Menopause is a biological, social, and emotional transition — one that is often misunderstood due to persistent myths. But approximately 50% of the population will go through menopause at some point in their lives. However, a study from Women’s Health found that 80% of women under 40 have limited knowledge about menopause. Misinformation causes fear, confusion, and stigma that prevents women from seeking help.
Take a look through this list of the top 10 myths about menopause, so you can make lifestyle changes and get the best care during your menopausal transition. If you’re experiencing symptoms of menopause, seeking treatment from a certified healthcare professional could improve your quality of life.
Key takeaways
- Menopause is the point in a woman’s life when she has not had a period in 12 consecutive months. It is preceded by perimenopause, and accompanied by many symptoms due to the body’s decrease in estrogen production.
- Menopause varies widely, from the age when perimenopause begins to the symptoms experienced. Don't believe one-size-fits-all advice, because it does not apply to every person.
- Unfortunately, myths about menopause discourage women from seeking treatment that could improve quality of life. Always speak with a certified healthcare professional rather than relying on anecdotal or social media information.
Myth #1 – Menopause happens overnight
Fact: Menopause unfolds gradually through perimenopause, often lasting several years before the final menstrual period.
A woman officially reaches menopause when she has not had her period for 12 consecutive months. However, you may often hear the phrase “in menopause” and assume it’s something that happens overnight, like a switch being flipped. This is a common misconception! Think of menopause instead as a transition. In fact, you’re likely to see the phrase “menopausal transition,” referring to the hormonal changes that begin with perimenopause and end with menopause.
Perimenopause is a phase where estrogen levels begin to fluctuate, and women show symptoms such as irregular cycles, mood changes, and sleep disruptions. On average, perimenopause starts in your 40s, but this varies from person to person. The symptoms of perimenopause usually last for 4–10 ten years, ending by the age of 55.
So no, menopause isn’t something that happens overnight. It’s a transition period that occurs over several years. For that reason, it’s important to understand the symptoms of perimenopause so you can take a mindful approach to your health during that transition.
Myth #2 – Hot flashes are the only symptom
Fact: More than 30 physical and emotional symptoms can occur — from sleep disturbance, anxiety, and brain fog to changes in skin, energy, and libido.
Hot flashes get a lot of attention in conversations about menopause because up to 80% of women experience vasomotor symptoms (hot flashes and night sweats), but they are far from the only symptoms women experience.
Many women experience a wide range of symptoms that are a result of the body’s natural decline in estrogen production. This is because estrogen does more than just regulate the menstrual cycle; it’s a key hormone responsible for the maintenance of bone health, hair, skin, and cardiovascular health.
Some other common symptoms of menopause include:
- Sleep loss
- Mood changes
- Vaginal dryness
- Pain during sex
- Night sweats
- Bone loss
- Weight gain
But the menopausal transition isn’t just a hormonal transition; it’s a metabolic transition, as well. As estrogen levels change, the body stores fat differently (particularly visceral fat around the belly), in a way that affects your cardiometabolic risk profile. Insulin sensitivity worsens, cholesterol profiles shift, bone turnover accelerates, and muscle mass becomes harder to maintain and rebuild. All of these factors contribute to quality of life changes that often go unaddressed.
Myth #3 – You can’t get pregnant during menopause
Fact: Pregnancy is still possible during perimenopause.
Pregnancy is possible during perimenopause, or the menopausal transition. This is because your body is still going through the menstrual cycle, which means it is still releasing eggs. During this time, ovulation will often occur infrequently — but that doesn’t mean you can’t get pregnant.
However, the likelihood of pregnancy decreases as you go through this transition period. According to the American Society for Reproductive Medicine, people in their 40s have a less than 5% chance of getting pregnant each month, compared to the 20% chance for those in their 30s.
Once you have gone through menopause — the point at which you have not had a period in 12 consecutive months — you can no longer get pregnant without medical assistance. Pregnancy may still be achievable through in vitro fertilization with the proper medical support.
