What to ask your clinician about menopause

Before you go

Bring a short log of your symptoms and bleeding pattern, a list of every medication and supplement you take, and your personal and family medical history. Decide which two or three symptoms bother you most. Clinicians tailor menopause care to how much symptoms affect your life, so being specific helps.

Making a short visit count

If time is tight, lead with your most important question rather than saving it for the end. It is fine to read from your list, and it is fine to say you did not understand something and ask for it again in plain language.

Ask the clinician to summarize the plan before you finish: what you will start or stop, what tests are being ordered, and when you will follow up. Write it down or ask for it in writing. If you think of more questions afterward, a follow-up message or visit is a normal part of menopause care, not an imposition.

Questions about your symptoms

Start by making sure everyone agrees on what is going on. Many symptoms of the transition overlap with thyroid disease, anemia, depression and sleep disorders.

• Do my symptoms fit perimenopause or menopause, and how sure can we be?
• Is there anything else we should rule out, such as thyroid problems, iron deficiency or sleep apnea?
• Do any of my medications or supplements contribute to these symptoms?
• Is my bleeding pattern normal for this stage, or does it need further testing?
• Which of my symptoms are likely to improve on their own, and which tend to persist?

Questions about hormone therapy

The Menopause Society considers hormone therapy the most effective treatment for hot flashes and generally appropriate for healthy women with bothersome symptoms who start before 60 or within 10 years of menopause. Whether it is right for you depends on your history, so ask directly.

• Am I a candidate for hormone therapy, given my age and time since my last period?
• What are my personal risks for blood clots, stroke and breast cancer, and how do they compare with the benefits?
• Would a patch, gel or spray be safer for me than a pill?
• I still have my uterus. Which progestogen will protect my uterine lining, and how should I take it?
• Would local vaginal estrogen help my vaginal or bladder symptoms, with or without other therapy?
• What dose will we start with, and what side effects should I watch for?

Questions about the product itself

Hormones come as FDA-approved products and as compounded preparations made by a pharmacy for an individual patient. Compounded hormones are not FDA-approved and have not gone through the same review for consistency, safety and effectiveness. The Menopause Society encourages women to discuss whether FDA-approved products are appropriate for them.

It is reasonable to ask which type you would receive, why it was chosen, and what the alternatives are. A good clinician will explain the trade-offs openly.

Questions about non-hormonal options

Hormones are not right for everyone, including many women with a history of breast or endometrial cancer, blood clots, stroke, heart disease or liver disease. Others simply prefer to avoid them.

• Which non-hormonal medicines could help my hot flashes, such as low-dose paroxetine or fezolinetant?
• Would cognitive behavioral therapy or clinical hypnosis be worth trying?
• What can help my sleep if night sweats are not the main problem?
• Are there treatments for vaginal dryness that do not involve hormones?

Questions about long-term health

Menopause is also a good moment to look ahead. Falling estrogen affects bone density and cholesterol, and those changes do not cause symptoms.

• Should I have my cholesterol, blood pressure and blood sugar checked?
• When should I have a bone density scan?
• Do I still need contraception, and for how long?
• Which screenings, such as mammograms and cervical screening, am I due for?

Questions about follow-up

Treatment decisions are not one-time choices. The Menopause Society recommends reassessing therapy periodically.

• How soon should I expect to notice a difference?
• When will we review whether this is working?
• What should prompt me to contact you before then?
• How long might I stay on treatment, and how would we stop it if I want to?

Symptoms to report right away

Whatever treatment you choose, contact a clinician promptly for vaginal bleeding after menopause, a new breast lump, or calf pain and swelling. Call 911 for chest pain, sudden shortness of breath, sudden weakness or numbness on one side, trouble speaking or a sudden severe headache, which can signal a clot or stroke.