hot flashes affect some groups of women more than others. Research shows Black women experience symptoms on average 10 years compared to 6.5 years for white women and Latin women 8.9 years.
For Diane Campbell, 62, of Western Springs, the first signs of perimenopause — brain fog, anxiety and mood swings — appeared at age 39. During her 50s, the “serious” hot flashes started — and continued postmenopause.
Campbell, a retired high school guidance and college counselor, recalled going to doctors, describing her angry feelings, sleeplessness and night sweats, and being told to take antidepressants: “And I wasn’t depressed.”
Six doctors later, she found a gynecologist who understood her concerns and experiences.
In January, Campbell began a hormone replacement therapy regimen of twice-weekly estrogen patches and vaginal cream for libido, chronic urinary tract infections and vaginal dryness — all symptoms that can continue beyond menopause.
On Valentine’s Day, she awoke to a gift: sleeping through the night without night sweats. The itchy skin and spiral thinking, also gone.
“My quality of life has improved significantly. I feel like I’ve got my life back — and didn’t even feel like pieces were missing until I got on hormones,” she said.
Myth: You can’t get pregnant during perimenopause
Dr. Traci Kurtzer, a gynecologist and nationally recognized menopause expert, said women can still get pregnant during the perimenopause transition.
She emphasized that until officially menopausal, pregnancy is always possible. Even with low fertility rates, there’s a chance a released egg can be fertilized, she said. She acknowledged being surprised by “how many people still don’t realize that there is still a pregnancy risk in our 40s, and potentially early 50s.”
Myth: Hormone replacement therapy is the only option to ease menopausal symptoms
When Paula Neale, of Edgewater, entered perimenopause in her late 40s, life became an emotional roller coaster. She cried, got upset more easily and communication with her then-husband became strained.
“I just didn’t seem to be myself,” said Neale, a commercial lease manager at Northwestern University.
By her early 50s, she’d hit menopause and gained 20 pounds. She’d never before had to diet or exercise, and this new body frustrated her. In postmenopause, the hot flashes and night sweats emerged, and she repeatedly asked for hormone replacement therapy.
But doctors said she was “too old.” Since January, Neale, now 66, has found support at the Northwestern Medicine Center for Sexual Medicine and Menopause clinic.
Today, she takes a daily non-hormonal prescribed pill, Veozah, to ease hot flashes and night sweats. She’s embraced her doctor’s words: “There is no reason for any woman to have to suffer menopause symptoms.”
Myth: If you have the BRCA gene mutation, hormones are off limits
Someone with a BRCA gene mutation has an increased lifetime risk for breast and other cancers.
“That doesn’t automatically make them off limits for using hormones,” Kurtzer said.
She stressed the importance of people having individualized discussions with their doctors that include a risk assessment and review of prior medical treatments and potential benefits of hormone therapy to overall health. She attributed the myth to fear and misinformation of the connection between breast cancer and hormone therapy.
Myth: Menopause doesn’t start until 50s
The normal range of menopause is between the ages of 45 and 55, but it can happen earlier. Before the age of 45 is called early menopause, before age 40, premature menopause.
“Early menopause is about 5% of the population, and premature menopause, depending on the source, is about 1% to 3% of the population,” Christmas said. It can be induced by surgery, radiation, chemotherapy or occur naturally.
A lot of younger women under 40 don’t realize some of the symptoms they’re having could signal early menopause, Kurtzer said. “They’re often dismissed by their physicians and being told, ‘Oh, you’re too young for this to happen to you,’” she said.