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September 09, 2022
You hear stories all the time—from mothers, sisters, friends, and, of course, the always-reliable Internet. But what’s the reality behind the menopause myths you may feel uncomfortable asking your doctor about? Dr. Ekta Kapoor, an endocrinologist at Mayo Clinic and a specialist in menopause and women’s sexual health, talked to Womaness to separate fact from fiction…and empower you with accurate information so you can enter this life stage on a positive note.
Dr. Kapoor: “You are not considered in menopause until you have not had your period for an entire year. But remember that this is a diagnosis made in hindsight. Because when a woman is having that final menstrual period, she does not know it is the last one. You really have to wait it out for 12 months, and if you’ve gone without having it for the full year, then you know you are in menopause.”
Dr. Kapoor: “Weight gain is nuanced. When you talk about pure weight gain, that is really not a menopause phenomenon but rather an age-related thing. What menopause does cause are changes in body-fat distribution—meaning that, due to the decline in estrogen, women tend to carry weight in the middle section or belly area. After menopause, your overall weight may not change at all, but we are all also losing muscle mass as we are getting older. So if you lose muscle mass, and gain fat, your overall weight may not change. The gained fat has a greater tendency to deposit around the belly after menopause rather than settling in the lower half of your body.”
Dr. Kapoor: “Yes. But that’s not the whole story. Hot flashes and night sweats are present during the menopause transition in about 75 percent of menopausal women, so they are the commonest symptoms of the menopause transition. But common is not synonymous with what is truly troubling to most women. The two most bothersome symptoms I find when I talk to women in the clinic are weight gain and sexual dysfunction.”
Dr. Kapoor: “There is data to support that menopausal experience can be hereditary. But it is not the same or as straightforward as a disease inherited via a single gene. The genetic influence over a woman's menopause experience is a softer one. Other things can matter more. What is your own health like? What is your body mass index? Are you a smoker? Do you exercise or not? These things can have a greater bearing on your menopausal experience than genetics alone. When it comes to early menopause, genetics can perhaps be a bigger player, but the genetic influence on early or premature menopause is not completely understood.”
Dr. Kapoor: “For most women, the perimenopause timeframe is in the ballpark of two to three years. But sometimes women are in it for longer. That can be upsetting and distressing as many women have the most bothersome symptoms during perimenopause. But for some women, symptoms such as hot flashes and night sweats may get better one they have had their final menstrual period.”
Dr. Kapoor: “Sleep disturbance is a multifactorial, complex issue. Several factors can affect sleep—night sweats, mood disorders, and even just the lack of estrogen due to menopause. Broadly speaking, women with anxiety and mood issues (which may be a result of the menopause transition) usually have trouble falling asleep, because the mind can’t stop. However, women with sleeping difficulties due to the menopausal state itself usually have greater trouble staying asleep—they tend to fall asleep easier but wake up in the middle of the night, and have a hard time going back to sleep.”
Dr. Kapoor: “This is multifactorial as well. Sleep deprivation and mood problems can certainly add to this difficulty, but [brain fog] can be isolated as well due to estrogen deficiency. Women often find it difficult to find words, focus, or just experience a general sense of haziness. Thankfully, these cognitive difficulties do tend to clear up for a lot of women a few years after the final menstrual period.”
Disclaimer: This article is intended for informational purposes and is not intended to replace a one-on-one relationship with a physician or medical advice. Womaness strives to share the knowledge and advice from our own network of experts and our own research. We encourage you to make healthcare decisions based in partnership with a qualified healthcare professional.