… for your appointment with your menopause practitioner.
My waiting list has gotten longer over the past year, and other menopause providers are in the same boat, and that makes me think about the folks who are patiently (or, impatiently!) passing the months until their visit. What do I wish for you when you walk in my door? And what would I want from my provider while I wait? This article is my answer to these questions. Your time waiting can be active time, instead of passive time. Here’s how:
Get your routine screenings
This basically means two main things:
· Get your mammogram – did you know that some breast cancers will grow faster if you are taking certain hormones? Even though we think it takes years of hormone therapy to alter your risk of getting breast cancer, a cancer that is already there is a different story. If you’re over 40 and think you might want to use hormone therapy, go get this done without waiting for your menopause provider to tell you to do it.
· Have any bloodwork your PCP recommends – For most of us, this includes cholesterol and diabetes screening. Oh you don’t have a PCP? Well, funny you should mention that…
Get a PCP
I know, you’re looking for the unicorn PCP. The one who takes your insurance, is close to your house, has a great bedside manner and makes shared decisions while being funny and smart and seeing less than 20 patients a day. I hope you find this person. But until you find them could you just get a regular old horse of a PCP? Horses aren’t magical but they can get a lot of work done. And even horses have waiting lists so let’s do future you a favor and have you get on someone’s waiting list now.
You need to have someone to help you deal with new medical conditions like headaches or abdominal pain – things your menopause provider doesn’t handle. Having a PCP helps you access care you need. Bonus, if you come to your appointment with me with the labwork you’ve had done with your PCP (say, in the past year), that could help us make a plan at your first visit instead of needing to do so at a follow up visit.
Learn something!
Going into your appointment with some foundational knowledge helps you ask better questions – because you’ll know the basics already. And while social media and podcasts seem like a good way to get information, unfortunately the information is piecemeal, incomplete, and chaotic in structure. Also, people tend to do less thorough research on information they present in these formats, which, along with the extemporaneous delivery, leads to more errors/misconceptions. When you need to learn comprehensively, and avoid fringy fads, books are still the way to go.
The two books I recommend most often are:
· The Menopause Manifesto by Jen Gunter
· Come Together by Emily Nagoski
I don't read many books on paper anymore, so it’s lucky for me that both of these books have audio versions narrated by the author that I can hear on my daily dog walks. You can get audiobooks for free from your library! What are you waiting for?
Handle your bleeding
Are you living with frequent bleeding or heavy periods or bleeding for 10+ days straight everytime you have a period? This is not normal. If you are having abnormal bleeding, it’s time to handle it. Don't waste months on my waiting list just living with this. Get into any OB/GYN and get the testing you need. Your menopause provider isn’t going to do ANYthing about your hormones anyway until they check out your bleeding so this is like getting a head start on the stuff that needs to happen.
Be your vagina’s BFF
If your concerns include vaginal dryness, pain with sex or urinary symptoms, you have the power to walk into any old pharmacy right now and start doing something about it. Maybe you’ve heard that vaginal estradiol is amazing, and it really does work well. But it’s not the only tool we have! Vaginal moisturizers are available without a prescription in any regular drugstore or supermarket. Get yourself using a vaginal moisturizer while you wait and you’ll already be in the habit of using a vaginal product a couple times a week, and you’ll be more feeling comfortable sooner.
Avoid creepy supplements
Everyone wants to feel better. But, sometimes the algorithm or your cousin’s massage therapist can lead you astray. Look for safety information on doses and long term use before you start any supplement. When I see someone’s labs really messed up it’s usually because they’ve been taking a supplement made from animal tissue. I strongly recommend you avoid any porcine (pig) or bovine (cow) glands (this includes ovaries, adrenals, and anything else someone dries up and puts in a capsule). If you are already taking something like this talk to your PCP right away about how to taper down. Don't hurt your liver or ruin your hormone signaling because you saw an ad or heard a rumor.
Transform fear and FOMO
When you’re waiting for your appointment, you might be tempted to gobble up whatever menopause info you can find – and if you’re on social media the algorithm will figure you out pretty quick.
Unfortunately, this may be worse for a person’s mental state. If you find yourself watching something on social media that is making you feel worried you’re missing out on something your need, or panicked about menopause being a terrible event in your life, this is not a content creator you should follow. When you notice yourself watching another reel or TikTok about menopause I would like you to have a habit where you stop and ask yourself “did I move my body today?” and if you haven’t, it’s time to break the spell. Put the phone down and do something. You could stay right in the room you’re in and do a plank or some squats. You could walk around the block. You could stretch. If you just don’t have the energy for these, consider this an invitation to take 10 deep breaths as you focus on sensations in your body.
Seriously folks, even a 5 minute break from the algorithm to take care of your actual body is a win in today’s menopause world. The menopause transition is a marathon, not a sprint. When you get into the habit of noticing fear and FOMO, and use that as a stimulus for self care, you are going to be in a better place for everything, including making healthcare decisions.
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