For many of us, perimenopause is unexpected and comes like a bolt out of the blue.
From unpredictable mood swings to disrupted sleep, the symptoms can be confused with other issues such as stress and anxiety, with many women hesitant to bring up their concerns with their doctors.
But perimenopause deserves attention and care, and starting the conversation with your doctor is an important step toward understanding and managing this phase. Whether you;re noticing subtle changes in your body or feeling overwhelmed by symptoms, talking to your doctor can provide clarity, solutions, and, most importantly, validation.
© Josep SuriaTo help prepare for this conversation and ensure your voice is heard, let this guide help you prepare for your visit, so you don't have to navigate perimenopause alone.
Recognizing the signs of perimenopause
Perimenopause often begins in your 40s, but for some women, it can start as early as your late 30s. During this time, hormone levels - particularly estrogen and progesterone - fluctuate, triggering a range of physical and emotional changes. Recognizing these signs is the first step toward understanding what’s happening in your body and seeking the right care.
Common symptoms to look out for include irregular periods and changes in your cycle and bleeding; hot flashes and night sweats; mood swings and irritability; sleep disturbances; fatigue; brain fog; vaginal dryness and changes in libido. Other subtle signs can be thinning hair, brittle nails, dry skin, or even joint aches.
Finding the right care in perimenopause
Taking time to find the right care is an investment for your health and wellbeing and needn't be complicated. "It can be an OB/GYN, Internal Medicine [Doctor] or Family Practice [Doctor]," explains Dr. Robin Noble, who is Let's Talk Menopause's Chief Medical Advisor and has been a practicing gynecologist for over 20 years. "Nurse Practitioners and Certified Nurse Midwives can also be well equipped to manage perimenopause and menopause."
© Ground PictureIf your concerns are dismissed or minimized, don't hesitate to seek a second opinion or ask for a referral to a menopause specialist. "Look for a Menopause Society Certified Practitioner or someone with a demonstrated interest, expertise and experience in this area of medicine," advises Dr Noble.
There are also organizations such as Midi Health and Alloy, who offer online consultations with experts and doctors and are perfect for getting personalized, affordable and convenient healthcare for perimenopause and menopause.
READ: 18 women share their menopause heroes, from skin-soothing oils to hair boosters
Preparing for your appointment
Monitor your perimenopausal symptoms before your appointment, noting down the frequency, intensity, and patterns of your periods and symptoms such as mood swings, sleep issues and hot flashes. Try using devices such as Oura which helps monitor your sleep and your movement plus apps such as Clue for help keeping your period in check. HELLO!'s not-for-profit partner, Let's Talk Menopause also has a great symptom tracker too.
Take note of your family medical history too, especially any history of menopause-related conditions such as osteoporosis and heart disease.
"Just come with an open mind and talk about your symptoms, and then the doctors will start iterating" explains Joanna Strober, CEO of Midi Health a virtual care clinic created by specialists in perimenopause and menopause covered by insurance. "It's that easy. There are things that the doctors can do to help you feel better, and the goal is to iterate until you find something that works for you."
© Monkey Business ImagesAdvocating for yourself
Unfortunately, many women feel unheard during healthcare visits, especially when it comes to perimenopause. But you must be assertive by politely but firmly stating your concerns.
"Don't hesitate to talk to your doctor," advises Tamsen Fadal, journalist, author and producer of The M Factor, the first-of-its-kind documentary film about menopause. "Advocate for yourself and don't brush off symptoms that feel out of the ordinary. We need to normalize conversations around menopause. If women feel they can’t talk about their symptoms, they’re going to suffer in silence.”
READ: I promise you will learn to love your life again after menopause
Some perimenopausal symptoms, such as changes in libido or vaginal dryness, can feel uncomfortable to discuss, but remind yourself that these issues are common and your doctor is there to help, not judge.
And experts also agree it is important to share your lifestyle habits with your doctors too. "This is a time to not only share your lifestyle habits but to double down on your efforts and discover changes in your habits," explains Dr. Somi Javaid, OBGYN and co-founder of women's health practice HerMD.
Dr. Javaid also stresses to share your mental health history as people who have experienced issues with mood and mental health during puberty, pregnancy or postpartum are at increased risks for exacerbations in the menopausal transition too.
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