Getting the best outcome from your Menopause Health Appointment

1 Introduction 

So, you think you’re perimenopausal and are experiencing multiple symptoms? You think you may want HRT but are confused by the options, and the media storm around Menopause. And the thought of the doctor’s appointment fills you with dread. 

Your  appointment (with a menopause specialist, your doctor, or nurse) is a pivotal moment in your journey towards managing menopause effectively.

This article aims to provide you with insights on how to make the most of your GP menopause appointment, so you get the best outcome for YOU.

2 Why it’s ok to be apprehensive

First and foremost, it’s perfectly normal to feel anxious about discussing menopause with your healthcare professional.

And there are many common concerns: 

• Will I be listened to?

• It’s embarrassing talking about vaginal atrophy or low libido

• I’m an emotional wreck so I’m just going to blubber for the whole appointment

• My friend’s appointment was a disaster, so why should I bother?

My clients report very different experiences of the ‘meno-consult’:

• Amazing! I felt totally listened to, and supported.  He couldn’t be more helpful.

• No clue… I was patronised for less than 10 mins, didn’t listen to my views, and was offered antidepressants.

• It took a while, but persistence paid off – 6 months on and I think we’re sorted.

• My HRT isn’t working but my doc won’t listen to my point of view.  

• There’s no menopause specialist at my surgery.

So, it’s a bit of a mixed bag, and it’s natural to feel apprehensive. Remember that you are in charge, your feelings are valid, & with some simple homework & planning you can approach your appointment prepared, & confident that you’ll receive the best possible outcome.

3 What to expect

During your menopause appointment, expect a comprehensive discussion based on the national  guidelines. 

This should  include:

• an explanation of the stages of menopause
• common symptoms and diagnosis
• lifestyle changes/interventions that could help general health & wellbeing
• benefits & risks of treatments for menopausal symptoms
• long-term health implications of menopause

You should then have an in-depth discussion about your own symptoms, lifestyle and medical history. 

Be prepared to discuss changes you’ve noticed in your body, emotions, sleep patterns, and overall well-being. Your doctor may ask about your menstrual history, family history of menopause, and any existing health conditions.

Diagnosis is highly likely to be made via symptoms.  Your blood pressure should be tested, but only in certain circumstances will a blood test be given – usually to check for other underlying conditions such an underactive thyroid, or cholesterol levels. 

After diagnosis your doctor will be able to give you the various options that are available to you.

This collaborative approach will help tailor your treatment plan to your specific needs.

4 Be Prepared!

You have a right to be informed about and involved in the decision regarding your treatment.

Effective communication is key. Express your preferences and concerns openly. Discuss your desired outcomes, such as symptom relief, hormone replacement therapy (HRT), or alternative treatments. 

• Do your research 
• Keep a record of your symptoms – ideally for a month before your appointment. 
• Plan what you’re going to say in advance – your symptoms, what you want to happen, treatment you don’t want
• Ask for a double appointment if you have lots of questions that need discussion
• Bring a friend or family member along if you’re particularly anxious
• Know your rights
• Be prepared to challenge   

5 Your Treatment Options

Your doctor will discuss various treatment options tailored to your needs. 

In most cases HRT will be an option that your doctor will encourage. There are many benefits of HRT for most women but it’s not for everyone.  There are other options available such as lifestyle changes, non-hormonal medications, or even anti-depressants.

Each option comes with its benefits and potential risks, so have an open conversation with your doctor to find the best fit for you.  And there is no one size fits all solution… don’t be swayed by what peers or media influencers are advocating…you know you!

HRT Prescriptions:

There are multiple options your doctor may discuss:

Combined HRT: contains oestrogen and progestogen. This can be sequential or continuous. 

Oestrogen-only HRT: usually prescribed to women who have had a hysterectomy.

HRT can come in the form of tablets, patches, gels and sprays…and in varied combinations.  

You may also here about synthetic v bio v body identical (body-identical is the most modern and safest form)

In addition, progesterone can be administered via the Mirena coil, which has the added benefit of contraception.

Non-HRT Options:

If HRT isn’t right for you, there are other alternatives that your doctor can prescribe for certain symptoms (such as clonidine for hot flashes). Most of these aren’t intended for treating menopause symptoms, but there is evidence to support their use for specific symptoms

Other treatments such as CBT, yoga and mindfulness may be discussed and advised.

Your doctor should discuss lifestyle changes such as  diet &  exercise (including smoking and alcohol advice) to help improve your symptoms and outlook. 

Remember that every woman is different, and the more aware you are of your own symptoms and the options available, the better your outcome

6 What to do if you don’t get the consultation or treatment you want.

In some cases, your doctor may hesitate to prescribe HRT due to your medical history or specific health conditions. Some doctors are still reluctant to prescribe due to outdated guidelines and research.  

Some doctors advocate anti-depressants as a treatment – you don’t have to accept this if you’re not comfortable with this.

If you disagree with the decision, ask for a clear explanation. You could ask to speak to another healthcare professional at your surgery, or ask to be referred to a specialist or menopause clinic. Alternatively, you could refer yourself to a specialist menopause clinic. 

Remember your rights as a patient. Your doctor will be more likely to consider your views if you are fully informed and understand any risks, and clearly explain the benefits to your health you believe that treatment would bring to your life and health.

7 Next Steps

After your appointment, you’ll probably have a treatment plan in place. 

It can take time to get your exact treatment right for you so be patient.  However, remember that menopause is a moving feast, and your needs may evolve over time. 

Your initial prescription may not work for you (give it time though).

Regular follow-up appointments will help monitor your progress, adjust your treatment if necessary, & ensure your well-being.

Most  guidelines recommend a follow up appointment 3 months after initial prescription but if you feel something isn’t right, or you have side effects you can ask for an earlier review.

8 Conclusion

Remember that you deserve the best possible care, and seeking support is a positive step towards reclaiming control of your well-being.

Embrace your right to be an active participant in your meno-health – know your stuff, voice your concerns, and work with your GP to create a personalised plan that empowers you to navigate menopause confidently. 

#menopositivity

Love Caryn 💞