Menopause is talked about in hushed tones, dramatic warnings, or casual dismissals, often all at once. For some, it’s reduced to hot flashes. For others, it’s framed as the beginning of irreversible decline. And for many women, it’s something to simply “put up with”.
But how much of what we believe about
menopause is actually true?
For this week’s Fact-Check Friday, we spoke to Dr Kiran Coelho, Senior Obstetrics & Gynaecologist at Lilavati Hospital, Mumbai, to unpack the most common menopause myths she encounters in her clinic, and what women really need to know.
1. Does menopause only happen when periods stop?
Myth: Menopause starts only after periods completely stop.
Fact: The menopausal transition begins years earlier.
“Menopause is officially defined as 12 months with no menstruation,” says Dr Coelho. “But the transition phase, called perimenopause, can last several years and includes symptoms like irregular cycles, sleep disturbances, hot flashes and mood swings.”
In other words, menopause is not a single date on the calendar. It’s a long biological transition that starts well before the last period and continues after it.
2. Are hot flashes the only real menopause symptom?
Myth: If you don’t have hot flashes, it’s not really menopause.
Fact: Hot flashes are common, but far from the whole story.
“Hot flashes are the most recognised symptom, but there are many others,” Dr Coelho explains. “These include sleep problems, vaginal dryness, recurrent urinary tract infections, mood changes and reduced libido.”
Many of these symptoms are underreported, underdiagnosed, and quietly endured, often because women don’t realise they are linked to menopause at all.
3. Is menopause always a time of suffering and decline?
Myth: Menopause inevitably means years of misery.
Fact: For many women, symptoms are mild and temporary.
“Menopausal symptoms are usually transitional and settle within a couple of years,” says Dr Coelho. “In many women, symptoms are minimal and not life-debilitating.”
For some, menopause even brings a sense of freedom—no menstruation, no pregnancy concerns. And for those with moderate to severe symptoms, effective treatments now exist.
“Menopause today should be something to rejoice for rather than suffer through,” she adds.
4. Is hormone replacement therapy (HRT) extremely dangerous?
Myth: HRT is unsafe and should be avoided.
Fact: For many women, HRT is both safe and beneficial.
“This is one of the most misinformed beliefs,” Dr Coelho says. “Current guidelines show that HRT in healthy women under 60 is very safe, with little to no risk compared to its benefits.”
HRT not only relieves symptoms but also protects against bone loss and cardiovascular disease. While risks such as thrombosis, stroke or breast cancer exist, they are largely linked to personal risk factors.
“With modern low-dose HRT formulations, these risks are very low in the general population,” she explains.
5. Is weight gain inevitable and caused only by hormones?
Myth: Menopause automatically causes weight gain.
Fact: Hormones are only part of the picture.
“Weight gain is influenced by
multiple factors, ageing, reduced activity, sleep disturbances, dietary changes and loss of muscle mass,” says Dr Coelho.
Menopause does tend to increase abdominal fat, but this is not irreversible. “Regular exercise, strength training and a protein-rich diet can effectively counter this,” she notes.
6. Does menopause kill your sex life?
Myth: Desire disappears after menopause.
Fact: Libido is influenced by far more than hormones.
“Reduced libido happens in some women, but not all,” Dr Coelho says. “Factors like relationship quality, body image, stress, sleep and vaginal discomfort all play a role.”
Vaginal dryness and pain, often blamed on ageing, are treatable with vaginal oestrogen and moisturisers. Sexual health during menopause is a medical issue, not a personal failure.
7. Do only older women go through menopause?
Myth: Menopause happens only in your 50s.
Fact: It can occur much earlier.
“In India, the average age of menopause is around 49–50 years,” Dr Coelho explains. “But it can naturally occur anytime between 45 and 55.”
Some women experience early menopause or premature ovarian insufficiency, even before 40. “That’s why awareness of symptoms and timely treatment is crucial,” she says.
8. Does brain fog mean dementia is coming?
Myth: Memory issues during menopause signal future dementia.
Fact: There is no evidence supporting this fear.
“Brain fog is a temporary symptom of menopause,” says Dr Coelho. “It does not guarantee dementia in old age.”
While frustrating, cognitive changes during menopause usually improve over time and are not a predictor of neurodegenerative disease.
9. Does menopause begin at 50 for every woman?
Myth: All women reach menopause at the same age.
Fact: Biology doesn’t work on a fixed schedule.
“Menopause generally occurs after 45,” Dr Coelho reiterates, “but in some women it can happen earlier than 40.”
Genetics, health conditions, and medical treatments all influence timing.
10. Does menopause make women overly emotional or irrational?
Myth: Menopause makes women unstable.
Fact: This is a crude and outdated generalisation.
“Sleep disturbances and hormonal changes can affect mood and stress tolerance,” Dr Coelho explains. “These are medical symptoms, not personality traits.”
With treatment, lifestyle changes and support, mood symptoms can be effectively managed.
11. Do you no longer need contraception once menopause starts?
Myth: Pregnancy risk disappears during perimenopause.
Fact: Contraception is still needed until menopause is confirmed.
“The chances of pregnancy are low, but not zero,” says Dr Coelho. “Until 12 months of no periods, contraception is advisable.”
12. If your mother had severe symptoms, will you too?
Myth: Menopause symptoms are purely genetic.
Fact: Genes matter, but they are not destiny.
“There may be a familial pattern in age and symptom tendency,” Dr Coelho says. “But factors like weight, smoking, stress and medical conditions also play a strong role.”
Early treatment can significantly reduce symptom severity.
13. Does menopause always cause depression?
Myth: Menopause inevitably leads to depression.
Fact: Mood changes are common, but depression is not inevitable.
“In most women, menopause causes irritability and mood disturbances—not clinical depression,” Dr Coelho explains.
For women with prior depression or severe symptoms, treatments including HRT and antidepressants are available and effective.
About Fact-Check Friday
Misinformation in health can be more harmful than the illness itself. That’s why every Friday, Business Standard brings you Fact-Check Friday, a weekly series where we unpack myths, wellness trends, and separate evidence-based medical insights from popular misconceptions.
From ageing and mental health to fitness, diets, and everyday remedies, our fact-checks are guided by doctors, researchers, and public health experts, so you can make informed choices for your well-being.
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This content is for informational purposes only and is not a substitute for professional medical advice.
 "What we get wrong about menopause: Gynaecologist busts 13 persistent myths")
