How To Talk To Your Doctor About Menopause
Menopause is a natural part of a woman’s life. But as a significant life transition, it’s often looked upon as a topic too complex or uncomfortable to discuss openly even with your doctor.
Whether it’s due to your upbringing, society’s discomfort with anything “women’s health,” or just plain awkwardness, menopause conversations can feel complicated. According to The State of Menopause Study, 45% of women didn’t know the difference between perimenopause and menopause. Even as a nurse, I used to be one of those women!
Ladies, this is our health, and we’ve got to tackle it head-on with confidence, clarity, and maybe a bit of humor.
No matter where you are in the menopause journey — whether you’re in your 30s or 40s dealing with perimenopause or well into post-menopause (50s and beyond) — your symptoms matter. You deserve to be heard.
With preparation, confidence, and a bit of humor, you should be able to take control of the conversation with your doctor. It’s a way to be sure your physical and mental health remains a priority. Let’s review what you need to know about the most common symptoms, necessary tests, procedures, choice of medications, health risks, and last but not least, how to build confidence to handle the visit!
When You Should Talk To Your Doctor About Changing Hormones
The average age of menopause is 51 but many women experience changes in how they feel 7 to 10 years earlier — during perimenopause. I was 44 in full menopause; perimenopause started in my late 30s.
This is the transition to menopause, the best time to talk to your doctor (something I wish I had known). Watch for symptoms of changing hormones such as:
- Change in periods
- Hot flashes
- Night sweats
- Moodiness
- Brain fog
- Weight gain
- Joint pain
Talking to your doctor about how you’re feeling physically and mentally is important so they can run tests to rule out other health conditions. You deserve to feel your best, especially during the ups and downs of changing hormones.
Be Prepared to Discuss Your Symptoms
This is no time to be shy. You can do this!
Every woman’s body and experience with changing hormones is different but they all matter! You might have hot flashes and night sweats, or you may be struggling with weight gain, vaginal dryness (yes, all skin becomes dry…even there), mood swings, rage, or brain fog.
These symptoms will inevitably affect your quality of life including intimacy and how you deal with stress. Often they aren’t always recognized as related to menopause.
Keep a journal or detailed log of your mental and physical symptoms for a few weeks or months, how often they occur, and how they impact your daily life. Check out my free resources page, which includes a symptom tracker you can print out, fill in, and bring to your next doctor’s appointment. There are symptoms listed you may not be aware are related to changing hormones.
We all know how doctor appointments can feel rushed. It’s important to have a list of questions you want answered and talking points you want to discuss (feeling stressed tends to make us forget things).
Tests Your Doctor May Order (no need to panic!)
During your visit, your doctor will likely ask about your menstrual history, family history, and any symptoms you’re experiencing.
Additional testing might be necessary, especially if you’re dealing with severe symptoms.
Here are some tests that could come up during your conversation or you should bring up if they aren’t discussed:
- Hormone Level Tests: These may include checking levels of estrogen, FSH (follicle-stimulating hormone), and LH (luteinizing hormone) levels to confirm where you are in the menopausal transition. You should be aware that since hormone levels fluctuate, these tests are not always reliable. Everything may look ‘normal’, but you may still feel like a sweaty mess.
- Bone Density Test (DEXA Scan): Menopause increases the risk of osteoporosis due to declining estrogen levels. A bone density scan can assess your risk of fractures and bone loss.
- Thyroid Function Tests: Sometimes, symptoms like fatigue, hair loss, and mood swings overlap with thyroid disorders. Checking your thyroid-stimulating hormone (TSH) can help rule out any thyroid issues.
- Lipid Profile (Cholesterol Levels): Due to an increased risk of cardiovascular (heart) disease during menopause due to decreasing hormones, your doctor should monitor your cholesterol levels, which include HDL, LDL, and triglycerides. Further testing with a Coronary Calcium Score: (see below) may also be needed to get a clearer picture before prescribing certain medications or hormone replacement therapy (HRT).
- Blood Sugar Testing: Menopause can affect your body’s insulin response, increasing the risk of developing Type 2 diabetes. Your doctor may suggest a fasting glucose test or A1C test to check for signs of insulin resistance or diabetes.
To understand your overall health and where you’re headed, it’s critical to know where you are now with baseline testing.
Discuss These Procedures
If you’re having particularly troublesome symptoms or there are concerns about your overall health, your doctor may suggest further testing or procedures such as:
- Endometrial Biopsy or Ultrasound: If you’re experiencing pelvic pain or abnormal bleeding, your doctor may perform these tests to rule out endometrial hyperplasia or cancer.
- Mammograms and Pelvic Exams: Routine screenings may be recommended to detect any changes in breast tissue or reproductive organs as you age.