Myth #4 – Menopause always starts at 50
Fact: Timing varies. The typical range is ages 45–55, but early or premature menopause can occur due to genetics, surgery, or health factors.
There is no specific age when menopause automatically “happens” — the age of menopause varies from person to person. The majority of women will experience natural menopause between the ages of 45 and 55, and the average age is 51.
Some may enter menopause before 45 (early menopause), or even before 40 (premature menopause). Additionally, some women may experience late menopause, which means she has her final period after the age of 55.
Menopause can also be caused by medical treatments or surgery, which can occur at any age. Medical and surgical menopause happen quickly or instantly, rather than gradually, leading to more severe menopause symptoms.
Because of the variation in how people enter menopause, it’s important to stay educated about what the menopausal transition looks like and to understand the symptoms. Taking a proactive approach to menopause care can help ease you into that new phase of your health.
Myth #5 – Weight gain is guaranteed during menopause
Fact: Hormonal changes shift fat distribution, but weight gain isn’t inevitable.
It’s true that hormonal changes in your body will naturally change the body’s fat distribution, and that metabolism slows due to aging. But this doesn’t mean that weight gain is inevitable, just that many women will need to make lifestyle changes to maintain a healthy weight.
During menopause, the body burns fewer calories at rest than it did at a younger age. Muscle mass also decreases. On top of that, metabolic changes during menopause can affect insulin sensitivity and increase diabetes risk. All of these factors can lead to weight gain or make it difficult to keep weight off.
Several strategies can help you support healthy weight control as your body undergoes the menopausal transition.
- Exercise: Aerobic activities and strength training can help preserve lean muscle mass and boost metabolism, which can prevent weight gain.
- Nutrition: Eating a healthy, nutritionally-dense diet that includes isoflavones (especially soy), protein, and vitamin D isn’t just good for weight control, but for managing other common menopause symptoms.
- Sleep: Sleep disruption has been proven to change hunger cues, making you feel like you’re hungry when you’re not so that you eat more. Better sleep hygiene can lead to increased energy, better moods, and the ability to maintain a healthier diet.
- Stress management: Chronic stress elevates cortisol levels, which can promote fat accumulation around the midsection. Also, when we’re stressed, we often feel too tired to make healthy lifestyle choices, like choosing to exercise or eat nutritional meals. Stress management strategies can help prevent stress-induced weight gain.
- GLP-1 treatment: Combining semaglutide treatment with hormone therapy and lifestyle changes can deliver positive results for people in all stages of menopause.
Myth #6 – Hormone Replacement Therapy (HRT) is dangerous
Fact: HRT is safe and effective for most women when prescribed appropriately.
In 2002, the Women's Health Initiative (WHI) released a study that suggested some women might experience increased risks of stroke, heart disease, and breast cancer due to hormone replacement therapy. This caused a lot of women to shy away from pursuing HRT to treat their menopause symptoms. Later reviews of the study found that results were taken out of context and inaccurately interpreted, which led to a misunderstanding about the risks and benefits of hormone therapy.
The truth is, for women under 60 or within 10 years of menopause, HRT benefits usually outweigh risks. This realization came from a follow-up analysis of the WHI study in 2014, which revealed that healthy women who start hormone therapy before 59, or within 10 years of menopause, actually have a decreased risk of heart disease compared to those who don’t.
Like many things, the risks and benefits of HRT for women in menopause vary. That’s why the best thing you can do is take a personal, holistic, and medically-guided approach to menopause treatment.
Myth #7 – Menopause ruins your sex life
Fact: Lower estrogen levels can cause vaginal dryness or discomfort, but there are many options — lubricants, vaginal estrogen, and lifestyle strategies — to maintain intimacy.
Menopause can change your sex life, but it doesn’t ruin it. Because estrogen helps maintain the elasticity and lubrication of the vagina, hormonal changes can result in vaginal dryness, pain, and itching. This can make intimacy physically uncomfortable. But more than that, it can also make you feel negatively towards sex, lead to low libido, or even cause strain in a relationship.
