Talking to Your Doctor About Perimenopause and Menopause

Before Your Appointment

Many women find it difficult to discuss perimenopause or menopause with their doctor. Symptoms can be vague, overlapping, and deeply personal. To ensure you get the most out of your short appointment time, preparation is key.

• Track your symptoms: Keep a diary for a few weeks. Note down physical symptoms like hot flushes and joint pain, but also psychological symptoms like anxiety, brain fog, and low mood.
• Note your cycle changes: If you are still having periods, record their frequency and heaviness. Changes in your cycle are a key indicator of perimenopause.
• Know your family history: Be aware of any family history of breast cancer, heart disease, osteoporosis, or blood clots, as this will influence the treatment options your doctor can safely prescribe.
• Book a double appointment: If possible, ask the receptionist for a double appointment so you do not feel rushed.

Starting the Conversation

It can feel daunting to open the conversation. Here are a few ways you can clearly state why you are there:

Key Questions to Ask

Use these questions to guide your discussion and ensure you leave with a clear plan.

• Based on my symptoms and age, do you agree this is likely perimenopause or menopause?
• Do I need a blood test? (Note: Current guidelines state that if you are over 45 and have typical symptoms, a blood test is not usually required to diagnose perimenopause).
• What are the benefits and risks of HRT for someone with my medical history?
• If I choose HRT, what type would you recommend? (Body identical HRT, delivered through the skin via patches, gels, or sprays, is often considered the safest option).
• How long will it take to see an improvement in my symptoms?
• What non hormonal options or lifestyle changes could help support my nervous system and overall health?
• When should we schedule a follow up review?

Current Guidelines and Facts

It is helpful to know the current medical consensus so you can advocate for yourself effectively:

• HRT and Heart Health: Starting HRT within 10 years of menopause can offer protection against cardiovascular disease.
• Bone Protection: HRT is highly effective at preventing osteoporosis and maintaining bone density.
• Mental Health: Antidepressants are not the first line treatment for the low mood or anxiety associated with menopause. HRT should be considered first.
• Testosterone: If your libido is significantly reduced despite using estrogen and progesterone, you can ask your doctor about a trial of testosterone.