Don’t go to your doctor for menopause without first reading this!
Welcome to our comprehensive guide on preparing for your first menopause appointment. This blog post is inspired by one of the most common questions we receive and my experience coaching many women through this important phase of life. Being well-prepared and informed can make a significant difference in managing menopause effectively.
My Personal Experience
When I decided to look into hormone therapy I was asymptomatic. I was hearing more and more about the benefits of hormone therapy, but without really understanding it. In the beginning I was unaware, unsure, and scared. So, I stared talking to my friends, my biohacking besties, listened to podcasts, and started learning everything I could about menopause. After coaching more women on how to start their research into the topic, I became more aware at how clueless most of us are about where to start. This experience highlighted the importance of preparation and knowledge.
Are You in Peri-menopause?
You may first want to ask yourself if it’s time to make that first appointment with a menopause specialist. So, you ask yourself, “Am I in peri-menopause? Understanding perimenopause is crucial. Perimenopause is the transitional phase before menopause, characterized by various symptoms like irregular periods, hot flashes, and mood swings. To determine if you are in peri-menopause, consider your health history and current symptoms.
Ask yourself:
– What symptoms am I experiencing?
– How severe and frequent are these symptoms?
– What are my health priorities and concerns?
For more detailed information on peri-menopause symptoms, visit our freebies, blog articles, join our membership program Biohacking Menopause or take the menopause quiz here.
How to Find a Menopause Doctor
If you passed the criteria and think it may be a time to find. a menopause trained doctor, then it’s time to start searching. Finding a doctor you trust is essential. Look for someone who listens to you, asks the right questions, is confident and provides the information you need.
Here are some resources to help you find a menopause specialist:
– Ask friends for recommendations.
– Google “menopause specialist” in your area.
– Ask a compounding pharmacist Another avenue you can take is to call your local compounding pharmacy. Ask the pharmacist who they would recommend for bioidentical hormone therapy for menopause. Compounding pharmacists work in a laboratory that makes bioidentical hormones as directed by a doctor. Some doctors prefer to tailor make a formula for a patient based on their patients individual needs (sensitivities, absorption and other issues). These pharmacists have a unique view into what a pracitioner is doing and may know which practitioners have the best knowledge about hormone therapy. Check websites like Women’s International Pharmacy or PCCARX
– Find the doctors recommended by my community in the blog article “Find a Menopause Doctor”.
For more personalized recommendations, ask our free Facebook community Biohacking Menopause or post your request in one of the many menopause Facebook groups.
Questions to Ask Your Doctor
Confidence in your doctor is crucial. Here are some questions to ask during your appointment:
– Where were you trained in menopause medicine, and how long have you been treating women in this phase of life? You may want to research the answer to this question in a Google search or call the clinic ahead of time.
– Do you treat just the symptoms or consider dosages for my future health?
– What are the risks vs. benefits of hormone therapy or other treatments?
– How do my personal and family medical histories affect my suitability for HRT?
– What are the risks if I do not take hormone therapy?
Consider the risks of no treatment, as highlighted by Dr. Daved Rosensweet, the author of Happy Healthy Hormones, including loss of energy, poor sleep, mood changes, low libido, and increased risk of osteoporosis, metabolic disorders, and cognitive decline.
Treatment Options and Questions
Explore various treatment options such as transdermal (cream, gel, oils, patch), oral, pellets/implants, injectables, drugs, lifestyle changes, and more.
Ask your doctor:
– What are the risks and benefits of each option?
– How do costs vary between different types and methods of HRT, and are they covered by insurance?
– How long will I need HRT?
– How does HRT affect other health conditions I have, such as thyroid issues, obesity, or diabetes?
– Are there any recent research developments or new treatments I should know about?
– How, when and where do I apply my hormones?
Monitoring and Follow-up
Ask your doctor:
– How will we monitor if HRT is working?
– What should I do if I need help with self-titrating and have more questions?
– How often do I need follow-up appointments?
– What testing should I be doing, such as DUTCH, serum, testosterone, bone density, and cardiovascular markers?
Questions Your Doctor Should Ask You
A thorough doctor will give you. a comprehensive questionnaire that you fill out before you have your first appointment.
