Myths vs FactsLet's Clear the Air

Fact It can affect the brain, heart, bones, skin, gut, joints and urinary system, and symptoms vary widely from woman to woman.

Fact Many common symptoms, including hot flashes, sleep problems, mood changes and memory lapses, start in the brain as estrogen falls, according to Dr Mosconi.

Fact Hormone changes can begin years earlier. Perimenopause often starts in the 40s, sometimes the mid-30s, and the final period averages around 50 to 52.

Fact Hormones swing too much in perimenopause for a single test to be reliable. NICE (opens in a new tab) advises that, for women over 45, diagnosis is usually based on symptoms.

Fact Weight tends to rise with age at a steady pace. What menopause changes is where fat goes (more around the belly) and how much muscle you keep.

Fact Dr Mosconi's team found no difference in cognitive performance between men and women before or after menopause. Women may feel tired, but they are just as capable.

Fact The picture is nuanced. Combined therapy carries a small added risk that grows with duration; estrogen alone carries little or none. Risks depend on type, timing and your history.

Fact Timing matters. Started before 60 or within 10 years of menopause, studies link it to less heart disease and lower death rates. Started much later, it shows no heart benefit and more stroke and clot risk.

Fact In the US, the FDA removed (opens in a new tab) its boxed warnings on heart disease, breast cancer and dementia from the first updated labels in February 2026. Risks still need discussing with your doctor.

Fact Non-hormonal options include CBT and newer prescription medicines such as fezolinetant (opens in a new tab) and elinzanetant.

Fact Not yet. It isn't currently recommended to prevent dementia (USPSTF (opens in a new tab)), though research into timing and type is ongoing.

Fact There's no fixed cut-off. The British Menopause Society (opens in a new tab) says arbitrary limits shouldn't be set, and The Menopause Society says longer use should have a clear reason and regular review.

Fact Whole-body hormone therapy is generally not recommended after breast cancer, but some women may be able to use vaginal estrogen after a discussion with their cancer team (British Menopause Society (opens in a new tab)).

Fact Low-dose vaginal estrogen works mainly where it's applied. The British Menopause Society (opens in a new tab) says there's no significant absorption into the body and no added breast cancer risk.

Fact Only a dozen or so eggs are collected, while many thousands are naturally lost each month. It does not bring menopause forward.

Fact Not really. Men's testosterone declines slowly and then levels off, and their testes keep working for life.

Fact In one trial, probiotics didn't change which bacteria were present, but did seem to change how they worked.

Fact Most women don't show measurable memory decline. In one study, stress, not menopause stage, was most linked to memory complaints.

Fact Mood changes are common, especially in perimenopause, but not universal. Risk tends to ease after menopause. Resilience and support make a difference.

Fact Frequent or early hot flashes are linked to worse cholesterol, blood pressure and early artery changes, so they're worth mentioning to your doctor.

Fact You can still ovulate, so contraception is still needed. UK guidance says until 1 to 2 years after your last period, depending on your age, or until 55.

Fact The WHO (opens in a new tab) warns that STIs, including HIV, can still be passed on, and thinner vaginal tissue may raise the risk.

Fact It isn't a diagnosis used in menopause guidelines such as NICE's, though the term is common online.