How to Choose the Best Perimenopause Doctor for You
In years past, I would have simply selected an in-network doctor on the list from my insurance plan. But now that I know fluctuating hormone levels affect nearly every body system, I’m committed to finding a doctor with the right training and temperament to help me feel great in perimenopause, menopause, and beyond.
Does Your Doctor Speak Menopause?
Here’s a sobering reality: the average physician receives very little formal education on menopause during medical school — sometimes only a lecture or two — and there is no specialty that focuses specifically on menopause. These gaps can leave some doctors ill-prepared to address the complex and interconnected changes that come with peri/menopause.
The Menopause Society (formerly the North American Menopause Society, FYI) keeps a list of providers who have sought out extra education and certification in order to better treat women in their patient population. I recommend starting here — if you’re in the US you can search by zip code and whether you prefer in-person or telehealth appointments.
What Kind of Doctor Do You Need?
Of course, in a perfect world, all members of your care team would understand the interconnectedness of the body and have advanced training in hormone health. Barring that, here are some things to consider that can improve your odds of getting the best care.
OBGYNs and Perimenopause and Menopause
Most women start with their OBGYNs when they first suspect their hormones are out of whack. While OBGYNs focus on reproductive health, only 31.3% of OBGYNs report having a dedicated menopause curriculum in residency, according to a recent study published in the scientific journal Menopause. Your OB is a fantastic place to begin, but even if you adore the doctor who delivered your kiddos, it’s worth asking some questions to see if they’ve sought additional education and/or are keeping up with the latest research.
What Should Your Primary Care Physician (PCP) Know About Perimenopause and Menopause
Your PCP is the quarterback of your care team — they manage your overall health. (Some insurance plans won’t even allow you to see specialists without a referral from your PCP.) This doctor will typically manage your annual physicals, screenings, bloodwork, and acute health issues like my tweaked knee or the flu.
In my experience, it’s really hard to find a PCP who a) has additional training in hormone health and b) has the time to listen effectively and help you sort through your symptoms. (To be clear, in most cases it’s not their fault! In a busy practice, most physicians only have 15 minutes or fewer due to insurance reimbursements. That’s not nearly long enough to dive into your health history, understand your medical issues, and explore options for symptom relief. It’s frustrating on both sides of the waiting room door!)
Functional, Integrative, or Lifestyle Medicine Physicians
Doctors who have any of these board certifications typically take a more holistic view of health. They’re trained to consider how interconnected systems and lifestyle factors like nutrition, sleep, and stress affect the entire body. This can make them excellent allies during perimenopause and menopause. Be sure to ask about their training and approach.
Specialists
Depending on your symptoms, you might need to consult additional specialists like an endocrinologist (thyroid, metabolic, and hormone health), dermatologist (skin issues or hair loss), psychiatrist (mental health & mood), neurologist (brain health and headaches), gastroenterologist (gut health), an orthopedist/orthopedic surgeon (frozen shoulder!), or rheumatologist (joint, muscle, and bone health).
A Note of Caution
Many (many!) women end up seeing multiple specialists for disparate perimenopause symptoms only to realize later that they’re all connected. It’s so common. Some specialists can be myopic about the part of the body they treat without considering the bigger picture, many never got adequate training in how menopause affects the body system they treat, and some may not be up-to-date on emerging research on women’s health. It’s worth it to shop around — promise!
How to Find the Right Doctor For You
As I mentioned, I’m in the market for a new primary care doctor. Here are some of the ways I’m rustling up recommendations and creating a list of practices to consider:
Check Credentials
Look for doctors who list menopause or perimenopause as an area of expertise. Doctors with menopause-specific certifications sometimes list the acronyms NCMP or MSCP after their names. (For example: Read my recent interview with Dr. Heather Bartos, MD, NCMP and Phosis advisory board member here.)
Ask for Recommendations and Read Reviews
Be shameless — ask for recs from your book club, your massage therapist, your yoga teacher, and of course your best friends. I consider online reviews less reliable, but I read them anyway with a healthy dose of skepticism. It may seem obvious, but you want someone who can relate to your symptoms, listen without interrupting or gaslighting, and most critically, seem like they genuinely want to help.
Call the Office
Don’t hesitate to ask the office staff if the doctor has a certification or specific experience treating women in menopause if it’s not evident based on their bio or website. If there are multiple doctors in the practice, ask the nurses who they recommend — they always have the inside scoop.
Explore Direct Health Practices
You won’t find these doctors on the “in-network” list on your insurance plan, unfortunately. Direct care models offer a more personalized approach by limiting the number of patients a doctor sees. While these practices may charge a yearly or monthly fee and typically don’t accept insurance, they can provide superbills for you to submit to your insurance for reimbursement. The benefits? Longer appointments and more direct access to your doctor via email or text. If finances allow, this can be a great option for getting to the bottom of complex health issues.
Consider Telehealth Options
If your local options are limited, there are lots of telehealth providers that have popped up recently to fill the (very large) gap. I haven’t tried any of them myself, but please do let me know if you have! My research has surfaced Midi Health, Alloy, and Versalie.
Prepping for Your Appointment
Once you’ve found a doctor, here’s how to get the most out of your visit:
Schedule the Right Kind of Appointment
This is a tip I hear from doctors frequently (particularly those who accept insurance). For example: If you’re seeing an OBGYN, some practices want you to book a “problem” visit rather than a standard annual exam to make sure there’s enough time to address your concerns. (If you’re not sure, call the office and mention that you want to have an in-depth conversation and ask what kind of visit to schedule. I also like to ask what time of day the doctor isn’t as rushed — the first appointment after lunch for example.)
Go in With a List of Talking Points
Think about how you’d run a meeting at work: You typically go in with a bulleted list of topics to cover, prioritized in order of importance. This will ensure you don’t leave anything out (thank you brain fog!) and helps your doctor understand what’s bothering you most. Be sure to explicitly state you believe your symptoms are related to perimenopause or menopause.
Confidently Ask Direct Questions
How do they suggest treating your symptoms? What are the pros and cons of each option? Different doctors have different approaches: Some start low and slow, perhaps with options that don’t require a prescription. Others go heavy and hard. Hear them out, and then decide what you’re comfortable with.
Remember You’re in Charge
I highly recommend doing your research once you get home. You don’t have to take any medication or schedule any procedures right away, and you can follow up with additional questions via the portal. Case in point: Last year I saw a new doctor who recommended testosterone pellets (a long-acting form of HRT injected under the skin). I said I wanted to think about it, researched the side effects, and learned this treatment can worsen hair loss – a perimenopause symptom that’s already bothering me. (I ultimately said no thank you and chose another approach.)
You Absolutely Deserve to Feel Your Best
Sure, perimenopause and menopause are “natural” phases of life, but that doesn’t mean you have to suffer through the symptoms. There are solutions out there and this lovely community is here to support you. Trust your gut, do your research, and advocate for the care you need and deserve.