How Do I Find a Menopause Specialist?

When I first started my menopausal journey, I thought that all I had to do was schedule a visit with my OBGYN. I was confident she—the one and only menopause specialist on my radar—would tell me which stage of menopause I was in, when I’d stop having my period, and how to treat menopause symptoms. Every single one of them. But, that was not the case. While visiting with your gyno is not a bad idea (it is, in fact, a good idea!), midlife is about much more than reproductive issues. No matter what menopause feels like to you—whether it’s totally eclipsing your life or merely casting a shadow—putting together a team of health and wellness professionals, as opposed to one expert, can help shed more light on your situation.

Why Is It Important to Have More Than One Menopause Specialist?

Why do you need to create an entire team of experts instead of choosing just one menopause specialist? The idea of a “specialist” is just that—they specialize in a particular area of health. But as we all know, menopause is really, really special; it affects more than one part of ourselves. You want to be ready with a list of go-to-expert resources when your potentially many menopausal symptoms rear their “charming” little heads.

What Does a Health and Wellness Team Do?

What role does a healthcare team play? Think of them like The Justice League. Sure, Superman may be really powerful (unless you’re reading comics from the year 1938, when he was significantly less powerful; then again, so were doctors!), but he can’t battle The Legion of Doom all on his own. Think of your health and wellness team like a superhero squad, with each individual utilizing their unique area of expertise/superpower to help you defeat the discomfort of menopause. You’ve got about as many options for who should be on your health and wellness professional team as Batman has choices of bat-vehicles. And not unlike those heading up the Justice League , you get to choose which professionals can join or leave your care team.

More specifically, a team of specialists can help you make sense of your symptoms and give you recommendations that meet your precise needs. To do that, they run the right tests to assess your hormone levels or to diagnose specific struggles based on root causes. Additionally, they educate, coach, and empower you to manage the stages of menopause with ease and a positive, confident mindset.

Why Do Menopausal People Avoid Seeking Professional Help?

If you’ve ever had anything more serious or chronic than the flu, you know that finding the right healthcare practitioner takes time. Menopause is no different. Statistics show that:

Of the 60% of people who seek medical attention, 75% of them are left untreated.
Only 1 in 5 cisgender women in the U.S. received a referral to a menopause specialist.
Costs can be a major barrier to uptake of hormone treatments.
Lifestyle intervention options as a way to manage symptoms are lacking.

Given the time it could take to compile your health and wellness professional team coupled with stats like these, patience very well may become a monumental virtue during menopause. So, the sooner you can put together your team, the better. The first step? Selecting who should be on your team.

How Do I Identify Who Should Be on My Menopause Provider Team?

If you’re shrugging your shoulders about putting together a team of practitioners, don’t worry, I’m here to help. You’ve already taken the first step: reading this article! The next step is listing your menopause signs and symptoms, and how bothersome each one of them is to you on a scale of 1 to 10. If you’re worried about sounding too dramatic by saying your joint pain is a 10 out of 10, don’t! Your doctor will appreciate your candor and numbers-oriented approach.

When it comes to tracking your symptoms and their severity, which I recommend you do using a menopause tracking app, spreadsheet, or scribbling in a notebook, the key is that more is . . . well, more. No, that’s not some ancient wisdom with a hidden meaning. The longer you track (and the more data you gather about your symptoms), the better. Next, refer to the data you’ve tracked and match your menopause symptoms with the kinds of practitioners that can best help you (check out the list below for examples). Then, get referrals from other menopausal mavens by asking directly or in online communities. After that, confirm that the doctors you want to see are covered by your insurance plan, if you have one. Finally, make an appointment and schedule follow-up visits, if needed (see the questions to ask your doctors below). Last but not least, put into action the plans prescribed or suggested by your practitioners and test, tweak, and retest until you find a solution that sticks.

What Types of Experts Should Be on My Menopause Healthcare Team?

At a minimum, 34 symptoms of menopause manifest themselves—some more common than others—during your epic journey to M Land (located on the Island of No More Periods—whoo-hoo!). Therefore, lining up the right expert for each of your signs of perimenopause is critical. For instance, you might think that you should see a dermatologist for your mysteriously very dry skin. But dry skin is actually a normal symptom of menopause. Visiting a hormone specialist or an integrative medicine doctor to get your hormones balanced and advice for supplements might address your root causes: decreased estrogen and collagen.

