Revealed! 4 Things You Didn't Know About Menopause (But Should!)

These must-know truths will help you get through it.

Published April 26, 2024

illustration gif of menopause references

Josie Norton

I first learned about periods from reading the book Are You There God? It’s Me, Margaret. by Judy Blume. My mom was of a generation where you “don’t talk about that stuff.” So, I relied on Ms. Blume, along with a video shown in 6th-grade health class with animated ovaries explaining what was happening to my body.

As little as my mom talked about getting a first period, she was even more closed-mouthed about having a last period.

I found out she was in menopause when I was home in my 20s and asked her for a sanitary product because I forgot to bring some. She shrugged and said, “I don’t need them anymore," without further explanation.

For centuries, menopause, or the "change," was seen as a negative event in a woman’s life. It was viewed as a loss of femininity and youth, accompanied by a series of uncomfortable, sometimes embarrassing bodily issues that were rarely spoken about except for in jest.

While we wait for Ms. Blume to write a sequel about our heroine Margaret facing mood swings and hot flashes (if you are reading this, Ms. Blume, a scene where Margaret and her now middle-aged friends lament, "We must, we must, we must decrease this dryness" would be awesome!), there are other resources available.

Dr. Stephanie S. Faubion, director of Mayo Clinic's Women's Center for Women’s Health and Medical Director for the Menopause Society, is one of the leading experts on menopause. She has written a new book, The New Rules of Menopause, hoping to shed light on this often misunderstood yet totally normal part of life.

While you may think you know all there is to know about menopause, here are four things that you might be surprised to find out:

1. Perimenopause and menopause symptoms are not one size fits all.

Just like some women suffer terribly from cramps, heavy bleeding and other period pains while others have no issues, the same is true for menopause. Dr. Faubion explains, “For some, symptoms are mild and a short duration, while others may experience symptoms that negatively impact their everyday life and can last over a decade.”

There is no reason for women to feel they need to "tough it out" if they are suffering or compare themselves to their peers. It isn't a contest (and the women who think it is a contest are probably the same ones who feel superior because they didn’t request an epidural during childbirth).

Unfortunately, there is so much to cover during medical training that many providers are not adequately educated on menopause, “says Dr. Faubion. "But there is a lot that can be done to improve your quality of life in perimenopause and menopause." If your medical provider says that "nothing can be done about your menopause symptoms," find another medical provider. Or do your research online at menopause.org or on the Mayo Clinic website.

2. Forget what you think you know about hormone therapy

Hormone Therapy (HT) used to be called Hormone Replacement Therapy (HRT), but that term is no longer used. Dr. Faubion explains, "HRT implies that women need to replace lost hormones and bring them back up to the levels a woman had at age 25. Instead, HT uses hormones (estrogen or a combination of estrogen plus progesterone) as a treatment for menopause."

There are several types of HT (different dosages and delivery methods, including pills, patches and creams). Before trying, a woman should discuss the risks vs. benefits with her provider. HT is not recommended for women who have certain health conditions. "For women who are not HT candidates, there are other non-hormonal treatment options that can be effective in treating symptoms, including low-dose antidepressants and the recently released prescription medication for hot flashes,” explains Dr. Faubion.

As for other “cures” you may see being promoted, be wary, she adds. Menopause products have become a big business. "While there are over-the-counter products to treat certain menopause symptoms (such as products for hair loss or sleep aids), none regulate hormones."

3. Menopause and heart issues

Heart disease is the number one killer of men and women in the United States; one in three women dies of heart disease. Whether it’s due to lower estrogen or general aging (probably a combination), heart disease risk increases in menopause (especially early or premature menopause).

“As you age, your arteries become less flexible, and stiff arteries are not as effective at maintaining blood flow,” explains Dr. Faubion. “The loss of estrogen increases lipids, blood sugar, and bad cholesterol." Menopause can also cause weight gain, increasing your risk of heart disease.

The best course of action is to learn all you can about your family history of heart disease and share this information with your healthcare provider. They may suggest additional testing and, if heart disease is detected, recommend certain medications. A healthy lifestyle (including not smoking, eating a well-balanced diet, regular exercise and maintaining a healthy weight) can also lower your risk of developing heart disease.

4. The change changes orgasms.

A decrease in estrogen can cause dryness all over your body — dry eyes, mouth and vaginal dryness. Less estrogen also causes reduced blood flow to the vulva, clitoris and vagina. The clitoris can also become less sensitive with age, and the vagina can have less elasticity.

All that doesn't mean that you can't have sex or reach orgasm; it may just take longer to get aroused. In other words, a "quickie" may be less satisfying than taking your time and having more foreplay before intercourse. "A vibrator can be a very effective tool to increase stimulation," says Dr. Faubion. "We need to normalize the use of one for menopausal women either on their own or as part of foreplay with a partner.” A vaginal lubricant or moisturizer may also help make sex more comfortable.

“Menopause isn’t a reason to stop having sex,” she says. “Instead, it’s an opportunity to revive your sex life.”

What has surprised YOU the most about menopause? Let us know in the comments below.

Randi Mazzella is a freelance writer and journalist. Her work has appeared in numerous online and print publications The Washington Post, Next Avenue, Your Teen for Parents, SheKnows and New Jersey Family. She writes about a wide range of topics including parenting, mental health, wellness, pop-culture, teens, finance and midlife issues. She is a wife and mother of three children who inspire her every day. To read more of her work, go to randimazzella.com.