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11 Perimenopause Myths Debunked

Debunking the common myths about perimenopause can help make this transition easier and improve your quality of life.
11 Perimenopause Myths Debunked
Last updated:
8/19/2024
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The Big Picture



Perimenopause is a life transition that affects millions of women globally, yet it remains surrounded by misconceptions and myths. This phase, which precedes menopause, typically starts in a woman’s 40s but can begin earlier. Understanding perimenopause is crucial for managing its symptoms and navigating this period of change with confidence and vitality. In this article, we’ll debunk some common myths and clarify what you need to know about perimenopause.

In this article

Myth 1: Perimenopause starts at the same age for everyone

One of the most pervasive myths about perimenopause is that it starts at a specific age. In reality, the age of onset of perimenopause varies widely among women. While many women begin experiencing perimenopausal symptoms in their 40s, some may start in their late 30s – or even earlier! The average age of onset is around 47, but this differs based on factors such as genetics, lifestyle, overall health, and other hormonal factors.

Early onset perimenopause can be influenced by factors such as family history, autoimmune disorders, and specific medical treatments, like chemotherapy. Conversely, some women may not notice symptoms until their late 40s or early 50s. Therefore, it’s essential to be aware of your own body’s signals and consult with a healthcare provider if you suspect you’re entering perimenopause.

Myth 2: Perimenopause is just a short phase

Many women believe that perimenopause is a brief phase that lasts only a few months. In reality, perimenopause usually spans several years. This transitional period typically lasts anywhere from 4 to 10 (yes, 10!) years before menopause occurs. (Menopause is defined as the point when it’s been a full 12 months without a menstrual period.) During this time, women experience a gradual decline in reproductive hormones, particularly estrogen and progesterone, leading to various symptoms that can fluctuate in intensity and duration.

The length and intensity of perimenopause symptoms can vary. For some women, perimenopause might be a relatively short phase with symptoms that resolve more quickly, while others may experience a prolonged transition with persistent or worsening symptoms. Overall, it’s important to recognize that for many women, perimenopause is not a fleeting inconvenience but, instead, a significant and sometimes lengthy life transition that requires attention and management.

Factors such as genetics, overall health, lifestyle, and whether a woman has had surgical interventions like a hysterectomy can influence the duration and severity of perimenopause. Women who have undergone chemotherapy or have certain autoimmune conditions might enter perimenopause earlier and experience a more intense or protracted transition.

Myth 3: Perimenopause only causes hot flashes

When you think about perimenopause, you may have the image of a woman fanning herself due to a hot flash. While flashes are a common symptom of perimenopause, they are far from the only one. Perimenopause affects multiple aspects of health and well-being.

What signals should you be aware of as potential signs that you’re in perimenopause? Common symptoms of perimenopause include irregular periods, which can become shorter or longer and vary in flow; hot flashes and night sweats that disrupt daily life and sleep; mood swings, irritability, and increased emotional sensitivity; weight gain and changes in body composition; vaginal dryness and discomfort during intercourse; and decreased sex drive. Additionally, many women experience sleep disturbances, such as insomnia, and cognitive changes, like brain fog, memory lapses, and difficulty concentrating.

These symptoms occur due to the fluctuations in estrogen levels -- and changes in progesterone levels --  during perimenopause. Each woman’s experience is unique, and symptoms can vary in type, intensity, and duration. The bottom line? Perimenopause is a highly individualized experience.

Myth 4: Perimenopause only affects older women

When you think about perimenopause, does an image of the “Golden Girls” come to mind? In reality, it should be more like the women of the “Sex and the City” reboot! Perimenopause commonly occurs in women in their late 40s and early 50s, but it’s not limited to this age group. Some women naturally start perimenopause in their early to mid-forties, and this is considered normal. Some women start perimenopause in their 30s – or even earlier – and this is known as premature ovarian insufficiency. Genetics, lifestyle, and medical conditions can contribute to this early onset.

Myth 5: Perimenopause is the same as menopause

The terms “perimenopause” and “menopause” are often used interchangeably, but they refer to different stages in a woman’s reproductive life. Perimenopause is the transitional phase leading up to menopause, while menopause is the point when a woman hasn’t had a menstrual period for 12 consecutive months.

Perimenopause is characterized by fluctuating hormone levels and irregular menstrual cycles, while menopause marks the end of menstrual cycles and a more stable state of lower hormonal levels. Understanding this distinction can help women better manage their symptoms and expectations during each phase.

Myth 6: You don’t need to see a doctor about perimenopause

Some women may feel that because perimenopause is a natural part of aging, it doesn’t require medical attention. However, consulting with a healthcare provider to address symptoms and receive appropriate care is essential. A doctor can help determine if symptoms are related to perimenopause or if other medical conditions might be to blame.

In addition, healthcare providers can offer guidance on managing symptoms through lifestyle changes, hormone therapy, natural remedies, or other treatments. Regular check-ups and open communication with your healthcare provider can help ensure a smoother transition and address any concerns you may have.

Myth 7: Hormone replacement therapy (HRT) is dangerous and should be avoided

Hormone replacement therapy (HRT) is often surrounded by controversy and misconceptions. While it’s true that HRT has been associated with risks, it can also be a beneficial option for many women experiencing severe perimenopausal symptoms. The key is to weigh the benefits and risks with the guidance of a healthcare provider.

