Clearing Up Menopause Misconceptions
- Dr. Chris Creatura
- Sep 13, 2024
- 4 min read
Updated: Oct 1, 2024
Setting The Record Straight About The Aging Process
Puberty Passes. Menopause Doesn’t.
Menopause isn’t finite. Unlike the transition from puberty to adolescence, then on to early adulthood, women remain in menopause, and millions will spend about a third of their lives this way. Failing as healthcare providers to address and treat the permanent cessation of hormones in women’s bodies signals we’re turning our backs on the opportunity to practice preventive medicine.
The prevailing opinions that hormone therapy is unsafe or should be prescribed only for patients with severe symptoms are problematic because we have solid data on preventative healthcare. We’re harming women by withholding HT. A patient will present to a doctor with a symptom that’s so clearly related to menopause, and she’ll be told she doesn’t belong in hormone therapy.
Depleted hormones impact your genitals, bones, joints, and blood vessels. We can’t simply tell women that if they tough it out for a few years, everything will go back to normal. The need for therapy doesn’t correlate with the end of the menopause transition.
Some symptoms are progressive and can worsen over time. Hot flashes may disappear, but other symptoms—decreasing bone and muscle mass, genitourinary system deterioration, neurocognitive issues—can exacerbate with age.
As a woman’s cardiovascular system ages, hormone therapy can arrest and decelerate the risk of serious disease. Anyone who asserts menopause has no lasting impact on a woman’s health is as ridiculous as claiming pregnancy has no effect on her health once she gives birth.
A percentage of women in the United States have no access to menopause care because it’s not considered essential, which results in a great deal of suffering. Even with the growing availability of online treatment, many women won’t get it because the costs aren’t reimbursable.
“Why Can’t A Woman Be More Like a Man?”
Rex Harrison, My Fair Lady
I see women with high blood pressure in my office every single day who’ve been told by more than one healthcare provider that they have ‘white coat hypertension,’ are just anxious, and need to relax. High blood pressure predisposes us to cardiovascular mortality. And we wonder why heart disease is the leading cause of women’s death in the United States.
Women and men with heart disease present differently. Chest pain, for example, isn’t always severe or even the most noticeable symptom in women. Our symptoms are difficult to understand and are understudied, undervalued, and marginalized. The way we’re trained as medical students leaves us poorly qualified to care for women, and we’re not treating them as assertively as we’re treating men.
Our health system is ‘gender biased.’ The aging process of women has been insufficiently investigated and undertreated because women’s health needs have never been prioritized. But this is changing.
Complicating matters is women’s willingness to suffer, even to deny their problems are serious enough to merit treatment. A man with hypertension immediately asks ‘What do I have to do to fix it?’ A woman claims her pressure is always normal when she takes it at home and wants to avoid using medication.
Female Sexuality: More Than a Wet Vagina
Vaginal lubricant makes intercourse possible, but not necessarily pleasurable. It isn’t going to improve female sexual health.
When you can’t become aroused, and feel that your vaginal tissue lacks sensitivity, you need hormones, blood flow, and oxygen. Everything won’t be fine once you make the vagina damp. So, it’s ridiculous when a woman says she’s “dry” and just needs a lubricant. I hope that there's more to female sexuality than a damp vagina.
Many women avoid saying the word ‘pain’ when I ask if they’re suffering during sexual activity. Although they clearly have pain when I examine them, they’ll use the terms ‘dryness’ or ‘uncomfortable.’
Even well-educated, professional, and empowered midage women believe there’s something shameful or embarrassing about wanting to be sexual if it’s not geared toward reproduction. Our culture doesn’t endorse female sexuality, which is connected to poor care during the menopause transition.
Where do we learn that we’re less sexual when we’re no longer young and don’t fit into a certain idea about how we should look? Where do we learn that we’re less valuable because we’re not producing babies? Older women aren’t permitted to express their sexuality or female autonomy.
The libido is complicated and isn’t defined only by hormones. Even with sufficient hormones, the culture says older women shouldn’t express their sexual agency.
Meet Dr. Creatura
*Dr. Chris Creatura graduated summa cum laude from Barnard College, where she was elected to Phi Beta Kappa, and earned her medical degree from Harvard Medical School. She returned to New York for her residency training at The New York Presbyterian Hospital Weill-Cornell Medical College where she maintains her academic appointment.
Those are mighty impressive credentials, but a first-rate education was only the gateway to Dr. Creatura’s stellar career that’s approaching four decades. She is a gynecologist, sex educator, menopause and sexual medicine specialist, and reproductive rights advocate.
A long-time patient eloquently explains why women in midlife respect and adore Dr. Creatura. (Gotta love the last line!)
“Dr. Creatura remembers the smallest details on your follow-up visits and asks all the essential questions. Her bedside manner is amazing—she is professional yet warm—and will explain complex things to you with great care and patience. Whenever I leave her office I feel so well cared for but a little sad, because it will be another year before I see Dr. Creatura again for my annual checkup. I always think how cool it would be to be friends with her outside her office. I kid not—I love her that much. She's truly top-notch in her field—there is no doubt about it.
Not fair that she also happens to be beautiful.”
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