A hot flash erupts without warning, periods vanish for several months in a row, and yet… nothing is as simple as it seems. A gynecologist obstetrician based in Aix-en-Provence decided to speak plainly on social media. His observation: perimenopause and menopause carry with them a whole slew of clichés, sometimes harmless, sometimes downright dangerous for health. Between « menopause happens overnight » and « no need for gynecological follow-up afterwards », it is time to sort out what belongs to common sense and what, deep down, is just a deeply rooted legend.
- Menopause is usually preceded by a gradual perimenopause that can last for several years, with exceptions such as oophorectomy or certain chemotherapies.
- Until menopause is confirmed by twelve consecutive months without periods, contraception remains necessary despite irregular cycles.
- There are persistent myths about hot flashes, vaginal dryness, hormone therapy, early menopause, and stopping gynecological follow-up.
- No, menopause does not fall from the sky overnight
- Irregular periods do not mean you can stop contraception
- Hot flashes, dryness, hormone therapy: what we think we know deserves to be nuanced
No, menopause does not fall from the sky overnight
Contrary to a widely held belief, menopause does not arrive like a thunderclap on a sunny morning. Before the permanent cessation of menses occurs, a transition phase takes place—the perimenopause—which can stretch over several years. Cycles become disrupted, periods may become more frequent or heavier: the body usually sends gradual signals, somewhat like a trailer before the main film. There are exceptions, however, notably in cases of ovary removal or certain chemotherapies, where the transition can be much more abrupt. In France, the average age of menopause hovers around 52 years, but the path to reach it is rarely a straight line.
Irregular periods do not mean you can stop contraception
This is probably one of the most common and riskiest traps. Because cycles become unpredictable, many wrongly think there is no longer any risk of pregnancy. Yet ovulation persists, simply in a haphazard way, which means that contraception remains essential until menopause is confirmed. Another reflex to abandon: rushing to have a blood test at the slightest doubt. Except in cases of abrupt cessation of periods before 45, the diagnosis rests primarily on a simple, straightforward criterion: twelve consecutive months without periods. Hormone tests, meanwhile, vary too much from day to day at this age to be reliable, and hormonal contraception further complicates the interpretation of the results.
Hot flashes, dryness, hormone therapy: what we think we know deserves to be nuanced
Even though hot flashes are the star symptom of menopause, they don’t tell the whole story. Other commonly held beliefs deserve to be scrutinized:
- “Hot flashes are the one and only symptom”: a simplification that masks other frequently occurring manifestations
- “Vaginal dryness must just be endured”: a discomfort that does not have to be suffered in silence
- “Hormone therapy causes cancer”: a fear that merits reexamination in light of current data
- “Menopause before 45 doesn’t exist”: a real possibility that is too often brushed aside
- “In menopausal women, gynecological follow-up is no longer needed”: an erroneous reflex that can be costly
All of these topics deserve to be discussed openly, without taboos or shortcuts, rather than remaining confined within certainties passed down from generation to generation.
In short, perimenopause and menopause remain stages shrouded in uncertainties, often fed by ideas transmitted with little verification. A better understanding of these mechanisms not only helps to demystify this period but also allows continuing to consult with confidence. And perhaps the best way to approach this life milestone is simply to ask the right questions at the right moment?
