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All women go through the natural process of menopause, but many may not know what to expect. Others may have heard things about menopause that aren’t true.

Here are some common misconceptions women might have about menopause and the accurate information about them.

What Is Menopause?

Before we get to the myth-busting, it’s helpful to have some facts at hand. There are two stages to the menopausal transition: perimenopause and menopause.

Menopause is a singular event. It’s the last missed period of your reproductive life. You won’t know it happened until at least one full year without a period or any bleeding or spotting.

The average age for menopause is 52, but it can occur earlier or later. After that last missed period, you’re postmenopausal. At this point, your ovaries won’t produce as much estrogen and progesterone hormones as they used to.

Perimenopause is the period leading up to menopause. It lasts an average of four years.

For some women, it may only last a few months. For others, it may last 10 years. You can still get pregnant during perimenopause.

Myth No. 1 — Menopause Is Just Hot Flashes

Hot flashes and night sweats — called vasomotor symptoms — are just one sign of menopause, and not all women have them.

About three out of four women have hot flashes before, during, or after menopause. But for many, hot flashes aren’t even the worst symptom of menopause. Women experience a wide range of symptoms.

Menopause can also cause:

• “Brain fog,” or trouble thinking clearly or concentrating.
• Changes in heart rate, such as palpitations or an irregular or racing heartbeat.
• Discomfort or pain during sex.
• Dryness in your vagina.
• Fatigue or tiredness.
• Feelings of sadness or anxiety.
• Headaches.
• Leaking pee, especially when you cough, laugh, or sneeze.
• Less interest in sex or a lower sex drive.
• Mood swings.
• Needing to pee more often than usual.
• Problems falling asleep or staying asleep.
• Tenderness or soreness in your breasts.
• Trouble remembering things.
• Weight gain or muscle loss.

Most women only experience some of these symptoms. They can also vary in severity.

Myth No. 2 — Menopause Symptoms Start When Your Period Stops

Hormonal changes cause symptoms of menopause. These changes start during perimenopause. During this time, hormone levels may shift up and down, causing symptoms.

After menopause, you’ll have to deal with a new reality of lower estrogen and progesterone levels. This drop can cause major changes in your energy level, bone density, and other factors, such as sex drive.

Myth No. 3 — My Menopause Will Have Many Similarities with My Mother’s

Genetics can affect how and when you experience menopause. But no two women’s experiences are the same, even for mothers and daughters. Many different factors affect when you start menopause, including diet, lifestyle, and environmental influences.

You may enter menopause sooner if you:

• Did not carry children.
• Had chemotherapy or radiation.
• Had surgery to remove your ovaries (surgical menopause).
• Have certain medical conditions, such as an autoimmune disease.
• Live at a higher altitude.
• Smoke.

Your symptoms may also differ — with more or less severity than they experienced.

Myth No. 4 — I Can’t Do Anything About Menopause

Menopause is a natural process everyone goes through, but that doesn’t mean you have to go through it without help. Symptoms can improve with behavior and lifestyle changes.

These habits can help:

• Improve sleep with a regular sleep schedule and avoid bright lights before bed.
• Improve your diet by eating lots of fruits, vegetables, whole grains, and lean protein.
• Make sure you’re getting enough calcium and vitamin D.
• Quitting smoking and drinking too much alcohol can reduce symptoms.
• Regular physical activity to help with sleep and mood swings.
• Strength training to strengthen your bones and muscles.
• Wear cooler clothing in layers, and grab a portable fan or sweat rag for hot flashes.
• Yoga, meditation, mindfulness, and similar activities can help reduce stress and improve sleep.

Not everyone needs treatment for menopause symptoms. If your symptoms interfere with your daily activities, talk to your doctor about medicines and other therapies.

Myth No. 5 — Hormone Therapy Is Too Risky

Hormone therapy (HT) is a type of medicine that contains the hormone estrogen. HT can treat hot flashes, sleep problems, and vaginal dryness. It can also reduce the risk of osteoporosis, diabetes, mood swings, and bone fractures or breaks.

HT may increase the risk of cancers, blood clots, and heart or gallbladder disease in certain women. Risks increase as you get older. Because of these risks, not everyone can take HT.

You probably can’t take HT if you:

• Are 60 or older.
• Have had blood clots, a heart attack, or a stroke.
• Have had breast, uterine, or ovarian cancer.
• Have a high risk of blood clots due to a health issue.
• Have a high risk of breast cancer.

The benefits of HT outweigh the risks for most women. It has a low risk of side effects before age 60 or within ten years of menopause. Talk to your doctor about the risks and benefits of HT for you.

Myth No. 6 — Hormone Therapy Is The Only Treatment for Menopause

For women who can’t or don’t want to take HT, other medicines can help treat menopause symptoms.

Some of these include:

• Fezolinetant for hot flashes.
• Flibanserin and bremelanotide for low sex drive.
• Gabapentin, oxybutynin, and clonidine for hot flashes.
• Low-dose antidepressants for hot flashes and night sweats.
• Ospemifene for vaginal dryness and painful or uncomfortable sex.

Each of these treatments has benefits and risks. Discuss them with your doctor.

Myth No. 7 — Plants and Herbs Are Safer Than Prescription Medicines

Many supplements and “natural” remedies say they’ll help improve menopause symptoms. Treatments like these haven’t undergone extensive safety and effectiveness testing.

Plant hormones may have chemical similarities to HT and your body’s hormones. Nonprescription “hormone” therapies often pose the same risks as prescription ones.

They just aren’t subject to as much regulation of dosage and purity. There’s less documentation of the risks.

Myth No. 8 — I Can’t Lose Weight After Menopause

The body’s metabolism slows down as you age, especially during menopause. You may have some weight gain or difficulty losing weight. But maintaining a healthy weight or losing excess weight is still possible.

A healthy diet and regular exercise or physical activity can help you maintain your weight. Other lifestyle changes and medicines can help with weight loss.

Myth No. 9 — My Sex Life Will Disappear After Menopause

Reduced desire or sex drive is a symptom of menopause. Certain lifestyle changes and medicines can help.

Vaginal dryness and discomfort during sex are also symptoms. Over-the-counter and prescription therapies can help here too. Talk with an ob-gyn or menopause doctor about what options you have to improve your sex life.

Myth No. 10 — Menopause Will Give Me Depression

Mood changes, brain fog, and short-term memory problems are some of the symptoms during the menopause transition. These are temporary and aren’t dementia.

If these problems interfere with your daily life, ask your doctor about your options.