DISCLAIMER: The following post outlines the writer’s personal perimenopause journey. It is not intended to act as medical advice. As always, please consult your doctor with any questions about perimenopause or menopause.
I had my daughter when I was almost 36 and was considered “advanced maternal age” for my pregnancy. For the first few years after having my daughter, I clearly was “post-partum.” I was exhausted, moody, anxious, and had no libido. For years I kept wondering, “When am I going to feel like myself again?”
Then one day I was out for a walk and I listened to a Mel Robbins podcast with one of the leading doctors in the menopause space, Dr. Mary Claire Haver. I almost turned the podcast off because as a 41-year-old at the time, I thought I was too young for this. But for some reason I kept listening . . . and I was so happy I did.
I realized that my “postpartum” symptoms were most likely NOT postpartum, but perimenopause. There are a lot of common symptoms between the two. I most likely transitioned from one hormonal roller coaster to another, which explains why I never went back to “feeling like myself” again. I felt so seen and from then on, I made it my mission to help educate women so they didn’t go through the confusion I did.
October is Menopause Awareness Month with World Menopause Day falling on October 18. Over the past year or so, menopause is having a (much needed!) moment due to popular doctors using social media to raise awareness. And I am here for it. However, with so much information out there it is important to know to advocate for yourself during perimenopause.
Menopause Information Overload
I think it is so amazing that there is so much information out there on menopause now, from social media to an Oprah special to stars like Halle Berry and Naomi Watts spreading the word. Menopause awareness is getting the moment she deserves.
But so many women I talk to are overwhelmed. There is SO much information out there now that it’s hard to decipher what to do. It can cause women to have analysis paralysis and not even know where to start.
Additionally, just because menopause is having a moment doesn’t mean that the health care system has caught up. Only 20% of OBGYNs say they feel comfortable treating menopause which makes it hard for women to get the care they need. Oftentimes women leave their doctors being misled or turned away from treatment they deserve and continue to suffer. I am here to tell you: if you were born with a uterus, menopause is inevitable–but suffering is not!
Where to Start If You Are Seeking Medical Treatment for Perimenopause
The first thing you can do is start tracking your symptoms. Most people think that perimenopause is just hot flashes, but that indeed is not true. Because you have estrogen receptors in every part of your body, the range of symptoms you may experience can be vast. From mood swings, weight gain, fatigue, itchy ears (yes that’s really a thing!) to painful sex, urinary incontinence, UTIs, and heart palpitations, you can experience symptoms virtually anywhere throughout your body.
In order to have an educated conversation with your doctor, the first thing I recommend as a certified perimenopause health coach is to track your symptoms. And, bring your tracker with you when you go to a doctor. This will help facilitate a conversation of what you are experiencing. According to the Mayo Clinic, a perimenopause diagnosis relies on your age, your menstrual history, and your symptoms (versus taking specific tests to diagnose). Therefore, you want to be able to keep track of the symptoms you are experiencing.
Tracking doesn’t have to be complicated. You can put a note in your phone and document the symptoms you are experiencing daily or use a tracker. You want to establish a history. Tracking for a month or two before you see your doctor will establish a decent baseline.
Know Your Treatment Options (and the Myths Associated With Them)
In 2002 the Women’s Health Initiative made a statement that Hormone Replacement Therapy (HRT) increases your risk for breast cancer. And this indeed is true. However, they didn’t report that the increase was only six cases per 10,000 people. Because of the study, many women were taken off their HRT, and many doctors stopped prescribing it altogether.
Quietly these findings have been walked back, however it hasn’t been shouted from the rooftops like the initial findings were. Because of this, there are many doctors that still will not prescribe HRT today. And because of that, many women are still denied HRT to this day.
If you are looking to get on HRT, here are some things you can do to advocate for yourself at your doctor’s appointment:
- Find a menopause specialized doctor using the Menopause Society’s provider finder (or ask a friend who they use and love!).
- When making your appointment ask for the doctor’s stance on HRT and if they prescribe it. If they tell you no, it saves you the time from going there and asking and allows you to find a new doctor.
- Bring a copy of the latest HRT guidelines from the Menopause Society. These guidelines specifically state: “The benefits of hormone therapy outweigh the risks for most healthy symptomatic women who are aged younger than 60 years and within 10 years of menopause onset.”
Other Things to Consider When Working With a Doctor
There are a few other things to consider as you prepare for your doctor’s appointment. Most doctors these days have limited time with their patients. If you know you will only see your doctor for seven to ten minutes, you want to maximize the time that you have.
Before you go, be sure to:
- Have your symptom tracker filled out, and bring it with you.
- Take the lead on the conversation with the doctor. Tell them why you are there and what you are seeking whether it be advice, HRT, etc. Don’t wait for them to ask you all the questions.
- Don’t settle for a no. There are very few contraindicators that should prevent you from getting HRT.
- If you still feel dismissed or not heard, you are allowed to change doctors and get the care you deserve.
Remember, while some of the perimenopause symptoms are not fun, you have options to not have to suffer. These decades can be some of the best of your life if you know how to advocate for yourself during perimenopause!