- Coronary Calcium Score: This non-invasive imaging exam measures the amount of calcium in the walls of your heart’s blood vessels. It can help detect heart disease in its early stages.
Remember, early screening and diagnosis can improve outcomes!
Prescription and Over-The-Counter Medications
Your treatment plan should be individualized based on your symptoms and health goals. Your physician may discuss the following:
- Hormone Replacement Therapy (HRT): This treatment can help alleviate hot flashes, night sweats, bone loss, and vaginal dryness. Be sure to have a comprehensive discussion about the pros and cons of HRT based on your health history as well as the different delivery systems (oral, patch, cream, nasal spray, gel, and vaginal cream or ring).
- Non-Hormonal Medications: Some women may prefer non-hormonal treatments for managing symptoms. Options include selective serotonin reuptake inhibitors (SSRIs) for mood swings and hot flashes, Veozah for hot flashes, Gabapentin for sleep issues, or Clonidine for blood pressure control.
- Supplements: Your doctor might recommend Calcium, Vitamin D, Vitamin B Complex, or Magnesium supplements to alleviate some of your symptoms as well as Omega-3 Fatty Acids for heart health. Discuss all medications you are taking with your doctor because OTC and prescription drugs can interact.
- Topical Treatments: For vaginal dryness, your doctor may suggest localized estrogen treatments like creams or rings, which have fewer risks than systemic HRT.
Health Risks in Menopause
Changing hormones brings new health challenges that are important to address. Declining estrogen levels can increase the risk of many conditions, including:
- Cardiovascular Disease: The risk of heart disease rises after menopause due to changes in cholesterol levels and blood pressure.
- Osteoporosis: Bone density decreases leaving you at risk for fractures post-menopause.
- Type 2 Diabetes: As mentioned earlier, insulin resistance becomes more common during this stage. Find out how to increase insulin sensitivity in midlife at my blog post ‘Five Easy Ways to Increase Insulin Sensitivity in Midlife.’
- Cognitive Changes: Many women complain of brain fog and memory lapses during menopause. It’s important to monitor these symptoms and discuss them with your doctor, as they may sometimes signal more serious concerns like dementia and require further testing.
Many women admit to knowing about hot flashes and night sweats but don’t realize all the health risks they could prevent with lifestyle choices and possibly starting HRT.
Building Confidence To Advocate For Yourself
It requires confidence and knowledge to talk to your doctor about menopause. It’s especially difficult if your concerns have been dismissed by doctors in the past.
However, being clear and assertive is key to getting proper care. Here are a few tips to help you feel more empowered:
- Educate Yourself: Knowledge is power. Read or listen to podcasts that are provided by reputable sources to gain an understanding of your changing body. Research your symptoms, treatments, and potential health risks of menopause before you see your doctor. This knowledge will help you feel more confident when discussing your options. Dr. Louise Newson has a wonderful podcast full of so much educational material, and Dr. Mary Claire Haver has written a book ‘The New Menopause‘ that’s also chock full of valuable information!
- Bring Questions: Write down a list of questions you have for your doctor ahead of time. This ensures you cover all your concerns and don’t forget important topics and questions you want answers to.
- Find a Supportive Doctor: If your concerns are being brushed aside, it’s time to find a new provider. Check the North American Menopause Society website for a menopause-educated practitioner near you who can support you and answer your questions appropriately. Your health is too important to be overlooked.
- Consider a Second Opinion: If your first appointment leaves you feeling confused, uneasy, and not supported, don’t hesitate to seek another opinion. Healthcare decisions should be a team effort. You have to feel heard and comfortable with your healthcare plan.
Next Steps
Talking to your doctor about menopause can feel daunting, but it’s a crucial step in taking control of your health. Don’t be afraid to ask questions. You have every right to request tests, medications, and treatments you feel you need.
Many of the women I work with admit that they knew very little about changing hormones but as they empower and educate themselves, they feel more confident having conversations with their doctors.
Remember, menopause is a natural transition, and with the right care and guidance, you can continue to live a long, vibrant, and healthy life and feel confident as you gain knowledge!
Reach out to me and let me know how your conversation with your doctor went. I’m also available for a free discovery call to discuss how I can support you in continuing the conversation with your doctor and making lifestyle changes to feel your best in menopause and beyond!
Kathleen is a registered nurse who became a certified life and health coach after going through a very difficult perimenopause (full menopause at 44). With the help of a health coach, she finally understood how making simple lifestyle shifts would improve her health and help her feel her best! She’s now on a mission to help other women tackle menopause head-on, embrace intuitive eating, and rediscover trust in their bodies — without all the stress or struggle.
