Menopause Fact vs. Fiction: Why You Suddenly Don’t Feel Like Yourself

For a lot of women, perimenopause and menopause don’t arrive with clarity. It often comes with a lot of confusion. Suddenly, sleep is off, anxiety spikes, brain fog rolls in, and the changes can feel so random that it’s easy to assume something else must be wrong. 

In an episode of Coming in Hot, host Caroline Baudino sits down with board-certified OB-GYN Dr. Mary Claire Haver to unpack why menopause is still so misunderstood, even within medicine, and why so many women have been told to dismiss very real symptoms as “just getting older.” Menopause is not a small hormonal footnote; it’s a whole-body transition that can affect everything from mood and cognition to inflammation, muscle mass, and long-term health.

Here are the biggest myths Dr. Haver wants women to stop believing—and the facts that matter more.

Fiction: Menopause is mostly about hot flashes
Fact: It affects your entire body

For years, menopause has been reduced to a handful of symptoms—hot flashes, night sweats, maybe some mood swings. But according to Dr. Haver, that’s a massive oversimplification. She explains that estrogen receptors exist throughout the body—in the brain, muscles, joints, skin, and cardiovascular system—which is why the symptoms can feel so random and disconnected.

What this actually looks like:

This is why women suddenly experience things like heart palpitations, vertigo, anxiety, brain fog, dry skin, and even ringing in the ears—and don’t connect it back to menopause.

It’s not in your head—it’s your entire body responding to hormonal change.

Fiction: Perimenopause is a slow, predictable decline
Fact: It’s often hormonal chaos

Many women assume menopause is a gradual tapering of hormones. In reality, perimenopause is anything but smooth. “It is not a general decline, it is chaos,” Dr. Haver says.

As egg supply declines, the brain and ovaries essentially misfire, sending signals back and forth in an attempt to regulate hormones that no longer respond the same way.

Why this matters:

That unpredictability is exactly why so many women feel like they’ve suddenly “lost themselves.” One day you’re fine, the next you’re anxious, overwhelmed, or reacting in ways that don’t feel like you.

Dr. Haver describes it as a complete disruption of a system that once worked: “It feels like the rug is pulled from under you.”

Fiction: Feeling off is just part of getting older
Fact: Many women are being dismissed instead of treated

One of the most shocking points in the conversation is how little menopause is actually taught in medicine. “They didn’t teach us anything…I got out of my training and thought I knew everything…and I didn’t,” Dr. Haver recalls.

And that gap has real consequences. Women are often told their symptoms are normal, stress-related, or something they just have to live with.

What this actually looks like:

You go to the doctor with anxiety, insomnia, brain fog, or sudden physical symptoms—and leave without answers. Meanwhile, everything in your body feels different.

That experience is incredibly common, and it’s not something women should be expected to just push through.

Fiction: Midlife health should focus on being thin
Fact: Strength and muscle matter far more

Dr. Haver is especially blunt about one of the most damaging narratives women carry into midlife: the obsession with being smaller. “They’re chasing skinny…and that is going to lead to frailty,” she notes.

Why this matters:

Losing weight without maintaining muscle can increase the risk of frailty, bone loss, and even cognitive decline later on. Instead of focusing on the scale, the priority should be building and maintaining muscle, supporting bone density, and staying strong.

Dr. Haver says to frame your thinking like you are “working out as a love letter to my 80-year-old body.” That mindset shift is critical—especially during a phase where the body is already losing muscle more easily.

Fiction: Less food and more restriction equals better health
Fact: Undereating can make things worse

In a culture that still glorifies restriction, many women enter this phase eating less when their bodies actually need more support. Dr. Haver puts it simply:  “Food is here to fuel you.”

What this actually looks like:

Prioritizing protein, fiber, and whole foods and not cutting calories at all costs.

That means focusing on what you can add in, not just what you’re removing:

• enough protein to support muscle
• fiber for gut and cardiovascular health
• healthy fats for brain function

Ask yourself, “What can I add to make this healthier instead of what can I take away?”

Fiction: Sleep struggles are just annoying side effects
Fact: They’re one of the biggest red flags

Sleep issues are often brushed off, but Dr. Haver calls them one of the most important things to address. “Nothing is more important,” she says.

Why this matters:

Chronic sleep disruption is linked to cardiovascular disease, dementia, and long-term health decline. And for many women, perimenopause is when sleep suddenly starts to fall apart—whether from hormone shifts, anxiety, or undiagnosed conditions like sleep apnea. “If you are not sleeping, that is the first thing we attack,” Dr. Haver says.

Fiction: Every trending wellness fix is worth trying
Fact: Most require caution and proper oversight

With so many new treatments circulating—from GLP-1s to peptides and NAD—it’s easy to assume more is better.

Dr. Haver takes a more measured approach: “Show me a human trial that shows efficacy, and then we can talk.”

What this actually looks like:

Some tools, like GLP-1s, can be helpful, but only when monitored carefully, especially to avoid losing muscle mass. Others simply don’t have enough data to support their use. Dr. Haver’s bottom line is evidence and long-term outcomes matter more than trends.

To hear all of Dr. Haver’s insights on menopause and perimenopause, listen to Coming in Hot wherever you get your podcasts.

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