Finding Care - Come Sit With Me | A Perimenopause Resource

Here’s something that will make you angry: the average medical school devotes less than two hours to menopause. Two hours to prepare doctors for a transition that affects half the population and lasts years.

This means most physicians—including many gynecologists—lack adequate training in perimenopause and menopause. They may not recognize symptoms. They may not know current evidence. They may default to outdated fears from the WHI era. They may dismiss you.

Finding knowledgeable care is hard. But it’s not impossible. And you deserve better than what many women receive.

The Provider Gap

The reality:

Most physicians receive minimal menopause training
Menopause specialists are often booked months out
Many women see multiple providers before getting appropriate diagnosis and treatment
Some women are dismissed for years before anyone takes their symptoms seriously

This isn’t acceptable. But knowing it’s common can help you understand that difficulty finding good care isn’t your fault.

What Good Menopause Care Looks Like

A provider who understands menopause will:

Take your symptoms seriously—not dismiss them as “just aging” or “just stress”
Know current evidence—including the timing hypothesis, the WHI reassessment, the difference between formulations
Discuss all options—hormonal, non-hormonal, herbal, lifestyle
Consider your individual circumstances—medical history, preferences, priorities
Partner with you—treat you as the expert on your own body, make decisions together
Follow up—check that treatments are working, adjust as needed

You may not find all of this in one provider. But these are the standards you deserve.

Credentials to Look For

NCMP (NAMS Certified Menopause Practitioner) is the gold standard in the US. These providers have passed a specialty exam and demonstrate expertise specifically in menopause. Find them at menopause.org.

Other helpful credentials:

Board certification in Reproductive Endocrinology
Ob/Gyn with stated menopause interest/focus
Internal medicine physicians with menopause specialty

In other countries, look for equivalent specialty certifications.

Telehealth Options

Several menopause-focused telehealth platforms have emerged—Midi Health, Evernow, Gennev, and others. These can provide:

Faster access to specialists (often within weeks, not months)
Providers specifically trained in menopause
Care regardless of where you live

Caveats:

May not be covered by insurance (though some are)
Not suitable if you need hands-on examination
Verify provider credentials—not all platforms are equal
May be better for follow-up than initial evaluation

For many women, telehealth menopause care fills a gap that local options can’t.

Self-Advocacy

You may need to advocate for yourself more than feels fair. Some strategies:

Track symptoms. Before appointments, document:

What symptoms you’re experiencing
Frequency and severity
When they started
What makes them better or worse
How they affect your life

Our symptom tracker can help with this—it stores everything locally on your device and lets you export a summary for your doctor. Written records are harder to dismiss than verbal complaints.

Be specific about impact. “I’m having hot flashes” may not convey the same urgency as “I’m waking drenched four times a night, I haven’t slept properly in six months, and I’m barely functioning at work.”

Request, don’t just accept. If a provider dismisses you, you can:

Ask them to document in your chart that you requested treatment and they declined, and why
Ask for a referral to a specialist
Seek another opinion

Know when to move on. A provider who refuses to discuss hormone therapy because of outdated fears, dismisses your symptoms as “normal,” or makes you feel unheard—that provider isn’t your only option. Keep looking.

Don’t gaslight yourself. If your symptoms are affecting your quality of life, that matters. You’re not being dramatic. You’re not asking for too much. You deserve care.

What to Do If You’re Dismissed

It happens. Providers dismiss women’s symptoms every day. If it happens to you:

Remember it’s not about you—it’s about their lack of training or willingness
Document everything—write down what happened, what was said, what was refused
Seek another provider—you don’t have to stay with someone who doesn’t help you
File complaints if appropriate—sometimes feedback to practice managers or licensing boards matters
Find community—online groups of women navigating perimenopause can provide support and recommendations

Preparing for Appointments

Make the most of limited appointment time:

Prioritize—what are the 2-3 things that bother you most?
Be direct—“I want to discuss [hormone therapy/specific treatment]. What are your thoughts?”
Bring questions written down—you won’t remember them in the moment
Bring a summary—especially if you have complex history
Bring a person if helpful—someone to take notes or support you

You Deserve Better

The current state of menopause care is inadequate. That’s not your fault, and it’s changing—slowly. More providers are getting trained. More women are demanding better care. The medical establishment is beginning to catch up.

In the meantime, you deserve providers who listen, who know the evidence, who take your experience seriously, and who partner with you in finding what helps.

Keep looking until you find them. They exist.