NEW YORK (CBS) ― As the old saying goes, there are only two things that are certain in life: death and taxes. Well, you can add menopause to that list for women who live into their 60s, and it’s nearly as misunderstood as it is universal.

“I had chronic headaches, migraines, those were awful,” menopause sufferer Barbara Berzack says. “I felt – funky is the best way to describe it – inside, sort of constantly a little anxious. I had mood swings.”

Berzack also had trouble sleeping and loss of libido. She was going through menopause, although she didn’t realize it because she was only in her 40s and wasn’t having hot flashes.

“I put it all down to various anxieties and stresses in my life,” Berzack says.

Menopause expert Dr. Tara Allmen says women often don’t realize they’re going through “the change” because the signs can vary from woman to woman – and even from day to day.

“There’s no predictability day-to-day, month-to-month, and that period of time can go on for years,” Dr. Allmen, a gynecologist, says.

That period is called peri-menopause, and Dr. Allmen says it’s just one of many misconceptions about menopause. Probably the biggest misconception these days is that women should always avoid hormone replacement therapy.

“[Patients’] risks are so low that they really ought not be concerned, unless they have an interesting personal history,” Dr. Allmen says.

That would include a family or personal history of blood clots or breast cancer.

For millions of other women, though, hormone replacement for just a few years can ease the hot flashes, sleep problems, night sweats, mood swings, and even thinking and memory issues.

Another menopause myth is that you’re done with menopause once you stop menstruating.

“From the time that you have your last period until the time that you die, you’re a menopausal woman,” Dr. Allmen says. “You have to be concerned about all of the issues that exist during that time.”

Some of those issues are that menopausal women are at increased risk for heart disease and osteoporosis, among other things. Hormone therapy helps with both, as do other medications that help build bones.

Berzack says hormone therapy changed her life.

“I’m great. Let me rephrase that – I’m really great,” Berzack says.

This doesn’t mean that all women should go running to get hormones, though. What it does mean is that, for many women whose lives are being severely affected by menopausal symptoms, hormones can be a huge relief – as long as they don’t have medical reasons to avoid them.

The key is to find a menopause expert who will help you decide on treatment based on your individual circumstances.

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