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Changing the Taboo of Menopause: When Does Menopause Start?

Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical Officer
Updated09/17/24
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In the US alone 1.3 million women enter menopause every–single–year. Every year women will enter into what was once called “The Change” and yet so many women are still asking the most basic question, “when does menopause start?” Meanwhile, their families, healthcare providers, and even by themselves are often ignored by a whole host of symptoms.

When peri- and menopause symptoms hit it can feel like a giant leap into the abyss. We don’t know what’s coming next, but it doesn’t look good if we don’t treat the symptoms.

We have to stop ignoring the symptoms of menopause and the lies and the myths surrounding it. It’s time to “Change the Change.”

Ladies, we are suffering in silence – not telling our employers, partners, or even each other.

“Until I met menopause and its dastardly little sister,  perimenopause, I thought I’d be fine and was told… Whatever you do, don’t take HRT. 

I was so wrong.

My own journey, which was more a Thelma and Louise car crash as my hormones went off a cliff…  (was) midlife’s magnificent shitshow.” 1

11 Ways For You To Change the Taboo of Menopause

  1. Recognize peri- and menopause for what it is
    Menopause happens because your hormones (estrogen, progesterone, and testosterone) drop as you age. Menopause is not an “old woman” thing.

    Millennials, you are likely entering perimenopause and you aren’t even 40 yet. Perimenopause means that your hormones are dropping sharply. Some hormones are now at 50% of what they were when you were 20!

  2. Start to talk about your symptoms
    You may be noticing increased anxiety, brain fog, weight gain (in new places) vaginal dryness, and maybe your knees suddenly hurt. You just don’t feel like yourself, and those ‘I just can’t cope with life.’ moments are more frequent.

    Thanks to the stigma attached to aging we rarely discuss menopause with friends and family. It’s time we share what we are going through, and include them in our efforts to curb the symptoms. The last thing we want is for them to be left wondering, “what’s going on?” They can understand and maybe even help if we talk about it.

  3. Don’t expect your doctor to know you are in menopause
    Largely doctors aren’t talking about it. There’s very little training in medical school or residency around helping women after their reproductive years. Only 20% of residency programs have formal menopause curriculum.1,2

    Physicians are more likely to prescribe antidepressants or look for Vitamin D deficiencies, hypothyroidism, and even pregnancy before getting to the possibility of perimenopause. That might be because they don’t know what to prescribe for the multitude of symptoms associated with perimenopause.

  4. Shatter the Myths
    This is not about luxury and vanity. This is about long-term health and sanity. Tackling symptoms and stigmas is not just a women’s issue, it’s a public health issue. Equal access to safe, natural hormones is key to healthy, happy communities.

    The topic of menopause is still the butt of too many jokes and saddled with a lot of myths. Let’s name a few of our favorites. Menopause is:

    1. The first sign that we are not sexy anymore and our sex life is dead. 

    2. At the end of your professional life, because we can’t focus, we have hot sweats and look too old.

    3. When your brain shorts out, you go crazy, and it never returns.

    4. The worst myth of all: We have no safe solutions to choose from. THAT IS NOT TRUE. Bioidentical Hormone Replacement Therapy (BHRT) is natural, safe, FDA-approved, and highly effective. There is a solution.

  5. Understand the misinformation we’ve been fed re:  HRT.  Accept the Newest Treatments Available and Ignore Outdated “scary” Science

    Natural Bioidentical hormone replacement therapy (BHRT or just HRT) made from yams, FDA approved, and identical to the hormones you used to make are THE most effective treatment for hot flashes.3

    Many women are reluctant to even ask a family medicine doctor or OB/GYN for HRT even though your body is literally screaming for it. The breast cancer-risk headlines from the old, outdated oral HRT pills – made from synthetic progestins and estrogen from pregnant horse urine – were seared into generations of women’s minds. 

