Why Is It So Damn Hard To Find A Doctor Who Understands Perimenopause?!

At my most recent yearly physical with my regular doctor, I brought up how I’d been feeling: like crap. I’m 45, and I was sure what I was feeling was something different than regular PMS symptoms. I was tired, moody, achy, and sick of it. I thought it could be perimenopause, but I wasn’t sure.

I expected I’d get a wealth of information from my doctor because we’re the same age, and she has two kids, too. I figured she’d have all the latest professional and firsthand knowledge on perimenopause. Instead, she just asked if I was skipping periods. No, though sometimes my cycle is off by a few days, I said. And then she shrugged her shoulders and suggested that because of my medical history and risk of breast cancer, we should wait to talk about HRT. All she had to offer was the option of doing some bloodwork.

My lab results — which she gave me over the phone a few days later — showed that my cholesterol level was high, and everything else was normal. I flipped out. My dad died of a heart attack at 54. Was I that unhealthy? I thought I had a great diet! I cook most of my meals from scratch and walk all the time! She recommended I exercise more and eat more plant-based foods… well, I was already doing that. I asked about a nutritionist, but apparently, my insurance wouldn’t cover it. Best we could do was repeat some labs in six months.

And that was it. I hung up the phone, and nothing was resolved. I felt like I was left hanging, wondering whether I was ok or not, with no idea where to go next.

Well, now I get it. From what I’ve learned in the months since, doctors get very little training in menopause. Confused about what to do next and with no answers from my physical, I turned to the Internet and social media and only got more confused. Should I be eating less sugar, drinking less caffeine, eating more protein, taking a bunch of vitamins, working on my cortisol, doing more cardio, doing less cardio, lifting more weights, or what? I was lost and was trying to figure this out on my own.

I knew there were doctors who could help, but I was clueless about how to find them. I live in Boston, a city with some of the country's best healthcare. It seemed like it should be obvious who to call, but I wasn’t sure where to go. I started looking at the list of doctors on the North American Menopause Society website, but there were hundreds of pages to sift through. How do I choose one? I was overwhelmed and quit looking out of frustration.

Later, I was reading my local mom's Facebook group page (shoutout to Marblehead Moms & Little Ones) when I spotted a conversation about a mom experiencing the same symptoms as me — mood swings, tired, overall feeling like crap — and learned that she had found a local doctor that validated her concerns. Other moms agreed in the comments — they’d gone to this doctor and experienced someone who listened to their concerns and offered solutions. I got inspired.

I returned to the NAMS website and found the doctor mentioned on my local Facebook page as a certified menopause practitioner. I reached out and was able to make an appointment with a two-month wait. In the meantime, I started to delve deeper into the perimenopause space online and started following Mary Claire Haver, MD, Rocio Salas-Whalen, MD, and Rachel S. Rubin, MD.

I finally went to my first appointment with my new doctor, Mary H. McCaffrey, PhD, MD, who specializes in menopause care — in late June of this year. Not all OB/GYNs have training in menopause; if yours doesn’t, check the NAMS website to find a certified menopause practitioner in your area.

I was nervous. But when I entered the office, everything felt different. They checked me in and quickly had a nurse take my vitals, and then they let me go back out to the waiting room rather than having me sit in the room by myself in my underwear.

When the doctor was ready, she invited me into a room, and I wasn’t asked to immediately hop on the table into the stirrups. We just chatted. For an hour, she listened to my story and validated my concerns. She reviewed my recent labs and procedures and then took out a blank sheet of paper and wrote down in a visual format what was going on with my body. She wrote notes and bullet points of what symptoms we would focus on first with actionable items.

I left feeling heard and relieved. Dr. McCaffrey prescribed me progesterone, an SSRI, and weight training, and said my husband should get a vasectomy because my body does not do well on birth control. She got me a referral to a high-risk breast clinic because my sister had breast cancer last year with no family history (my previous doctor said to stick with my mammograms). And she told me to schedule an appointment to return in three months. She would review how I felt; we could tweak and discuss further treatments.

Ultimately, everybody’s experience of perimenopause (and later, menopause) is different, and most doctors aren’t trained in care. What I learned from this whole experience is if you don’t feel like your doctor is listening to you, keep looking. It sucks that it’s one more thing on you, but you can do it. Talk to friends, especially if you know older women who may be well into menopause. There’s somebody out there who’ll make you feel heard.

Katy Elliott is the Personal Stories Editor at Scary Mommy. She loves to cook, garden, and chat with people about anything from how much you love your kids to how much your kids drive you nuts. She’s a mom to two kids and lives in Marblehead, Massachusetts.