For most women, menopause is more than just hot flashes and night sweats; it’s a complicated, and often misunderstood, period of a woman’s life. Even those who are in the process of this transition find they have so much more to learn—from the symptoms they will experience and how to get relief to potential risk factors for other conditions—and can benefit from understanding all the surprising facts. 1. It can lead to osteoporosis. Because estrogen helps control bone loss, during menopause (when we lose estrogen), women lose more bone than is replaced. Over time, those thinning bones become weak and brittle—what’s known as osteoporosis. Be sure to talk to your doctor about your risk (he or she may suggest a bone density test) and what you can do to help prevent or treat osteoporosis. 2. It’s when symptoms usually end, not begin. People tend to think of menopause as the symptoms most women experience, including hot flashes, night sweats, and trouble sleeping and concentrating. But when you reach the medical definition of menopause, after a year of not having a period, these symptoms typically begin to taper off, or may disappear altogether. It’s the time that precedes menopause (perimenopause) when symptoms are usually at their peak. 3. It can increase your risk for heart disease. After menopause, women are more likely to have heart disease. This could be due to many factors, such as changes in estrogen levels or conditions that go along with aging, such as gaining weight or high blood pressure. Talk to your doctor about what you can do to protect your heart, such as having your blood pressure and cholesterol checked regularly. 4. Hot flashes can linger for years. It would be nice to think the signature hot flashes associated with menopause will come and go in a “flash,” but the reality is, there’s no way to predict when they will start or stop. Menopausal women may experience hot flashes, on average, from six months to two years, and for some, as long as 10 years. A small number of women may find their hot flashes never go away, or that they recur more than 10 years after menopause. 5. Your memory will return. You may have heard that women often have problems with concentration and memory, and a general “foggy” feeling, during perimenopause and the years right after menopause. But data suggests a woman’s memory after the menopause transition is as good as it was before. In fact, memory problems are more often chalked up to normal cognitive aging, mood and other factors than to menopause. To help prevent memory loss, keep up a good social network, stay physically and mentally active, eat a healthy diet, avoid smoking, and consume alcohol in moderation. 6. Chemo and radiation can induce menopause. Chemotherapy and radiation therapy may lead to menopause symptoms such as hot flashes during or shortly after the course of treatment. But be aware menstruation and fertility are not always permanent after chemo, so you may want to continue any birth control measures. 7. Smoking—and surgery—can lead to early menopause. A study suggests women who are heavy or habitual smokers are more likely to experience menopause, on average, 1 to 2 years earlier than women who never smoked. And women exposed to high levels of passive smoke as a child and adult had an earlier menopause by about one year. Surgery to remove your uterus (a hysterectomy) will also make your periods stop (which is menopause). But you may not have menopause symptoms right away if your ovaries aren’t removed since they can still make hormones. 8. You can Downward Dog your way to fewer hot flashes. Some studies show that yoga, as well as tai chi and qigong (a series of slow movements and meditation), may be effective in decreasing the number of hot flashes in perimenopausal women. Acupuncture has also been known to be effective. Talk to your doctor about what may work well for you. Often a class is the best way to learn proper postures and breathing techniques.