These days, there might be as many types of healthcare professionals that can help you as there are menopause symptoms. Consider each of them—listed not in any particular order below—and how they may help with each of your specific symptoms. Add any expert to your health and wellness team who could help make your menopausal journey as joyful (or at least un-sucky) as possible.

Primary Care Physicians

Your pursuit of the perfect menopause healthcare team will likely start with your primary care physician or family practice doctor. If menopause is messing with your sleep or making you feel anxious or depressed, they can prescribe medications that can help you get those symptoms under control. Then they can refer you to specialists that can address more specific or less common symptoms like joint pain or tinnitus. Pros of primary care physicians? General knowledge and help with the most common symptoms, plus insurance coverage, if you have it. Cons? Their knowledge might not be specific enough for what you need.

OB/GYNs

The advantage of visiting an obstetrician/gynecologist is that they specialize in the female reproductive system. You might think that their expertise is only relevant to you during pregnancy or childbirth, but they are also trained in ways to help you navigate menopause and grow older gracefully…or at least with fewer bumps. Either the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine can help you find an OB/GYN in your area who is a member of ACOG, which is the leading professional membership organization for OB/GYNs.

Important (and unfortunate) note! Not all OB/GYNs have extensive knowledge about the stages of menopause, hormone replacement therapy, and the finer points of menopause’s many ailments. To help you find a menopause clinician who is right for you, the North American Menopause Society (NAMS) has assembled this search feature of health professionals who provide healthcare for people through perimenopause and beyond.

Endocrinologists

An endocrinologist is a doctor who specializes in the diagnosis and treatment of hormone-related diseases and conditions, including those that pop up during the stages of menopause. They will likely look at any blood work you have had done to glean the exact state of your hormones. Then, they will educate you about what each one does and prescribe some form of hormone replacement therapy, such as estrogen replacement or a combination of estrogen and progesterone. Pros of endocrinologists? Focusing on hormones means they can get to the root cause of your menopausal problems more effectively. Cons? If you’re already on birth control or some form of HRT when you visit one, which you would want to disclose, that may mask how your hormones are really doing and not get you any closer to an answer. You can find an endocrinologist through the American Association of Clinical Endocrinologists.

Chiropractors

Aside from the stress-reducing benefits of a good deep-tissue massage, chiropractors (depending on their training) may also provide evaluation and treatment of bone-strength issues you might have. Since you might not even know you have them until you break a bone, it might be a good idea to visit a chiropractor to receive a bone density test. Menopause does put you at higher risk of developing osteoporosis, after all. According to the American Chiropractic Association, “the U.S. Preventive Services Task Force (USPSTF) recommends that all women older than 65 and women younger than 65 at high risk for fractures receive a bone density test.”

Naturopaths

Naturopaths are often confused with homeopathic practitioners because they both rely on either natural substances or natural methods of treatment. Naturopaths, however, work to get your body to heal itself or to identify and remove its own obstacles to recovery, a principle called “vis medicatrix naturae.” Pros of a naturopathic approach? It’s natural and has potentially fewer side effects. Cons of that approach? Not as much scientific evidence behind it and, if you’re desperate for relief of common menopausal symptoms NOW, this approach might or might not take longer than conventional medicine to get you where you need to be. The American Association of Naturopathic Physicians can help you find a member who has graduated from an accredited naturopathic medical school, passed a national competency exam, and holds a license in a jurisdiction.

Functional Medicine Doctors

The Institute for Functional Medicine defines functional medicine as an approach focused on finding the root causes of diseases. Although menopause is not a disease, a functional medicine doctor can help you zero in on not only your particular “party” of hormone deficiencies, but other possible causes of your not-feeling-good-itis. Pros of functional medicine doctors? Based on personal experience, I find that they tend to listen more intently to your description of your symptoms and your medical history. Then they’ll likely take a few hundred vials of blood (jk, it’s not that many but it may feel that way) to assess what your body’s doing, and prescribe either natural or pharmaceutical remedies as needed. Cons of functional medicine doctors? Not all insurance companies cover them, so your visits and blood tests might cost a pretty penny.