This questionnaire should include:
– Family history of disease
– A possibility to send in any recent labs, images, and reports
– Period history, birth control history, and pregnancy and miscairrage details
– Daily life impact of symptoms
– Current medications or supplements
Awareness of various symptoms related to hormone deficiencies or excesses. The questionnaire ideally will have a tick list of possible symptoms. This is impornat as you may not even be aware of certain symptoms being related to menopause. This list should include the following:
- Night sweats
- Hot flashes
- Kicking off covers at night
- Periods – infrequent, too frequent, gone (for how long), painful, heavy, lighter, PMS
- Back or joint pain
- Vaginal dryness – pain during sex, leakage, bladder issues/infections, frequently waking to pee
- Libido – diminished sexuality or sensuality, no intimacy, or overdrive
- Sleep – Racing mind at night, frequent awakenings, trouble falling asleep or staying asleep
- Bloating
- Hair loss
- Depression, moodiness, anxiety, nervousness, anger, sadness, weepy, impatient or snappy with a clear mind, indecisiveness
- Weight gain, diminished love of your body or body image
- Cognitive function – brain fog, forgetfulness, attention deficit disorder
- Headaches and migraines
- Heart palpitations, chest pain
- Breast or nipple tenderness or pain, breast swelling, dense breasts
- Fibrocystic breasts
- Nausea
- Fantom smells
- Pelvic cramps,
- Endometriosis, fibroids
- Fatigued, stamina
- Muscle cramps, muscle loss, flabbiness, weakness, difficulty standing from a squat or off the floor, low coordination or balance
- Less motivation, less aggressiveness, less sense of security
- Less armpit, body or pubic hair
What to Avoid
There are some things you want to try to avoid if possible and challenge your doctor on if they mention any of the following:
- Synthetic hormones (e.g., Premarin, Prempro)
- Pellets – Initially you want to avoid these and maybe consider them once you figured out your optimal dosage. I am generally not a fan of pellets, ever.
- Oral or sublingual estrogen. Consider the benefits of transdermal therapy, which bypasses liver metabolism and results in more stable serum estradiol levels. Oral estrogen may increase our risk of heart attacks and stroke.
- Estrogen only prescriptions. Always include progesterone when taking estrogen. Even if you don’t have a uterus. The main function of progesterone is to prepare the endometrium (lining of your uterus) for a fertilized egg to implant and grow. If a pregnancy doesn’t occur, the endometrium sheds during your menstrual period. If conception occurs, progesterone increases to support the pregnancy. When we don’t take progesterone on board when we are on estrogen, we risk this uterine lining building up and creating a breeding ground for uterine cancer. That being said, even if. you had a hysterectomy, there are still amazing benefits to progesterone, such as improved sleep, mood, lighter periods, and protection of the bone, brain, and heart.
- Too much, too fast, too soon – especially for sensitive types and those women who hae not had hormones for many years.
- Estrogen and progesterone first. I personally like to see the improvements on just estrogen and progesterone beore adding testosterone or DHEA.
- A doctor who is not confident. If your doctor isn’t 100% confident, you won’t be either.
Informed Decision-Making
Go prepared and educate yourself. Bring your research and show the doctor you can engage in an informed discussion. Be curious, skeptical, and polite, but firm in your beliefs. Identify any biases the doctor may have and ask for unbiased opinions and a range of choices. Consider seeking second or third opinions if needed.
Closing the Appointment
Ensure clear communication with your doctor between appointments via email or phone. Ask how to self-titrate and report any changes. Discuss possible testing for other issues or diseases and plan follow-up appointments to monitor progress.
Conclusion
Being well-prepared and informed for your first menopause appointment is empowering. This is your body, your health, and your future. Take control by educating yourself on menopause and hormones, finding a qualified doctor, making a list of questions, and knowing what you want and don’t want. Make a shared, informed decision and plan for future appointments and communication.
You got this! If you’re still reading, you’re on the right path. Remember, you are important and worthy of feeling your best through this transition. For more resources, visit hackmyage.com.
Remember, menopause is inevitable, aging is inevitable, but suffering is optional.
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