UAB OB/GYN takes a deep dive into common misconceptions surrounding women’s health.From adolescence to adulthood, women’s health is often surrounded by misconceptions that can lead to confusion and misinformation. Sarah Dunk, M.D., assistant professor in the Marnix E. Heersink School of MedicineDepartment of Obstetrics and Gynecology, addresses some of the most common misconceptions
Misconception: Hormonal acne only appears during teenage years
While hormonal acne is most common during puberty, it is prevalent in adult women as well. In fact, around one in four women reports acne in her 40s. It can present as persistent acne that continues from adolescence, as a first occurrence in adulthood or as a recurrence after prior resolution
“In general, acne is caused by increased levels of androgens, a group of steroid hormones,” Dunk said. “This increase happens during puberty because androgens help with sexual development.”
Conditions such as polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome, can cause elevated androgens even after puberty and lead to adult acne. Hormonal acne is uncommon after menopause — so if severe symptoms occur suddenly after menopause, it is worth notifying a healthcare provider
Misconception: All menstrual cycles are 28 days long
While 28 days is considered average, normal menstrual cycles can range from 21 to 35 days
There is considerable normal variation in menstrual cycle length — both between women and between one’s own cycles. Almost half of women experience up to seven days of variation from their shortest and longest cycles over a year. If they fall between 21 and 35 days, this is a good sign of normal ovulation
Misconception: Irregular periods are normal and nothing to worry about
Consistent irregular periods are not normal and could be a symptom of underlying health conditions like PMOS
“Skipping a single menstrual cycle can be normal, especially during a period of stress, illness or travel,” Dunk said. “Recurrent or missed periods, however, do warrant evaluation.”
There are many causes of abnormal cycles, including PMOS, thyroid disease, elevated prolactin, obesity and malnutrition/eating disorders. This is why it is important to be evaluated if multiple cycles are missed
Misconception: Women cannot get pregnant during their menstrual period
It is unlikely, but it can happen. While chances are low, women with shorter menstrual cycles have a slightly higher chance of pregnancy due to earlier ovulation in their cycle
There is a fertile window lasting approximately five days prior to ovulation and including the day of ovulation, when intercourse can lead to pregnancy
In women with shorter menstrual cycles, such as every 21-24 days, ovulation may occur shortly after menstruation ends. This means that sperm from intercourse during the late days of a period may still be
“Sperm can survive in the female reproductive tract for up to five days,” Dunk said
Misconception: Only sexually active women need to see a gynecologist
Gynecologic care is about much more than sexual activity. It focuses on overall reproductive and hormonal health at every stage of life. Adolescents and women who are not sexually active may still need care for:
- Menstrual concerns (irregular, painful or heavy periods)
- Hormone health
- Breast health
- Pelvic health, including things like pain, ovarian cysts and pelvic floor muscle
- Preventive health education and counseling
- Vaccinations, such as the HPV vaccine to prevent certain cancers
“Routine visits help normalize conversations about the body, catch potential issues early and provide guidance tailored to each person’s needs,” Dunk said
Sarah Dunk, M.D., addresses common misconceptions surrounding women’s health with research-backed insight.The American College of Obstetrics and Gynecology recommends all women see a gynecologist at least once a year, regardless of sexual activity or whether a pelvic exam is performed.
Annual exams cover much more than a pelvic exam — including HPV vaccination assessment, menstrual health evaluation, contraception counseling, screening for risky behaviors and preventive medicine. All of these are relevant regardless of sexual activity
Misconception: Birth control pills cause infertility
“Birth control pills do not cause infertility,” Dunk said. “Most women return to their normal fertility after stopping them.”
The evidence shows that use of birth control pills, even when used for many years, does not cause infertility. In fact, when comparing 12-month conception rates in former pill users, they are comparable to rates seen in women who used IUDs, condoms or natural family planning like cycle tracking
There can sometimes be a short delay in resumption of ovulation after stopping pills, typically around three menstrual cycles. This is temporary and does not cause any permanent issues
Misconception: Birth control is only for preventing pregnancy
Hormonal contraceptives are frequently prescribed as treatment for a wide range of gynecologic and medical conditions, such as endometriosis, acne, PMOS, cycle regulation and managing heavy periods
They can significantly decrease blood loss for women with heavy cycles, reduce pain for women with painful periods and regulate androgen levels in women with PMOS. They can also be used to improve acne, lessen excess facial hair and reduce symptoms of PMS
Long-term use of birth control pills can also reduce a woman’s risk of ovarian and uterine cancer risk by almost half
Misconception: Women should not exercise during their period
Exercise during your period is safe and can even help relieve symptoms like cramps and fatigue
“There is no medical reason to avoid exercise during menstruation,” Dunk said.
In fact, there are multiple studies that show both low- and high-intensity exercise can reduce pain during the menstrual cycle. It can also improve PMS symptoms such as anxiety, bloating and constipation
Misconception: “Mom brain” causes long-term cognitive decline lasting one to two years after childbirth
“Mom brain” is not a medical condition and does not cause long-term cognitive decline. Some women may experience temporary forgetfulness or mental fog during pregnancy and early postpartum, often due to sleep deprivation, stress and hormonal changes
Dunk explains that, while many women do report memory and attention concerns during pregnancy and postpartum, this has never been consistently demonstrated on any objective cognitive testing
“In women who experience these symptoms, we thankfully do not see it as permanent,” Dunk said. “In fact, when we have compared mothers and fathers during various time points in pregnancy and postpartum, we see no difference in memory between the two groups.”
Mothers and fathers also reported improvement in memory at the same rate, supporting the theory that environmental factors such as stress and sleep deprivation, which both parents experience, likely lead to the perceived decline
Misconception: Pelvic floor problems after childbirth are something women just must live with
Pelvic floor issues after childbirth are common and treatable. Pelvic floor physical therapy, lifestyle changes and medical interventions can significantly improve or even resolve symptoms
“The physical strain of delivery and weight of the growing uterus can overstretch and weaken the pelvic floor muscles,” Dunk said
These weakened muscles can make it more difficult to control urine, flatus or stool. Sometimes the muscles and ligaments weaken enough to provide inadequate support to the pelvic organs, resulting in prolapse
Despite how common these issues are after childbirth, this does not mean they cannot be managed or treated. Pelvic floor muscle training is the first-line treatment for postpartum urinary incontinence, fecal incontinence and pelvic pain. This can be done at home through Kegel exercises or under the supervision of a professional pelvic floor physical therapist
Misconception: Menopause means a woman is “getting old”
“While menopause does signal the end of reproduction, it is not a disease or a marker of aging and decline,” Dunk said. “It is a natural biological transition. Many women after menopause remain healthy, active and vibrant for decades.”
The average age of menopause in the United States is 51 years, with most women experiencing it between 45 and 56 years. The average life expectancy for women in the United States is around 81 years — meaning women can spend up to 40 percent of their lives in the postmenopausal stage
There can be many positive experiences associated with menopause, including relief from PMS, menstruation and fear of pregnancy. While the hormonal changes can cause bothersome symptoms, there are multiple treatment options to help manage them