    Today’s BHRT lowers your risk of health conditions associated with the decline of hormones, including heart disease, stroke, osteoporosis, cancers, and dementia.1,3

  6. Embrace That You Are Not Alone
    Every year in the US alone, millions of women will enter menopause and perimenopause (the stage before menopause). Perimenopause can last a decade or longer and start as young as your 30s.2 Many women in their 30s or early 40s experience hot flashes, night sweats, insomnia, and vaginal dryness.

    By 2024, the Bureau of Labor Statistics estimates that more than 55 million menopausal women, over the age of 50, will be in the labor force. Menopausal women are already the fastest-growing demographic in the job market.3

  7. Know that you are not crazy
    While moodiness, mental health issues, depression, and suicidality increase with age, oftentimes these issues are related to menopause You can treat these symptoms that can be due to decreased hormones. Suicide rates are at their highest during menopause, and about ⅔ of the women that go to their doctor during menopause are offered antidepressants rather than HRT.1 If necessary, adding antidepressants to hormone replacement therapy (HRT) can be a great combination. Always talk to your physician before adding any medications.

    Is it menopause or dementia that is linked to estrogen deficiencies? Untreated menopause can have a heavy toll on the second half of every woman’s life. The latest research shows HRT’s extraordinary long-term health benefits for osteoporosis, diabetes, and dementia, which women are twice as likely to get as men.2


  8. Stand up against female ageism and the stigma surrounding menopause
    Yes, menopause represents aging — and no one really wants to deal with that —  but women suffer far more from ageism than men. 

    Enduring menopause at work can impact job performance and job security. It only makes sense that hot flashes, fatigue, depression, poor memory, and concentration will impact job efficiency and lead to job stress. But what woman would feel comfortable telling their boss they need a day off due to menopause?  Nine out of ten women say that menopause has adversely affected their work.2

    Menopause feels like a secret which leads to a lot of misinformation. By embracing menopause as a stage, just like puberty or like our reproductive years, we can normalize the phase and honestly approach menopause.

  9. Accept that maybe you are in Peri- or Menopause TODAY
    The earlier you start to treat the symptoms, the better. Wait too long (past 60 years of age and never tried HRT) and you may not be able to receive the treatments that could help you most. Don’t let yourself get pulled into the old stereotypes. There is no need to endure the turmoil of menopause symptoms without help and support.

    You may not want to admit it, but you likely have signs of menopause.  We encourage you to accept it and treat the symptoms of decreasing hormones so that you can live your healthiest, happiest life. 

  10. Refuse to “Endure It” or “Suck-It-Up” –  Why Should You?
    A big part of the problem is that family, friends and sadly our doctors just aren’t prepared to talk about perimenopause and menopause. Our mom’s rarely want to go into any details, likely because (like childbirth) they want to forget it.

    Surveys of thousands of women in peri- and menopause show that the majority of women felt better about life after treating their menopause symptoms than they did 10 years ago. They experienced more hope, increased happiness with their bodies, newfound optimism about career, and were excited about their family.1

    “The compounded estrogen, progesterone, and testosterone worked brilliantly…  Within four days, my hot flushes and palpitations disappeared forever, my memory returned, and – unexpectedly – my mood lifted and my joints became supple. Estrogen was the oil I needed in my engine. I just wish my GP had told me about body-identical HRT in the first place.”  Katie Muir

  11. Pivot to accepting this as a phase of independence and an awakening of YOU
    Once we accept that menopause and its symptoms are treatable, we can move into a phase of life that is far more welcoming. As we age we can become more independent and capable. For decades, we worried about whether we were good enough. Now, we can liberate ourselves, but first, we must rid ourselves of the symptoms and complications of menopause and LIVE OUR BEST LIFE.

Summary:

We must work to oppose the discrimination, misinformation, and disregard for women’s quality of life during their second act. Safe, natural, body-identical HRT is available to everyone with Winona if prescribed. Winona was created by menopausal women, for menopausal women – and their partners and families.

A simple question, “When does menopause start” can lead to so many answers. We all have a story to tell. Let’s work together to prevent other women from unnecessarily falling off the cliff. Reach out to our Winona physicians for your free consultation today bywinona.com.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.