How to Talk to Your Doctor About Menopause

Older woman talking with her doctor
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If you are reading the title of this article and saying to yourself, “Why do I need to see a doctor?” that is absolutely okay.

Menopause and perimenopause are not diseases or ailments; they do not necessarily require treatments or cures (even though media and some product developers have led us to believe otherwise). After all, we don't necessarily take our children to the doctor when puberty strikes, do we? That said, checking in with your doctor, being proactive, and using regularly scheduled appointments as an opportunity to check-in regarding changes in your health are all good ideas.

And, there could be some symptoms that potentially interfere with your quality of life and you may wish to discuss options with your physician.

Approximately 20% of women experience no symptoms at all. 80% of women experience some physical, physiological and/or psychological/emotional changes—ranging from mild to extreme. If you're not among the 20% or the mild group, know this:

  1. Symptoms related to mid-life hormonal shifts are real.
  2. You do not have to suck it up or suffer in silence.
  3. If one health care provider dismisses your symptoms or tells you “you’re not there yet,” you have other options.

Perimenopause symptoms can be frustrating because they are most often the ones we dismiss the most (we—being women). Particularly in our mid-30s and through our 40s, we’re not really sure if we’re dealing with symptoms of perimenopause or symptoms of life (“I’m just stressed from work…the kids…the divorce, etc.”).

Frustration grows when you add in the common misconception that menopause (and therefore symptoms) do not start until you’re 50. (The average age of menopause—the 12 month anniversary of your last period—is 51.2. Perimenopause can start anywhere from 5 to 15 years prior.)

When to Consult Your Doctor

Often women tend to put the first nuances or noticeable changes on the back burner. However, not investigating can mean overlooking a more serious health concern. Better to rule those out; better to be safe than sorry.

The Menopause Book by Pat Wingert and Barbara Kantrowitz offers the following as a guideline for when you should see a doctor concerning symptoms possibly related to fluctuating hormones, midlife and/or menopause and perimenopause:

  • Irregular cycles
  • Very heavy bleeding with clots, or periods that last for more than a week
  • Frequent spotting between periods
  • Bleeding with pain or fever
  • Blood in your urine
  • Abrupt cessation of periods
  • Symptoms that are interfering with your ability to function: hot flashes, night sweats, erratic bleeding
  • A missed period that could indicate pregnancy
  • Any bleeding that occurs after one year of no menstrual periods
  • Painful or swollen breasts
  • Vaginal dryness/pain during intercourse
  • Urinary problems/incontinence
  • More than one panic attack
  • A general sense of unhappiness or a persistent negative mood
  • Inability to experience pleasure or to enjoy the things you used to do
  • Constant worrying
  • Chronic anxiety
  • Obsessive thoughts or compulsive actions that you can’t control
  • Suicidal thoughts or paranoia
  • Extreme fatigue, wired-but-tired, sleep changes such as insomnia, inability to stay asleep or oversleeping
  • Significant weight changes
  • Memory lapses that make it difficult for you to function normally
  • Profound difficulty reading, writing or speaking
  • Anger or rage
  • Itchy or restless legs
  • Changes to skin and hair, or hair loss
  • Family history of thyroid problems

Whether you’ve made an appointment to specifically discuss perimenopause with your health care provider, or you’re going for a regular check-up or annual exam, it is good to review a list of possible perimenopause symptoms and track them for a month or more prior to your appointment. Make a list of changes, such as those listed below, and use a scale of 1-10 to track the severity.

  • Amount of flow
  • Cramps
  • Sore breasts
  • Fluid retention
  • Hot flashes (or flushes)
  • Night sweats
  • Mucous secretion
  • Constipation
  • Headache
  • Sleep problems
  • Feeling frustrated
  • Feeling depressed
  • Feeling anxious
  • Changes in appetite
  • Breast size
  • Interest in sex
  • Energy
  • Feeling of self-worth
  • Outside stresses

Keep in mind that doctors are scientists and they love data. Showing up to your appointment with one or two months of tracked data to describe your symptoms will go a long way to help your doctor help you.