Getting help in perimenopause

Not everyone will need help in the menopause transition - it's a normal event in our reproductive lives! But if you're feeling like it's time for some support, I want you to get the most out of your healthcare visit. And here are the things I think will help when you check in with your primary care provider or pelvic health provider :

• Don't expect to handle menopause concerns at your annual visit: from your provider's perspective, the annual visit is to make sure you don't die of preventable diseases. They need to figure out what screenings you need and make sure you get them. So there's no time left to deal with a problem. If you're one of the lucky ones whose provider is a superhero who goes above and beyond, you could try slipping in the phrase "I'm going to make a visit to come back and talk about some vaginal dryness and hot flashes I've been noticing" which gives the provider a chance to address it now if they have time.

• Schedule your screenings. If you're hoping for a hormone therapy prescription, know that your provider probably has standards for what it means to use hormone therapy safely. Common expectations include making sure you're up to date on routine screenings like blood pressure, mammograms, cholesterol tests and any other screening recommended for you. If life has been busy and you've gotten behind on these things, get them scheduled. Even better, make sure your provider has access to the results so you can get more done at your visit.

• Try to distill your concerns down to one or two main problems. For those of you who are really feeling the effects of perimenopause, you're probably tempted to list the dozens of changes that are bothering you. I don't recommend this. It tends to overwhelm less experienced providers and also make them more likely to think your problem is depression. Keeping the focus on 1or 2 of your most disruptive problems like night sweats, sleep problems, mood problems or joint pain. This allows you and your provider to target the most disruptive problems first.

• Give a little hormone context. If your problem started right when your periods became irregular, let your provider know "this all started when my periods became irregular" so they can make the connection with your hormonal state.

• Even if you're hoping for a particular solution, give the provider a chance to bring it up first. Your provider was trained to listen to the information, determine what the problem is, and then choose a solution for the problem. When you offer a solution before the provider understands the problem, it can feel unsafe to them and may trigger resistance. They need to do their job and giving them a minute to do that is probably in your best interest.

• If you don't like your provider's solution, ask about your ideal solution. If your provider suggests antidepressants or supplements for you when you were hoping for hormone therapy for instance, it's ok to say "I'm not comfortable trying that medication" or "I'd prefer to avoid that" and add that you were wondering about hormone therapy (or whatever approach was interesting to you.) Many providers are happy to honor their patient's preferences as long as the preferred approach is safe and effective.

I hope these tips are helpful in getting support when you need it! If starting with your own providers doesn't work out, you might try looking for a Menopause Society Certified Practitioner at menopause.org.