Preparing for Your Perimenopause or Menopause Evaluation: What to Expect and How to Get the Most Out of Your Appointment
If you are a woman in your late 30’s or 40’s and have been feeling a bit “off” lately - there is a high chance you are wondering whether perimenopause may be responsible for your symptoms. Maybe there are changes in your periods, or suddenly you are feeling very warm, or your mood seems to be on an unpredictable roller coaster. Seeking a comprehensive evaluation with a physician that specializes in perimenopause and menopause can provide valuable insights and support, but can be an intimidating step to take. As a doctor who sees patients experiencing this important life transition, I want to provide some of my tips to help you get the most out of your perimenopause appointment.
Understanding Perimenopause and Menopause
Before your appointment, it’s helpful to understand what perimenopause is and what symptoms to look for. Perimenopause typically begins in the late 30’s or 40’s, but can start earlier or later. It is marked by erratically fluctuating hormone levels, primarily estrogen and progesterone, which can lead to a variety of symptoms and changes in the body. Menopause is the point in time that a woman has not had a menstrual period for 12 months, and the transitional phase before this is called perimenopause. Some common symptoms during this time are:
Changes in your periods: This includes frequency, flow, or duration
Hot flashes: Sudden waves of heat, often accompanied by sweating
Night sweats: Hot flashes that occur at night, and can disrupt sleep
Mood Swings: A change in irritability, anxiety, or depressive symptoms
Sleep disturbances: Difficulty falling asleep or staying asleep
Vaginal Symptoms: This includes dryness, itching, and/or pain during intercourse
Changes in libido: Reduced sexual desire and satisfaction
Cognitive changes: Difficulty focusing or concentrating - also referred to as “brain fog”
Remember that this is not an exhaustive list, and everyone experiences perimenopause a little differently. Make note of anything that doesn’t feel right to you.
Preparing for your Perimenopause/Menopause Appointment:
Track your Symptoms
Use a simple calendar or planner to record your symptoms - including mood, sleep issues, and sexual health. Make sure to note how long the symptoms last, how often they occur, and their severity
Keep track of your menstrual cycle, including length of periods, time between them, and heaviness of flow
Compile Your Medical History
Gather information about your past medical conditions and surgeries. Also bring information about preventative health screenings you have completed (mammograms, pap smears, colonoscopies, etc).
Bring a detailed list of all medications, supplements, and over the counter products being used.
Make a note of any family medical history - this includes information about menopause in close relatives (age, symptoms, etc), osteoporosis, cancers, and cardiovascular disease.
Be prepared to discuss stress levels, diet, exercise, sleep patterns, and any sexual health concerns that can affect your overall well-being and perimenopausal symptoms
Find a clinician you can trust and be honest with - this is so important for implementing effective change.
Prepare a List of Questions for Your Doctor - Remember no question is too silly or too embarrassing to ask. Some examples include:
Are these symptoms normal for perimenopause, and are there other medical conditions that could be causing them?
What are my treatment options and what are the associated risks?
Are there any over the counter supplements I can take to help my symptoms?
What can I expect with hormone therapy, if I decide to use it?
What to Expect During Your Appointment
An in-depth discussion of your medical history, symptoms, and specific health goals.
Your physician will ask specific questions related to menopause symptoms, and also need to rule out other contributing medical conditions.
A comprehensive physical examination, including a pelvic exam.
The pelvic exam will likely be different from the exam you receive during your annual well woman visit. The physician will assess the external genitalia, internal vaginal and cervical changes, vaginal pH, and pelvic floor muscle tone.
Indicated Blood Tests and Imaging
This may include checking your hormone levels, and also tests to rule out other medical conditions that may be contributing to your health concerns.
Your physician may also need to order imaging studies to complete the assessment.
Once your doctor has all the necessary information, they will work with you to develop a personalized treatment plan, with options that may include:
Lifestyle modifications - specific advice regarding diet, stress management, sleep hygiene, and exercise
Hormone replacement therapy - To improve symptoms that are related to menopause. This will include a detailed discussion of expected benefits and any relevant associated risks.
Non-hormone medication recommendations - to manage any non-hormonal medical conditions identified during the evaluation, and also to inform you of non-hormonal menopause treatments
A discussion on efficacy and safety of any over the counter supplements, herbal remedies and alternative therapies such as acupuncture
A plan based on shared decision-making between you and your doctor, that is tailored to your goals, your comfort, and your lifestyle.
Some Final Thoughts
Remember, the experience of perimenopause is different for each woman, and the research on this transition is evolving every day. Finding the right treatment plan for you may take time and require adjustments. It’s important to be patient in finding the best balance of medications and lifestyle adjustments to manage your symptoms, and recognize that the plan may change as your body changes over the course of perimenopause to postmenopause. Have a close relationship with your doctor - the more they get to know you, the better they can help you. It really and truly is an exciting time for advancements in women’s health, and I would encourage any woman who is concerned about menopause to talk to their physician sooner rather than later!
If you currently do not have a doctor that is experienced in menopause care, we are accepting new patients. We are passionate about integrating the latest advancements in medical therapies with proven, evidence-based lifestyle improvements to meet our patients where they are at, and to help them live the best life they can. Visit our website to schedule a Meet and Greet, and to learn more about how we can help you in your journey through menopause. We look forward to working with you soon!
