Talk with Your Doctor
Finding a great doctor or other health care provider is only half of the picture. You are the other half. You need to be an active, informed, involved partner in your health care program. Reading this book indicates that you understand the importance of becoming well informed about menopause issues, symptoms, and treatment options. Use the information you find here (and in the recommended resources listed in Appendix C) to decide what kinds of questions and options you want to explore. The following sections discuss some simple ways you can prepare to be a good collaborator who brings out the best in her good provider.
Taking Charge — Start with Honesty
If you're seeing a doctor or practitioner about issues related to menopause, you aren't a kid anymore. As obvious as that seems, it's important that you drop a lot of the passive techniques you may have developed when dealing with doctors in your youth. Do your health care provider a favor, and approach your consultation as an exchange of information — not a tell-me-what-to-do-and-I'll-leave event.
During your initial office visit, the doctor or practitioner will ask you questions about your individual and family health histories. As a rule, you'll need to report on any personal and family history of blood clots, heart disease, breast cancer, osteoporosis, and other selected conditions. Your doctor or practitioner will also ask you about your current medications — both over-the-counter and prescription drugs — as well as your use of alcohol, recreational drugs, and tobacco. You're not running for class president here, so don't attempt to whitewash the facts by presenting yourself as you think you should be. If you drink or smoke, say so. And don't forget that over-the-counter medications such as pain relievers, vitamins, minerals, and nutritional supplements count; report any substances you regularly consume, so your doctor or practitioner can be aware of them when he or she prescribes treatment.
When you're visiting your menopause specialist, tell it like it is — don't exaggerate or downplay the symptoms you've experienced. Your caregiver needs to understand the full range and severity of your symptoms. You can't get the best treatment if you aren't completely honest.
During your first visit, remember to mention all symptoms you've been experiencing — both emotional and physical. If your periods have become irregular in any way, report the irregularities. (Take your menstrual calendar to the visit.) Mood swings and depression are important indicators of your current health, as is any change in your interest in sex. If you're suffering from periodic involuntary urine release, report that and explain the conditions. Take a written list of symptoms, questions, and concerns with you to your visit, and write down the answers.
If you've been keeping a menstruation journal or menstrual calendar (see Appendix B), take it to your initial visit with your menopause specialist. Your doctor can gain valuable information about your current condition by reviewing even a two- or three-month history of your symptoms. Add to your calendar any symptoms that seem to run in cycles, such as headaches, water retention, or unusual pelvic pain.
Ask for What You Need
Before you leave the office, make sure you understand all of the information you've received during your visit. If you need further explanation, ask for it. If your doctor or practitioner is using terms you don't understand, ask for a translation. Asking for clarification immediately is preferable to calling the office after you've returned home to admit that you didn't understand something you were told. Many doctors' offices also have helpful brochures describing various aspects of menopause, so feel free to ask.
Finally, discuss all treatment options that interest you, regardless of the medical specialization of the health care provider you've chosen. If you're interested in pursuing a combination approach to managing symptoms of menopause, explore whether this doctor or practitioner is open to that approach. If you are looking for relief from specific symptoms, such as incontinence or insomnia, say so and ask if any recommended treatment options specifically address those symptoms. If you think you may want certain tests that the doctor hasn't actually offered, speak up. If you have insurance coverage issues, bring this up as well. The more you understand about the details and goals of treatment options, the better able you'll be to decide which plan is right for you (and the more likely you'll be to follow the plan as recommended).