After working up a lot of courage, you approach your doctor to discuss menopause. You describe having hot flashes or night sweats, feeling more irritable, gaining weight, and losing hair. But after you tell your doctor that it must be menopause, he or she smiles and chides you about being too young to be menopausal. You leave, feeling confused, angry, and even doubtful. You vow never to bring up the subject again, to find another doctor, or to simply ignore how you feel.
Talking to our doctors about menopause can be a miserable experience. Doctors are busy professionals and medical experts. We have fewer doctors to deal with growing numbers of patients. Doctors and patients feel rushed these days, making it more difficult to talk about medical issues at great length. You cannot avoid talking about menopause forever, nor can you ignore menopause and hope it will just go away if your symptoms are interfering with your life. You may live in an area with a doctor shortage making switching healthcare professionals impossible. Is there any hope?
Your doctor will usually think of menopause in terms of measurements; when you stopped having periods, your age, and diagnosed hormone levels. In other words, you doctor has been trained to think of menopause in clinical terms. On the other hand, you report symptoms like hot flashes, insomnia, and mood swings which are harder to ‘prove’ biologically. Can you and your doctor meet in the middle?
1.Your doctor says: 'You are too young for menopause! We’ll talk later.'
You want to: Scream! Your doctor just dismissed your concerns.
The problem is not whether or not one of you is right, but rather how to open up the lines of communication. You have real issues that should be addressed and nobody knows your body better than you do. Try saying something like, 'I understand that I may not fit the biological textbook definition of menopause but I am concerned about changes in my body. Can we review my symptoms as they apply in my case and not women in general?'
2.Your doctor says: 'Hot flashes/insomnia/irritability (insert other symptom here)? You must be mistaken!'
You want to: Rant and rave to prove your point or run out of the office feeling ashamed.
It is difficult to explain symptoms to someone else and you feel as though you have to fight to prove that you are not making it up. Try keeping a log of your symptoms to bring to your next doctor visit, and note as much as you can during each episode. The more specific the details, the better chance you have of being heard.
For example, note how long your night sweats last, exactly how you feel, and why these feel very different from anything you have ever experienced. ‘I know the difference between being hot and uncomfortable because my bedroom is hot or there are too many blankets on the bed. I am concerned because these night sweats come on suddenly, they last for 15 minutes, my sheets are drenched, and my hair is soaked. I keep the room cool and do not sleep with more than one blanket.’
3.Your doctor says: ‘Your memory or your body aren’t what they used to be. It’s no big deal and it’s not menopause.’
You want to: Make your doctor understand that you have real fears beyond just getting older.
Changes to our bodies and our minds are going to happen. But that does not mean that we cannot learn more about how these changes can affect us. You are looking for reassurance that you are not losing your mind or that you are doomed to keep those extra pounds. Try telling your doctor that instead of just letting menopause happen to you, even if you are not quite there yet, you want to learn more now to be able to deal with various health issues down the road.
4.Your doctor says: ‘You can still have kids/you are not at risk for disease so why worry?’
You want to: Force your doctor to understand that changes are happening before you can adjust to them.
You may be having a tough time with the end of your reproductive years, or wondering about coming off birth control. You also have questions about increased risks for cancer or heart disease and what role if any does menopause play. Try explaining your desire to be proactive: ‘I need time to adjust to what my body is going through and will go through. I want real suggestions to help me deal with how I am feeling and how we can work together to improve my overall health.’
Whether you stick with your current healthcare provider or are shopping around for a new doctor, it is vital that you work together as a team. Things may not always go as smoothly as we would like, and you may have to take a calm but firm approach when you and your doctor clash about menopause. Knowing how you doctor diagnoses menopause explains his or her attitudes. Take control of menopause and your life to work with and not against your healthcare provider.
Menopause, Your Doctor, and You