For most women, the lead up to menopause (that single day when you’ve not had your period for a year) is more like a marathon than a sprint. Perimenopause is a process. It begins with the slow decline of estrogen eight to 10 years before your last period. This happens in the 40s, but some women experience perimenopause as early as their late 30s. After menopause, symptoms like hot flashes tend to lessen.
There are a lot of myths about what happens to our bodies during perimenopause. And though the years leading up to menopause are different for every woman, there are enough facts backed by science to help guide you through what can be a challenging time. Here are a few myths — and truths — about menopause and aging.
1. One day I just won’t have my period when I am supposed to, and that will be menopause.
False. Menopause happens gradually, over time. Perimenopause can start years before your last menstrual cycle. The first signs of perimenopause are irregular periods, hot flashes, vaginal dryness, and sleep issues. The average length of perimenopause is four years, but for some women, it lasts a decade. Once you’ve not had a period for a full year, you’re officially postmenopause.
2. A woman can get pregnant during perimenopause.
True. It’s often assumed that if you’re in perimenopause, you can no longer get pregnant. But if you’re having periods, no matter how irregular, you can still get pregnant. Some women have more difficulty getting pregnant in their late 30s to early 40s, since that’s when fertility drops dramatically, and some get pregnant unexpectedly even when they think there’s very little chance.
3. I can get tested for menopause.
False. But you can have your hormone levels tested. There are a few ways to measure hormones: saliva testing, a blood test, or a urine test. Saliva testing is often expensive and not always accurate. Your health care provider may ask you to collect all urine passed in a 24-hour period. This is called a 24-hour urine sample test, and from there they will be able to test your hormone levels.
4. If I go through menopause early, my health is more at risk.
True and false. There are some health risks associated with early menopause. If you have symptoms in your 30s, the first thing you should do is see your doctor to rule out other causes, like a thyroid issue. The health risks for early menopause are similar to regular menopause, including increased risks for osteoporosis, ovarian and colon cancers, gum disease, tooth loss, and cataracts.
5. Menopause can be reversed.
False. Menopause is a natural part of growing older. There’s no going back.
6. Menopause accelerates aging.
True. There is evidence of that. One study found that the cells of postmenopausal women were aging 6 percent faster than those of women who were not postmenopausal. The same is true for women even if they’d experienced early menopause naturally or medically. However, women who used hormone replacement therapy (HRT) after surgical menopause showed signs of younger cells, as opposed to women who didn’t use HRT.
Another study by UCLA found that sleep disorders, which can be caused by hormonal shifts before menopause, can accelerate aging, with the possibility of leading to an increased risk of heart disease and cancer.
7. I will gain weight after menopause.
True or false. We all experience muscle loss starting around age 30. That accelerates after 40, and many women do gain weight right around the time they start experiencing other menopause symptoms. The sleeplessness and lack of energy that often accompany perimenopause can make it more difficult to exercise and get rid of extra pounds. A healthy diet full of lean proteins and vegetables becomes even more important for maintaining your weight for a lifetime.
8. Menopause causes wrinkles.
True — sort of. All through your life, hormones can wreak havoc on your skin. The decline of estradiol during perimenopause can cause the skin to age faster. And when estrogen drops, fat gets redistributed. As a result, the supportive fat under the skin of the face is reduced, leading to sagging and wrinkles. The decline of estrogen also leads to a decline in melanocytes, which can make you more prone to sun damage.
To learn more about perimenopause, read What Age Does Perimenopause Start?