Hot flushes. Vaginal dryness. Moodiness. Brain fog. Night sweats. Now that you’ve consulted Dr Google, you’re ready to get real answers to your questions about these common menopause symptoms. But let’s face it: Having a one-way consultation with an online health site is a whole lot easier than talking about unpleasant, often embarrassing, symptoms with an actual health care provider.
Menopause, which occurs when a woman has had 12 straight months without a period, is looked upon as a taboo subject, says Dr Mary Jane Minkin, an expert in gynaecology and reproductive sciences. “We live in a puritanical society and menopause involves things that have to do with female sexuality,” she explains. “Another issue is we tend to go through menopause as we get older, so it’s a sign you’re getting older, and we’re a society that worships youth. It’s a loaded discussion.”
Making matters worse, research suggests doctors don’t always have a full understanding of menopause and the hormonal upheaval that happens to women when they quit having their period, which usually happens at age 51, on average. According to a seminal study published in the journal Menopause, only 20 percent of medical residents who responded to a survey said their program in obstetrics and gynaecology included a formal menopause curriculum.
But that doesn’t mean you should be left to navigate the menopause experience—or, for that matter, the perimenopausal years that precede it—on your own. Here are five ways to make sure you get the information you need from your healthcare provider.
1. Pick the right doctor.
You may have a long, healthy relationship with your gynaecologist and an even longer one with your GP. But if neither is up to speed on all things menopause—meaning not just the best treatments, but also the other conditions that can kick in when you go through menopause—then ask for a referral to a specialist.
“Start with your GP and say, ‘I understand that going through menopause puts me at greater risk for cardiovascular disease and osteoporosis. Can you tell me how to protect myself?’” suggests Dr Minkin. “If you get a good solid answer, fabulous. If not, ask if there’s a menopause specialist they could recommend.”
2. Arrive for your doctor’s appointment prepared.
The average doctor’s visit lasts 18 minutes, according to a recent study published in Medical Care. To make the most of a one-on-one with your doctor, bring a list of medications, notes on your symptoms, and an understanding of your medical history and your family’s. Especially important to know: How old the women in your family were when they went through menopause. “Let’s say you’re 41, but you’re having hot flushes and irregular periods”—classic signs of menopause, says Dr Minkin. “But your mum, sisters, and aunts went through menopause at 55. Your doctor may want to look for other causes. It may not be menopause that’s giving you funky periods.”
Family history is very relevant, particularly bone health and cardiovascular history, adds Dr Minkin. That’s because your risk for things like osteoporosis and heart attack goes up after menopause. “Did your mum fracture her hip at age 60? Did she have a heart attack at 60? That’s helpful for your doctor to know,” says Dr Minkin.
3. Bring a list of questions.
It’s easy to forget everything on your to-discuss list once you’re in the exam room, so be sure to write them down in advance, and in order of importance. “Write down everything you’re experiencing, whether you think it’s related to menopause or not,” says registered nurse. “So often we think menopause is hot flushes and only hot flushes, but it can also be sleep disturbances, weight gain, vaginal dryness. We might be like, ‘I’m having trouble sleeping, but that can’t possibly be menopause,’ but it definitely can be. ”
4. Be open and honest with your doctor.
Whatever you have to say about your health habits, know this: Doctors have heard it before. No matter what “it” is. Say, for instance, you’re a smoker. Here’s why you shouldn’t keep it a secret from your care provider: Although fertility falls during perimenopause, you still need to use birth control because you aren’t fully protected from an unplanned pregnancy until you’ve reached menopause. For women who don’t smoke, a doctor might recommend low-dose birth control pills, which can also help reduce hot flushes, maintain bone health, and improve the acne that can flare up around menopause. “But if I have someone who is 45 and in otherwise good health, but she smokes, she can’t take a low-dose birth control pill,” says Dr Minkin. The combination raises your risk for stroke and heart attack.
For smokers or any women who would prefer a hormone-free option, your GP might recommend a hormone-free, non-prescription option that can help with symptoms. “For example, one thing that’s been shown to work is soy,” whether it’s found in supplements or in foods such as tofu, edamame, and soy milk, says Dehn, citing a recent study published in the journal Menopause. The research found that a plant-based diet rich in soy reduces moderate to severe hot flushes by 84 percent, from nearly five per day to fewer than one per day.
5. Ask how you can relieve symptoms.
During perimenopause and menopause, the ovaries make less and less oestrogen, leading to a variety of symptoms and changes in your body, including hot flashes, mood swings, and sleep disturbances. You may also experience vaginal changes, including dryness, irritation, soreness, and itching.
“Vaginal irritation has to be addressed for a whole bunch of reasons,” says Dr Minkin. “Since bothersome vaginal symptoms often goes along with bladder issues, menopausal women are at an increased risk of urinary tract infections (UTI). One of the most common causes of death among older women is urosepsis,” or sepsis caused by a UTI. Ask your doctor about vaginal oestrogen tablets, creams, or capsules, as well as hormone-free options, including supplements.
One thing to note: Since no two women experience menopause exactly alike, be specific with your healthcare provider about the symptoms you’re looking to target. And be sure to ask about the science behind any therapy, whether it’s available by prescription or over-the-counter. “Ask your provider: ‘What’s the data? Does the data support the claim?’ ” suggests Dehn. “Go for something that has actual evidence and not magical thinking.”
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