Personal qualities aside, the most important factor in your choice of a health care provider should be professional training. When you're choosing medical care specifically for your treatment during menopause, you need first to decide what kind of special training you want your caregiver to have. If you want someone with specialization beyond that of a family practitioner, you can choose from among several types of traditional and nontraditional health care providers.

Traditional Health Care Providers

You may be the sort of person who feels most comfortable with a traditional provider, or you may live in a city or town where that is the only choice available to you. Within the realm of traditional medicine, here are some of your choices:

• An obstetrician/gynecologist (ob/gyn) is specially trained in prenatal care for expectant mothers and the delivery of babies (the obstetrician part) and care of women's reproductive health from menarche to menopause and beyond (the gynecologist services). These physicians can provide long-term treatment for women at any development stage or age. You can also choose an ob/gyn with a specialization in menopause. These specialists remain up-to-date on menopause symptoms, testing, and treatment methods, and new developments in the use of menopausal hormone therapies (MHT).

• A reproductive endocrinologist is a doctor who specializes in hormone imbalances and infertility. Since these physicians focus on reproductive hormones, they are familiar with MHT and other treatments and issues that impact menopausal women. Some of these physicians deal strictly with infertility issues, so check before you make the appointment.

• A nurse practitioner is a registered nurse (R.N.) who has advanced training and can perform physical examinations, diagnose and treat illnesses and injuries, prescribe medication, and provide other health care functions. A women's health nurse practitioner (W.H.N.P.) has special training in the area of women's health. Recent studies have shown that many people of both sexes are choosing nurse practitioners as primary health care providers, citing satisfaction with such factors as how much time they spend discussing health issues and how available they are to their patients.

• Naturopaths are healthcare providers who work with the body's natural ability to heal itself and may employ many approaches to your menopausal symptoms including diet changes, nutritional supplements, herbal medicine, acupuncture or Chinese medicine, hydrotherapy, massage, joint manipulation, and/or lifestyle counseling.

Complementary/Alternative Care Providers

Complementary and alternative medicine (CAM) is big business in the United States. According to the National Center for Complementary and Alternative Healthcare (NCCAM), a branch of the National Institutes of Health (NIH), 36 percent of adults in the United States use some form of CAM. If you consider megavitamin therapy and prayer specifically for health reasons, that number rises to 62 percent. Many women turn to alternative health care techniques during menopause; here are some of the types of health care providers they choose:

• Herbalists prescribe herbal supplements and treatments to combat symptoms of menopause. Herbal remedies are growing in popularity in Western cultures, and herbalists are trained to help determine the best types, amounts, and delivery mechanisms for herbal treatment of menopause symptoms.

• Homeopaths offer a type of medical treatment that operates on the principle that like cures like. Homeopaths prescribe small doses of substances that, if not diluted, would actually make symptoms worse; homeopathic prescription amounts are based on the severity of symptoms, rather than the age and weight of the patient.

• Acupuncturists use a 2,000-year-old treatment technique that involves rotating fine, sterilized needles into the patient's skin to bring about a therapeutic response. Many women in menopause turn to acupuncture for relief of such symptoms as headache, hot flashes, anxiety, insomnia, and fatigue.

For a more complete discussion of alternative treatments for symptoms of menopause, see Chapter 12. Many women use alternative medicine techniques to combat symptoms of menopause in conjunction with traditional medical health care. If you're interested in exploring both traditional and alternative medical approaches to treating your menopause symptoms, make sure any health care provider you choose is open to helping you as you pursue this approach.