Integrative Medicine Doctors

The American Board of Physician Specialties defines integrative medicine as “treatment and care of the whole person integrating scientifically-validated therapies of conventional medicine with select practices derived from areas sometimes considered to be complementary and alternative medicine.” This means that an integrative medicine doctor will put more time and effort into

Establishing a partnership with you
Considering all factors that influence health, wellness, and disease—including mind, body, and spirit
Using conventional and alternative methods to facilitate the body’s innate healing response
Considering less-invasive and less-harmful interventions, when possible, while addressing the whole person in addition to the disease

Pros of integrative medicine doctors? If you want to go the more natural route, but still have pharmaceutical options, they’re more likely to be knowledgeable about all of the possibilities. Also, they’re more knowledgeable about remedies of either kind for the less-common symptoms of menopause. Cons of integrative medicine doctors? While their numbers have increased in the last 20 years, insurance coverage hasn’t necessarily kept pace. Damn you insurance restrictions! Daaaaammnnnn yooooouuuu! Contact your insurance provider and ask them these questions provided by the National Center for Complementary and Integrative Health :

Is this complementary or integrative approach covered for my health condition?
Does it need to be:
- Pre-authorized or preapproved?
- Ordered by a prescription?
Do I need a referral?
Does coverage require seeing a practitioner in the network?
Do I have coverage if I go out-of-network?
Are there any limits and requirements—for example, on the number of visits or the amount you will pay?
How much do I have to pay out-of-pocket?

Herbalists

Herbal practitioners choose herbs based on your symptoms. They may perform a clinical exam, inspect certain areas of the body, and create a personalized prescription. If you’re really hating those hot flashes, chances are they’ll extol the virtues of black cohosh or any of these other supplements for menopause.

Herbs don’t just come in capsules, though. They may also be prescribed in:

Teas
Bath salts
Oils
Skin creams and ointments

The supplements herbalists will likely prescribe tend to address the most common menopause symptoms, like anxiety, hot flashes, and irregular periods. Pros of herbalists? If you want to avoid prescription medication altogether, herbalists are your best option. Cons of herbalists? Again, there’s the question of insurance coverage. Also, the quality of herbs and supplements can vary greatly between manufacturers, and they’re not regulated by the FDA, so it’s a matter of a lot of experimentation to find which herbs are effective for you. And a friendly reminder that natural solutions don’t mean no side effects, so be sure to let your herbalist know of any pre-existing conditions and medications, and cross reference your herbalist’s advice with a doctor!

Menopause Specialists

Menopause specialists are healthcare professionals of any type who’ve received special training and certification in all things menopause. Even a therapist or nurse can have a menopause certification. The best place to find one? Menopause.org. Pros of seeing a menopause specialist? If any of your menopause symptoms, common or less-common, are really raining on your life parade, a menopause specialist is likely to be more practiced in the reasons behind that and thus the best ways to address them. Cons? They may or may not have the ability to take into consideration other health or lifestyle factors that might be contributing to your menopause blues.

Massage Therapists

Say hello to this literal hands-on approach to care. The American Massage Therapy Association shares 25 benefits of massage, including studies to back them up. The ones that relate specifically to common menopause symptoms are supporting feelings of stress and anxiety, promoting better sleep, easing symptoms of depression, supporting cardiovascular health and osteoarthritis, promoting relaxation, and lowering blood pressure. We encourage regular massage as one of our top 16 ways to practice self-care, which is included on our list of menopause treatments.

Acupuncturists

Although some research shows that the insertion of special needles in certain points of the body can help alleviate pain, the jury’s still out on its effectiveness for other ailments. Still, the reduction of pain alone might make for a smoother monthly cycle, if you’re still having one. Pros of acupuncturists? If you believe in or are open to the traditional Chinese medicine concept that good health is the result of a harmonious balance of the complementary extremes of “yin” and “yang” of the life force known as “qi” (pronounced “chi”) and that illness is a consequence of an imbalance of the forces, acupuncture can help you get your balance back. Cons? Needles. So many needles.

Therapists

Many people think of therapists as a broad category of professionals who provide mental health therapy. In reality, though, there are distinct groups of professions within and around that term. A cognitive behavioral therapist, for instance, is not the same as a psychologist. While they may help you work through the stress, anxiety, or depression that might come with menopause, they’ll likely do so in somewhat different ways. Some, such as psychiatrists, have the ability to prescribe medications to help you feel better. Some don’t. Both the pros and cons of therapists depend very much on which type of therapist you choose—whether it be a cognitive behavioral therapist, a psychologist, a psychiatrist, a counselor, or social worker—and whether or not you “mesh” well with them.

