There’s a lot of changes happening in your body during perimenopause. You may suddenly be dealing with heavier-than-usual periods, mood changes, and trouble sleeping, and it can be a lot to navigate at once.
Bringing your symptoms up with your doctor is important to make sure you’re on the same page, and that you’re given all the information you need about treatment options. But menopause experts say that it’s important to prioritize what you want to discuss before your visit.
During the “Healthy Hormones: Heart, Mind & Soul” panel at the SHE Media Co-Lab at South by Southwest, experts shared their advice on getting the most out of these visits to make sure you come out of them as well-informed as possible. Here’s what they revealed.
Make a special appointment to discuss your concerns.
The best time to talk to your doctor about your perimenopausal concerns should not be during your annual wellness check. “If you are seeing a physician and using your insurance, which the majority of people are, of course, don’t loop in the menopause discussion with your annual exam,” says Flow Space Advisor Heidi Snyder Flagg, MD, menopause specialist and founder of Spring Ob/Gyn. “We are screening you for all sorts of things in that 15 to 20 minute visit.”
Instead, Flagg recommends making a separate appointment, follow-up visit, or “problem visit” to carve out that time to speak with your doctor. “Give it enough time,” she says. If you’re interested in hormone therapy or similar treatments, she recommends being aware that risk factors like having had breast cancer, a history of a stroke, or liver disease need to be taken into account first. “Obviously, your physician has to screen you for those,” she says. “So, if any of those are in place, we have to go down a different path and discuss other options.”
Your doctor may recommend some lifestyle changes.
In addition to hormone therapy, Flagg says she focuses on lifestyle medicine with patients going through menopause.
“You really can affect a lot of change,” she says. “I try to get the woman’s context in terms of what’s distressing her. The most often it’s sleep, or weight gain.” Flagg says she will “just start chipping away” with patients. “It’s sleep hygiene, it’s substance use, it’s social connections, it’s exercise, nutrition,” she says.
“We focus on those six and pick one or two to really focus on and you can really affect a lot of change and get yourself feeling better,” she says. That can include doing things like cutting down on alcohol (which can impact your sleep), spending less time on your phone, stopping caffeine after noon, and restricting your fluids in the evening if you’ve been getting up to pee in the middle of the night.
Try to focus on one thing at a time.
Flow Space Advisor Piraye Yurttas Beim, PhD, founder and CEO of Celmatix, says it’s important to really focus on what’s bothering you — and do your best to tackle that. This could mean focusing your appointment with your doctor around this to make sure you’re getting all the advice you need, and doing what you can afterward to try to tackle your symptoms. “For some women, it’s sleep. For some women, they have achy joints. For some women, they’re gaining weight or gaining weight and places, they don’t want to be gaining weight, they have unwanted hair,” Beim says. “All of these things are a chain reaction biologically.”
Beim says that, “in a perfect world,” you’d follow all the healthy lifestyle recommendations that you can. But she also admits that they can be overwhelming. “If your biggest issue is sleep, then you really learn the sleep hygiene. And you learn how certain things impact your sleep, and you build from there,” she says. “It can be very overwhelming to 100 percent focus on one or two at a time.”
Ultimately, it’s important to have an in-depth conversation with your doctor about what’s happening in your life and what matters to you. They should be able to make personalized recommendations from there.