6 Common Myths About Perimenopause and Hormone Therapy: What Those Born with Ovaries Need to Know

Despite the fact that approximately 40% of people born with ovaries experience perimenopausal symptoms, with 95% of those reporting that symptoms interfere with their daily lives, misinformation remains widespread — especially when it comes to hormone therapy.

As a Canadian Nurse Practitioner specializing in perimenopause and menopause, and as someone going through perimenopause myself, I have seen how outdated narratives and healthcare gaps continue to leave people born with ovaries underserved, underinformed and struggling when it comes to the menopause transition.

Let's clear up six of the most common myths — with facts Canadians born with ovaries need to feel empowered in their care.

"You're too young to be in perimenopause."

Perimenopause can begin in your late 30s or early 40s. It is not about age — it's about fluctuating hormone levels. Symptoms like irregular cycles, anxiety, sleep disturbances, fatigue and mood swings often appear well before your periods stop.

"There is nothing you can do — you just have to tough it out."

This is one of the most damaging myths. Perimenopause symptoms can be debilitating, and there are evidence-based treatments available in Canada — including lifestyle, non-hormonal, and hormonal options. You do not have to suffer silently.

"If you're still getting your period, hormone therapy isn't an option."

Contrary to this belief, perimenopause is actually one of the best times to begin hormone therapy. While your menstrual cycles may still be regular, fluctuations in hormones during perimenopause can be significant, causing troubling symptoms. Starting hormone therapy during this stage can help stabilize hormone fluctuations, providing relief and improving overall well-being.

"Hormone therapy is only for hot flashes and night sweats."

While hormone therapy is highly effective for alleviating menopausal symptoms such as hot flashes, night sweats, and vaginal dryness, it also supports bone health, cardiovascular health, mental health and overall well-being.

"Hormone therapy causes breast cancer."

This myth stems largely from early misinterpretations of the Women's Health Initiative (WHI) study. Since then, updated data- including guidelines from the Society of Obstetricians and Gynaecologists of Canada (SOGC) — confirm that hormone therapy is safe and effective for most people born with ovaries under the age of 60 or within 10 years of menopause. The absolute risk of breast cancer is small and must be outweighed against proven benefits.

"Natural products are safer than hormone therapy."

Many women in perimenopause turn to natural products, such as herbal supplements or plant-based remedies, believing they are safer alternatives to hormone therapy for managing symptoms like hot flashes, mood swings, and irregular periods. While Health Canada does regulate some natural health products, many of these lack many robust scientific evidence to support their safety or effectiveness for perimenopausal symptoms. The Menopause Society of Canada points out that just because a product is "natural" doesn't mean it's risk-free.

In contrast, hormone therapy is a well-researched and regulated treatment option with a known safety profile. When prescribed and monitored by a healthcare provider, it offers a more reliable solution for managing perimenopausal symptoms.

The Bottom Line

Perimenopause is a natural and inevitable transition, but it doesn't have to be overwhelming or debilitating. Unfortunately, myths and outdated information still persist, leaving many people born with ovaries feeling confused, underserved, and unsure of their options.

By clearing up these common misconceptions, it's my hope that more individuals in perimenopause can feel empowered to take control of their health. Whether through hormone therapy, lifestyle changes, or other treatments, there are effective solutions available to help navigate this phase of life with confidence and well-being.

If you've been told any of these myths — or been dismissed altogether by your care provider — it's time for a conversation.

By Andrea Marsh