How To Talk To Your Doctor About Perimenopause
Get answers about HRT, contraception, symptoms and more
Hello, everyone,
This month I have been immersed in co-teaching my first semester-long college course in Women’s Brain Health. I am happy to report that the semester is off to a great start as we delve into important topics in women’s health. Last week my lecture focused on the similarities between three women's life stages—puberty, pregnancy, and perimenopause. The latest cutting-edge research supports that these are not only reproductive phases, they are actually neuroendocrine transition stages that induce structural changes in the brain.
Believe me, the best feedback I’ve received from students was in the form of all the “head exploding” emojis dropped in the zoom chat.
So for today’s newsletter, I thought it would be a good time to update my recommendations on how to talk to your doctor about perimenopause, menopause, and hormone therapy. It’s no secret that menopause often goes untreated and many doctors have largely given up offering and prescribing hormones to women. It all goes back to one study that looked at the safety of taking HRT—the Women’s Health Initiative (WHI)—that was halted in 2002. Widespread misinterpretation of data and bungled communication scared an entire generation of women (and their physicians) away from taking HRT. Sadly, because we now know that HRT is very safe for most women and the only truly effective treatment we have for menopausal symptoms like hot flashes, brain fog, and vaginal discomfort.
Not only that, the most comprehensive study to date found that initiating HRT within 10 years of menopause reduces dementia risk by as much as 32%.
If you want to understand what’s going on with your hormones or have questions about HRT, I’ll give you the same “back of the napkin” advice I give my girlfriends—the practical tips you need to know to find the best care before, during, and after perimenopause.
Why do I care so much about women at this stage of life? Read the backstory of how I became interested in perimenopause, practiced menopausal medicine, held menopause workshops for women (starting in1995), and how this informed my current expertise in protecting the brain from cognitive decline: Me and perimenopause, we go way back.
Today, we are delving into what you might want to know about perimenopause as you enter this new phase. Then, next time, we’ll go into:
Prepping for the visit: know before you go
Know the terminology
Find the right health care provider (HCP)
A checklist to take stock of your health
List your symptoms—be specific
Ask the right questions
Red flags: when to find another doctor or healthcare provider
After the visit: next steps
4 Things To Know About Perimenopause