HRT can help alleviate symptoms such as hot flashes, night sweats, and vaginal dryness by supplementing estrogen and, in some cases, progesterone. Modern HRT options are more targeted and personalized, reducing some risks associated with earlier formulations. Your healthcare provider can help determine whether HRT is a suitable option based on your health profile and symptom severity.

Myth 8: Lifestyle changes can’t help manage perimenopause symptoms

While hormone fluctuations play a significant role in perimenopause, lifestyle changes can have a substantial impact on managing your symptoms. Adopting a healthy lifestyle can help alleviate many of the discomforts associated with perimenopause.

Research has shown that dietary changes and exercise, along with stress management and adequate sleep, can all contribute to better symptom management. Physical activity, for example, can help regulate mood, improve sleep, and manage weight gain. A diet rich in fruits, vegetables, and whole grains can support overall health and reduce the risk of weight gain and other issues. Stress-reduction techniques, such as meditation or yoga, can also be beneficial in managing mood swings and anxiety.

Myth 9: Perimenopause means you’re done with your reproductive years

Many women assume that perimenopause signifies the end of their reproductive years. While it’s true that fertility declines during perimenopause, it’s still possible to become pregnant! The fluctuations in menstrual cycles and hormone levels can make ovulation irregular, but pregnancy is still possible.

If you’re not ready to become pregnant, it’s important to continue using contraception during your perimenopause until you reach menopause and have gone an entire year without a period. Consulting with a healthcare provider about contraception options during perimenopause can help you make informed decisions based on your reproductive goals and health.

Myth 10: Perimenopause has no impact on mental health

Mental health is a critical aspect of overall well-being, and perimenopause can significantly impact it. Perimenopause can bring about significant mood changes, including mood swings, anxiety, and depression for many women.

During perimenopause, women experience disruptions in their normal hormonal rhythms, which can contribute to mood changes. The fluctuations in estrogen and progesterone levels can affect serotonin, a brain chemical that promotes feelings of well-being and happiness. As hormone levels drop, serotonin levels may also fall, leading to increased irritability, anxiety, and sadness.

Women in perimenopause may experience:

  • Mood swings
  • Increased irritability, crankiness, and anger
  • Anxiety and panic attacks
  • Feelings of sadness or depression
  • Loss of confidence or self-esteem
  • Difficulty concentrating and forgetfulness

Women with a history of depression or anxiety, who have experienced postpartum depression, and women whose moods have typically been sensitive to hormonal fluctuations are at a higher risk of experiencing more severe mood changes during perimenopause.

Myth 11: All treatments for perimenopause are the same

There is no one-size-fits-all solution for managing perimenopause symptoms. Treatment options can vary based on the severity of symptoms, overall health, and personal preferences. Some women may find relief through lifestyle changes and natural remedies, while others may require medical treatments such as HRT or other medications.

It’s important for you to work with a healthcare provider to develop a personalized treatment plan that addresses your specific symptoms and health needs. This collaborative approach ensures you receive the most effective and appropriate care for your situation.

A note from Paloma

It’s important to understand that while perimenopause is a natural part of aging, its length and impact can vary widely. Understanding the truths about this transition, along with regular communication with your healthcare provider, can help you manage symptoms and develop effective strategies and personalized approaches to support your health throughout this significant period in your life.

Whether it’s recognizing that perimenopause can start during your 30s to 50s, understanding the full range of symptoms, or exploring treatment options, having trusted partners for your medical care is vital. Paloma Health’s knowledgeable providers can provide comprehensive perimenopause and menopause care that will allow you to experience this transition with greater confidence and clarity, improving your health and quality of life. Consider becoming a Paloma member for an integrated approach to your perimenopause and menopause treatment – complemented by comprehensive care for hypothyroidism.

References:

Perimenopause: Age, stages, signs, symptoms & treatment. Cleveland Clinic. Published 2021. https://my.clevelandclinic.org/health/diseases/21608-perimenopause 

Health W. Perimenopause vs Menopause. Scripps Health. Published August 8, 2018. https://www.scripps.org/news_items/6457-how-to-tell-the-difference-between-perimenopause-and-menopause 

Perimenopause: Lifestyle Approaches for Maintaining Optimal Health and Wellness. The Institute for Functional Medicine. https://www.ifm.org/news-insights/perimenopause-lifestyle-approaches-for-maintaining-optimal-health-and-wellness/ 

Hao S, Tan S, Li J, Li W, Li J, Cai X, Hong Z. Dietary and Exercise Interventions for Perimenopausal Women: A Health Status Impact Study. Front Nutr. 2022 Jan 27;8:752500. doi: 10.3389/fnut.2021.752500. PMID: 35155511; PMCID: PMC8828936. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8828936/ 

Grandi G, Di Vinci P, Sgandurra A, Feliciello L, Monari F, Facchinetti F. Contraception During Perimenopause: Practical Guidance. Int J Womens Health. 2022 Jul 15;14:913-929. doi: 10.2147/IJWH.S288070. PMID: 35866143; PMCID: PMC9296102. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296102/ 

Payne J. Can Menopause Cause Depression? www.hopkinsmedicine.org. Published 2024. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression 

As Menopause Nears, Be Aware It Can Trigger Depression And Anxiety, Too. NPR.org. https://www.npr.org/sections/health-shots/2020/01/16/796682276/for-some-women-nearing-menopause-depression-and-anxiety-can-spike 

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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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