To find one, you could either google “therapists near me,” ask for recommendations from trusted friends, family members, or work buddies, or visit the websites of

Pelvic Health Physical Therapists

Are you peeing your pants like you’re in preschool again? Because your pelvic floor tends to weaken at the onset of menopause, strengthening the set of muscles that support your pelvis and “house” your bladder and reproductive organs becomes more important. And, as it turns out, there are professionals that can help you with that too! The Academy of Pelvic Health Physical Therapy provides training and education to physical therapists around the country. Pros of seeing a pelvic health physical therapist? They can give you concrete, science-backed techniques to strengthen your pelvic floor, thus improving your bladder control and possible making sex a little more enjoyable. Cons? Like Black Canary who’s only superpower is screeching really loudly, their expertise is hyper specific. While they can be an important member of your team, they’re not able to address a wide range of symptoms.

Nurse Practitioners in Women’s Health (NPWH)

A nurse practitioner in women’s health is an advanced-practice registered nurse and mid-level practitioner (i.e., not quite a doctor but also no newbie) who specializes in providing uterus owners with biologically-specific, holistic care. Of course, there’s an association for them too, and through it, you can find a NPWH near you.

Yogis

A yoga is someone who has dedicated a significant portion of time to the practice and teaching of yoga, which includes not only postures (asana), controlled breathing (pranayama), and meditation (dhyana), but also, possibly, meditation, mudra, mantra, tapas, yogic philosophy, bhakti (devotional) yoga, karma yoga (selfless service), and ethical guidelines (yamas and niyamas). A 2010 article in the Journal of Midlife Health presented evidence that yoga can, in fact, improve hot flashes and night sweats, decrease certain risk factors for cardiovascular disease, and manage common menopausal symptoms “fairly effectively.”

How to Engage With Your Healthcare Team

The decision about when to see a healthcare professional is personal but generally hinges on how much your symptoms interfere with your daily life. For example, if you’re wanting to strangle your partner simply because they said “peanut butter” twice in one sentence, chances are your menopausal mood swings are reaching super villain proportions. Now may be a great time to get in line to see the pros.

What Information to Share With the Pros

When you do meet with your health and wellness team, be prepared with a list of all medications or supplements you’re currently taking. You’ll also want to fill them in on any efforts you’re making (or not making, because you’re just that tired) to adjust your lifestyle. No detail is too small. For example, my integrative medicine practitioner even wanted to know what I typically ate for breakfast, lunch, and dinner every day! Giving them as much relevant information as possible will help them construct a treatment plan that is realistic for you. Whether or not you need a follow-up appointment will depend on the practitioner, but if your symptoms worsen, don’t be afraid to call back and at least speak with their medical or physician’s assistant to seek better solutions.

Specifically, consider doing the following before and during your appointments:

Capture your tracking information in digital or print format and take it with you to your healthcare professional’s appointment.
Provide a copy (digitally or physically) to your professional service provider.
Go over each item that relates to their area of expertise. As you do, ask questions and jot down their answers, including recommended treatments or other solutions.
For information outside of their area of expertise, ask for service provider recommendations. Add that person to your healthcare provider team list.

What Questions to Ask Your Menopause Specialists

When you visit with a menopause specialist, it’s critical to ask the right questions. So, how do you know what to ask? Check out the lists below with suggested questions.

Questions to Help You Choose a Menopause Specialist

Here’s some filtering questions to help you know whether they should be on your health and wellness team:

Are you certified by the North American Menopause Society?
Will you explain your position on hormone replacement and why?
What lifestyle changes do you recommend, if any, and why?
How do you treat those in menopause and perimenopause differently than premenopausal patients?
What is the difference between perimenopause and postmenopause and how do you treat both stages of menopause?
What kinds of problems and outcomes have you seen for people dealing with menopause issues?

For specific signs during your perimenopause to postmenopause journey, consider customizing and asking these questions based on your symptoms:

What type of specialist should I see for this (share your symptoms)?
Should I get blood or saliva tests to gather more definitive information?
Are my symptoms for sure caused by issues relating to menopause? Or, could they be caused by something else?
How long can I expect to experience these symptoms?
My symptoms are interfering with my daily life. What type of treatment or solution do you recommend?
Should I get screened for anything that you feel I am in a high-risk category?

It’s a Wrap!

As preferable as it definitely is to never have to deal with menopause symptoms, the reality is that you or someone you love is on the (cue dramatic music) Menopausal Journey. Chances are you or they will need some help—a little or a lot—somewhere along the way. There is no shame in proactively assembling a team that will give you the tools you need to survive, if not master, menopause, and support you every step of the way.

Sources

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