While menopause may mean changes to your sex life, treatment — particularly hormone therapy — can help. Sexual health is absolutely an important part of overall wellness. A healthy sex life can lead to lower stress, emotional well-being, and more confidence in your day-to-day life. There’s no reason to let menopause “ruin” your sex life! Discuss your options with a menopause-trained clinician through Carrot or a similar provider if you experience menopause symptoms that impact your ability to be intimate with a partner.
Myth #8 – Mood swings and depression are inevitable
Fact: Hormonal fluctuation can affect mood, but mental health outcomes vary.
The only inevitable outcome from menopause is that you will one day no longer have a period. But stories about horrible mood swings and depression during menopause can be scary for midlife women.
It’s true that the menopausal transition comes with physical and emotional changes that can increase your risk of sadness, irritability, and fatigue. In fact, according to a 2025 report published by Carrot and Olly, 70% of women reported that menopause affected their mood or mental health. Research has also shown that the menopausal transition is a high-risk period for developing depressive symptoms.
Awareness about the mental health effects of menopause is your best defense to manage, and possibly even prevent, persistent mood issues. If you’re concerned about mood changes during menopause, here are expert-recommended strategies for coping:
- Stay active and move your body. Physical activity helps manage your body’s metabolic changes and has been shown to reduce depressive symptoms in midlife women.
- Prioritize quality sleep. 40% of perimenopausal women report sleep problems, leaving them feeling exhausted and depleted. Good sleep hygiene can help your body regulate its circadian rhythm and reduce mood changes caused by lack of restful sleep.
- Practice good stress management. Mindfulness, meditation, therapy, and connecting with support groups are great ways to reduce stress and learn how to manage mood changes.
- Consult with a clinician. If you are experiencing persistent mood changes or depressive episodes — or even if you don’t feel entirely like yourself during perimenopause — reach out to your primary care provider. They may recommend medical treatment, such as antidepressants or hormone therapy.
Myth #9 – Menopause equals aging and loss of vitality
Fact: Menopause begins a new phase of health, not decline.
Menopause is far from the “beginning of the end” for women. Most women live an average of 30 years beyond reaching menopause — that’s a lot of life left to live! And many women in postmenopause report that time to be the happiest in their lives.
Among other things, some ways women get their energy and vitality back during perimenopause (and beyond) are:
- Getting exercise
- Eating healthily
- Seeking emotional support
- Starting HRT
The menopausal transition can be challenging, for sure, but it’s simply a biological milestone. With it, you can find new energy, priorities, and renewal.
Myth #10 – There’s nothing you can do about symptoms
Fact: Evidence-based treatments exist for almost every symptom of menopause.
There is a long list of symptoms that accompany menopause, from fatigue to bone density loss, and even weight gain. The list may look overwhelming, especially for someone who is early in the menopausal transition or is trying to prepare for what's to come.
The good news is that you can find evidence-based treatments for the majority of menopause symptoms. For instance:
- Lifestyle adjustments, such as resistance training, adopting a heart-healthy diet, practicing mindfulness, therapy, and getting regular sleep.
- Medical treatments, such as hormone therapy, antidepressants, and non-hormonal hot-flash treatments.
- Seeking outside support, such as community and support groups, counseling, and menopause-trained practitioners.
FAQs
Does everyone gain weight during menopause?
Not necessarily. While it is common for people in menopause to gain weight due to hormonal and metabolic changes, whether or not a person gains weight depends on multiple factors. If you’re concerned about weight gain during menopause, consider making lifestyle changes like daily exercise, strength training, a healthy diet, and practicing sleep hygiene. You may also want to speak with your care provider about how HRT or GLP-1s can help manage your weight.
Will taking estrogen help me from gaining weight during menopause?
Taking estrogen can help alleviate many of the symptoms that can contribute to weight gain, such as bone density loss, lack of sleep, insulin resistance, and stress. Estrogen through HRT and GLP-1 treatment can complement each other. A Mayo Clinic study found that women who used HRT for menopause, along with tirzepatide, lost 35% more weight than those taking tirzepatide alone.
