Looking for a Menopause Specialist? Start Here

Transcript:

Jamie Forward: Seeking care over these symptoms can sometimes be just as challenging as this phase of life, and sometimes people often leave the doctor feeling dismissed. So, Dr. Ali, why is it so important for women to see a specialist?

Dr. Nina Ali: You know, there are so many reasons why I feel like it’s important, but one of them being that – Dr. Piasta just mentioned about the Women’s Health Initiative trial. And there are so many things about that trial that have made it difficult to take care of women in menopause just because of the fears that came up out of the initial results of the study.

But one of the big things that we did learn from the WHI and subsequent studies was how important it is to time the care for menopause. So, that timing hypothesis about when we initiate hormone therapy is really important. So, we want to initiate hormone therapy, if we’re going to do it, in perimenopause or the early part of menopause. So, that is a short window where you don’t want women to miss that opportunity to at least be informed. So, we know there’s a few categories of women who are better avoiding hormone therapy, and there are the contraindications.

So, having had a blood clot, having had a heart attack or stroke, having a personal history of breast cancer, there are some contraindications. But vast majority of us, as we go through this transition, at least it’s important to know at the right time what your options are.

So, often, you need to see someone who has made the effort to keep up with the latest information, which is hard to do. And I have been a general OB/GYN for many years, and I know how much is expected of our doctors in short periods of time. And really to get into all the different aspects that affect menopause care and the whole transition, you need time, you need to be able to understand the nuances. There aren’t, like, blanket ways to manage women, we have to really get into the specifics. And then it evolves, so what works at 48 may not work at 54. So, a specialist is somebody who has devoted the time to understand that well and really enjoys taking care of women through that transition.

So, you want to look at people’s credentials and look at that they have that interest and they have the networks to understand, “Hey, this is something that I’m not comfortable with; I can get you to someone who is comfortable in that space.” So, that really helps people get the best care at the right time.

Jamie Forward: Sure. And, I mean, just by the people that have answered our poll here, 82 percent of people feel like they’ve been dismissed by their doctor. So, Dr. Piasta, what are some signs that maybe a conversation isn’t going well with a provider?

Dr. Jackie Piasta: So, I try to, anytime anybody asks me for advice through social media or whatnot, my one piece of advice is to separate the menopause visit from your yearly wellness exam. So, if you are trying to receive menopause care through the most common channel, which is through either your primary care clinician or your OB/GYN clinician, whether that’s a nurse practitioner or physician, to separate it from that yearly annual visit.

Number one, that’s important for you because it gives it the time that it’s due. If we’re going through the insurance-based model, insurance dictates how much time your clinician can spend with you. And so, that’s what I would do, is separate it.

And then maybe preempt that conversation, especially if you’re going to somebody that you’ve had a relationship with a considerable amount of time, send a portal message to that nurse, the person’s nurse, or that person before the appointment and just say, “You know what? I’m having these symptoms. I’d really like to schedule some time with you to go over these. Is this something that you’d be comfortable sitting down and discussing my options with me? Or is there somebody that you feel like might be a better fit for this?” Because that keeps us from, Jamie, these situations where we feel like we’ve been dismissed. Because then you’re not putting your clinician on the spot, sort of setting you both up for failure.

And you’re sort of feeling out that relationship ahead of time. But I think, of course, back to your original question quickly, is just if somebody says, “Oh, this is just something that women go through. Oh, it’s just a part of getting older. It’ll get better with time.” Like Dr. Ali said, we don’t want to suffer, we don’t need to suffer. Actually, the data shows that starting treatments early leads to better health outcomes. So, that’s what I would say about that.

Jamie Forward: Yeah. That’s such an important point to share. So, of course, how can you find a specialist? I know that through The Menopause Society website they have a way to find a specialist. Do you guys agree that that’s probably – Dr. Ali, do you agree that that’s one of the best ways to do that?

Dr. Nina Ali: I mean, I think it’s an amazing resource, it has been so helpful for so many women. I mean, the hard fact is that we have, one, a shortage of providers for women’s health nationwide in general, and then when you kind of get to the level of, we’re looking at a specialized type of visit, it’s hard to find.

And I think those of us who are in this space often have the challenge of having long waitlists to get in. So, I think telemedicine and these platforms have really been helpful in that regard, so there are a lot more ideas for better access, hopefully, forthcoming. But yes, I think The Menopause Society database is a great way to at least see who is certified in my area, and how can I get in with that person?