Is Your Doctor Dismissing You? Medical Red Flags To Watch For
Dr. Angela McCool-Pearson and Dr. Christy James Guepet share signs it may be time to find a new menopause provider and how to seek qualified, informed care.

We want to start with something we think every woman in menopause and perimenopause really needs to hear: You have spent a lifetime learning to push through.

You showed up to middle school with cramps and heavy bleeding and on the verge of tears — wishing you could just hug a heating pad in bed at home. Since then, you have been quietly talking your body out of asking for what it needs, literally for decades. That ends now.

We want to dispel a widely held myth — that because menopause is a natural process, women are better off managing symptoms without medical intervention. The science shows otherwise.

We understand that this choice may be right for some women. We simply do not believe it is the superior choice for most.

We care so deeply about this particular season of a woman’s life that we made the deliberate decision to dedicate our medical practice to menopause care. We want every woman to be well prepared to have a conversation about menopause treatment options with her provider.

This list is intended to help you think through information that will help guide the conversation.

Give yourself a quiet hour to think about your body:

• Your symptoms
• Your goals
• Your stressors
• Your relationships

Think about what you have been tolerating and what you can no longer tolerate.

Know up front: Menopause care requires an ongoing time commitment — time to reflect on how your body is responding and time in regular consultations with your physician.

A menopause treatment consultation can’t happen at your annual wellness visit. Those appointments are dedicated to your general exam, cancer screening, vaccine counseling, lifestyle review, and consideration of bone, colon, and skin health.

If your wellness care isn’t current, schedule that first — then request a dedicated hormone consult as a separate appointment.

A helpful way to prepare for your treatment consultation is to consider and rank what matters most to you.

Ask yourself: “What is holding me back the most from enjoying my life and my body?”

We often ask this at new hormone consultations — and most women have trouble answering, not because they have no answers, but because they have never been asked nor considered the question.

Write down your top three symptoms or goals before you step foot in the doctor’s office.

Note: Sometimes we need to adjust that order based on clinical findings. For example, irregular or abnormal bleeding must be evaluated before focusing on quality-of-life goals. Any such redirection is in your best interest, although we understand it can feel like a frustrating delay when you have been waiting so long to feel like yourself again.

Have these answers immediately available — every minute spent searching a glitching portal is a minute we could be spending with you.

• When was your last period? Are your periods regular, and have they changed in the past one to two years?
• How long do they last, and what is your cycle length? Are your periods heavy or painful?
• What is your current method of birth control?
• Have you had a uterine ablation or tubal ligation?
• How many pregnancies have you had? Were your deliveries vaginal or by cesarean section?
• If you’ve had a hysterectomy: Why, when, and was your cervix or ovaries removed?

We know paper feels pretty vintage, but electronic medical records rarely talk to each other. Please bring printed copies of your:

• Most recent mammogram report
• Most recent Pap test results
• Recent lab work and any imaging reports (such as ultrasounds or bone density scans)

“We don’t prescribe hormones for any woman over 40 without yearly mammograms on file, and we require Pap tests every three years — because we wholeheartedly believe in the power of prevention and early detection.”

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Dr. Christy James Guepet and Dr. Angela McCool-Pearson

We know you have been suffering and are holding on to hope. Here are some realistic possibilities:

• You may leave your first visit with more questions than answers — that means we’re doing the work thoughtfully.
• We may ask about factors you’ve never considered. Write these questions down, and schedule time to carefully consider the answers.
• We may order labs before writing a prescription for hormone therapy. The second visit is often where breakthroughs begin.
• There’s no magic bullet for treating menopause symptoms. However, there is a carefully built, deeply personalized plan that requires attention to detail, perseverance, and follow-up.

“Your body is changing. You are aging. In our book, that is something worth celebrating. However, what works at one stage may need to be adjusted later.

This is a relationship, not a one-time transaction. It takes unpacking — and the right physician will stay engaged with you for the long haul.”

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Dr. Christy James Guepet and Dr. Angela McCool-Pearson

The truth is that practices that focus on menopause care are rare. We want to help you find one or find the right healthcare provider within a more traditional practice. Look for:

• A doctor of medicine (M.D.) or doctor of osteopathic medicine (D.O.) with dedicated interest in menopause care — Nurse practitioners and physician assistants can be wonderful members of a care team as well.
• Board certification recognized by the American Board of Medical Specialties (ABMS) — This is the gold standard of physician credentialing in the U.S.
• Certified menopause practitioner designation — Healthcare providers with this credential have undergone additional training in menopause care.
• Membership in the Menopause Society or the International Society for the Study of Women’s Sexual Health (ISSWSH)
• A practice structure that allows for longer, dedicated hormone consultations, with evidence of focused interest on their website and social media

A word of caution: Be wary of hormone clinics that seem to appear overnight. These are often cash-generating operations with little clinical oversight.

Credentials, longevity, and physician engagement matter enormously. Keep an open mind about practice structure — different may be exactly what you need right now.