When your body went through its first big hormonal change—aka puberty—you (hopefully) got some education by way of school health class, dog-eared library books or “the talk.” And there was likely no shortage of websites, apps, magazines and mommy blogs to guide you through pregnancy. But when women round the corner toward perimenopause, the helpful chatter often goes silent. That can lead to a lot of worry — and a lot of misconceptions. Here, experts help clear up some of the biggest perimenopause myths.
Myth: You can’t get pregnant during perimenopause.
Reality: Menopause isn’t like a switch that flips your ovaries from “on” to “off.” Instead, you can think of perimenopause as a slow — we’re talking yearslong — winding-down period for your reproductive system. During this time, the level of hormones produced by your ovaries will fluctuate from month to month, so there may be times when you’re still quite fertile, even if your cycles are irregular. Women over 40 have one of the highest rates of unplanned pregnancies, says Mary Dolan, M.D., director of the Midlife and Menopausal Health Center at Emory University, and you’re still at risk of getting pregnant until it’s been at least one year since your last period.
Myth: My mom had her last period at 52, so that means I will too.
Reality: In the United States, the average age of menopause is 51, but it can happen as early as your 30s or as late as your 60s. And perimenopause — that symptom-filled, winding-down period — can last anywhere from two to 10 years. “There is a genetic link; in other words, if your mother went through menopause early or late, you might too,” says JoAnn Pinkerton, M.D., executive director of the North American Menopause Society. “But it’s hard to make a real prediction. And it also doesn’t mean that you’ll have the same perimenopausal experience.” Genetics also isn’t the only factor: Having a hysterectomy, smoking cigarettes and going through chemotherapy can all contribute to earlier menopause. Unfortunately, there’s not much you can do to predict the exact age menopause will hit. “There is a blood test that infertility doctors use called an AMH, or anti-mullerian hormone, test,” Pinkerton says. “If the results are normal, then you probably won’t go through menopause in the next two years, but that’s about all it tells us.”
Myth: Taking birth control pills will postpone perimenopause.
Reality: Oral contraceptives contain man-made versions of the same hormones produced by your ovaries. The pills “take over” for your ovaries, regulating your menstrual cycle and suppressing monthly ovulation. But just because your ovaries are on hiatus doesn’t mean they’ll come roaring back to life as soon as you ditch the pill. “If you take them, say, until you’re 50 — and today’s low-dose pills mean it’s safe for many women to do so — when you go off you may find that your periods simply end,” Dolan says.
Still, the pill does have a big advantage: Taking it significantly curbs or eases perimenopause symptoms. “Hot flashes, insomnia, brain fog, breast tenderness, mood changes — those symptoms occur because of wild swings in hormone levels,” Pinkerton says. “The pill smooths over all of that by keeping your hormone levels steady.” You may still notice some hot flashes or other typical perimenopause symptoms during your placebo weeks, but hey — one week out of four ain’t bad.
Illustration by Jade Schulz
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